HEME

Question 1

MC congenital bleeding d/o

Answer 1

von willebrand disease

Question 2

Mgmt Type 1 vWD

Answer 2

desmopressin, cryoprecipitate

Question 3

Mgmt Type 2 vWD

Answer 3

cryoprecipitate

Question 4

Mgmt Type 3 vWD

Answer 4

cryoprecipitate

Question 5

What is cryoprecipitate?

Answer 5

• fibrinogen
• von Willebrand factor
• factor 8
• factor 13

Question 6

Mgmt hemophilia B

Answer 6

recomb factor 9 or FFP

Question 7

Mgmt hemophilia A

Answer 7

recomb factor 8 or cryo

Question 8

Dx HITT

Answer 8

• Elisa test for Ab against plt factor 4

- serotonin release assay

Question 9

MOA heparin

Answer 9

potentiates antithrombin 3

Question 10

Side effects protamine

Answer 10

hypotension, bradycardia (can produce HF if given too quickly)

Question 11

Sxs thrombocytopenic purpura (TTP)

Answer 11

• low plt count
• hemolytic anemia
• neurologic complications
• renal failure
• AMS
• bilateral LE petechiae

Question 12

Patho idiopathic thrombocytopenic purpura (ITP) vs. thrombocytopenic purpura (TTP)

Answer 12

ITP: Ab (created in spleen) against plt
TTP: spleen sequesters plt

Question 13

Mgmt ITP vs. TTP

Answer 13

ITP: steroids -> anti-IgG Ab -> splenectomy
TTP: plasmapheresis + FFP (not plt); splenectomy considered if refractory, but curative only in 40%

Question 14

Pediatric population with ITP

Answer 14

often self-limited in majority, especially by age 5

Question 15

When plt count <20 in pediatric pt w/ ITP, risk for…?

Answer 15

intracranial hemorrhage

Question 16

What is in FFP (plasma)?

Answer 16

contains all coagulation factors including fibrinogen

Question 17

What is fondaparinux

Answer 17

indirect Factor Xa inhibitor

Question 18

Plt dysfunction can be treated with…?

Answer 18

desmopressin - causes release of vWF, facilitating plt aggregation

Question 19

MOA aspirin

Answer 19

irreversible inhibitor of PG metabolism of platelets by acetylating COX enzyme

Question 20

MOA clopidogrel

Answer 20

inhibition of GP IIIb/IIa binding site