Heme/ID Flashcards
IgG antibodies against glycoprotein IIb/IIa and IR/IX; dx
Immune thrombocytopenia purpura
Most significant factors influencing oxygen content in the blood
Hgb and Hct
Binds to plasminogen and increases plasmin production
Streptokinase
binds to glycoprotein Ib on the platelet
Von Willebrand factor
Contributes to platelet aggregation and sealing at site of injury
Thromboxane A2
Binds platelets to fibrinogen to form platelet plug
GPIIb/IIIa
Catalyzes fibrin from fibrinogen stabilizing platelet plug
Thrombin
Abciximab, eptifibatide, tirofiban; MOA
inhibit GPIIb/IIIa
Most common inherited hypercoaguable disorder; mechanism
Factor V Leiden, cannot be activated by protein C
Acute mild transfusion reaction; tx
Slow transfusion and observe 30min, can administer antihistamine
First-line treatment surgical bleeding in patient with type I and II vW disease
Desmopression
First-line treatment surgical bleeding in patient with type I and II vW disease
Desmopression
Warfarin induced skin necrosis; tx
stop Warfarin, administer vit K, start systemic heparin
Hx vW disease type 3 s/p trauma with large epidural hematoma; tx
factor VIII/vWF concentrate
CHADS-VASc score
Congestive heart failure [1 point if present], Hypertension [1 point if present],
Age >75 years [2 points if present],
Diabetes [1 point if present],
Stroke/TIA/Embolism [2 points if present],
Vascular disease,
Age 65 to 74 years [1 point],
Sex category female [1 point]
Non-valvular afi, CHA2DS2-VASc <5 undergoing low risk surgery ie IHR; periop warfarin mgmnt
Stop 5 days before
Periop management of DOACs (apixaban)
Held 2 days pre-op
Periop management warfarin with CHADS-VASc 6 or higher
Bridge
HIT treatment
Stop heparin and switch to argatroban
HIT; MOA
Heparin-dependent antibody IgG binds to platelets are formed when heparin binds to platelet factor 4 (PF4)
HIT in patient with liver failure
Switch to Fondaparinux
Post-op bleed in hypothermic patient; next step
Rewarm
Uremic bleeding with renal failure; tx
desmopressin (dDAVP) or dialysis
Uremic bleeding with renal failure; tx
desmopressin (dDAVP) or dialysis
Only blood product without risk for viral hepatitis transmission
Albumin
Consequence of massive transfusion
Hypocalcemia -> hypotension decreased pulse pressure, long QT
Heparin; MOA, half-life and reversal agent
Activates antithrombin III, 1hr, protamine
Enoxaparin; MOA, half-life and reversal agent
Activates antithrombin III, inhibits factor Xa, 5hrs, protamine
Fondaparinux; MOA, half-life and reversal agent
Activates antithrombin III, inhibits factor Xa, 17-20hrs, none
Dabigatran; MOA, half-life and reversal agent
Direct thrombin inhibitor,12-14hrs, Idarucizumab some PCC
Argatroban; MOA, half-life and reversal agent
Direct thrombin inhibitor, <1hr, PCC
Bivalrudin; MOA, half-life and reversal agent
Direct thrombin inhinbitor, 20-30min, none
Rivaroxaban; MOA, half-life and reversal agent
Directly inhibits factor Xa, 5-9hrs, Andexanet alfa, some PCC
Apixaban; MOA, half-life and reversal agent
Directly inhibits factor Xa, 9-13hrs, Andexanet alfa, some PCC
Warfarin; MOA, half-life and reversal agent
Vit K antagaonist, PCC, vit K, FFP
Hx of Factor XI deficiency, tx preop
FFP
R time; what, issue and tx
Clotting time, no factors, FFP
K value; what, issue and tx
Clot time to strengthen, Fibrinogen, cryo
Alpha angle; what, issue and tx
Fibrin accumulation, fibrinogen, cryo
MA; what, issue and tx
Max clot strength, platelets, platelets or dDAVP
LY30; what, issue and tx
Lysis, Excess fibrinolysis, TXA
