Hemostasis

Question 1

Maintains blood in a fluid, clot free state in normal vessels. Induces the formation of a hemostatic plug at the site of vascular injury

Answer 1

normal hemostasis

Question 2

What would be the risk category of a surgery that involves non-vital organs and has a limited degree of surgical dissection?

Answer 2

low risk

Question 3

What are the three examples from the lecture of low risk surgeries?

Answer 3

lymph node biopsy, herniorrhaphy, dental extractions

Question 4

What are the four phases of hemostasis?

Answer 4

vascular, platelet, coagulation, fibrinolytic

Question 5

During what phase of hemostasis does an injured blood vessel constrict?

Answer 5

vascular

Question 6

At what point is the coagulation phase complete?

Answer 6

conversion of fibrinogen to fibrin

Question 7

What factors require vitamin K for activation?

Answer 7

VII, IX, X, prothrombin

Question 8

Breaks down fibrin and fibrinogen into degradation products

Answer 8

plasmin

Question 9

Enzymes responsible for the activation of plasminogen to plasmin in the extrinsic pathway

Answer 9

t-PA and urokinase

Question 10

Enzymes responsible for the activation of plasminogen to plasmin in the intrinsic pathway

Answer 10

factor XIIa, HMWK, kallikrein

Question 11

Enzyme responsible for the activation of plasminogen to plasmin exogneously

Answer 11

streptokinase

Question 12

What cells are responsible for synthesizing and secreting von Willebrand factor (factor VIII)?

Answer 12

endothelial

Question 13

Provides assessment of platelet count and function. Normal value is 2-8 minutes

Answer 13

bleeding time

Question 14

Measures effectiveness of the extrinsic pathway. Normal is 10-15 secs

Answer 14

prothrombin time (PT)

Question 15

Measures effectiveness of the intrinsic pathway. Normal is 25-40 secs

Answer 15

partial thromboplastin time (PTT)

Question 16

Measures time for thrombin to convert fibrinogen to fibrin. Normal value is 9-13 secs

Answer 16

thrombin time

Question 17

What is the best way of evaluating unsuspected bleeder after an H&P?

Answer 17

Peripheral Blood smear…thrombocytopenia

Question 18

Most common cause of bleeding disorders

Answer 18

vessel defects

Question 19

Common causes of thrombocytopenia

Answer 19

bone marrow failure, hypersplenism, ETOH, thiazide diuretics

Question 20

What is hypersplenism associated with in patients with cirrhosis?

Answer 20

portal hyptertension

Question 21

How does liver disease alter hemostasis?

Answer 21

malabsorption of vitamin K reduces production of coagulation factors

Question 22

Required for vitamin K absorption. Various intestinal diseases interfere with its metabolism and ultimately vitamin K dependent coagulation factors

Answer 22

bile acid

Question 23

Name the five drugs or drug classes mentioned in lecture that interfere with hemostasis

Answer 23

ASA, anticoagulants, abx, ETOH, anticancer

Question 24

Type of bleeding pattern that does not blanch with pressure

Answer 24

petechiae

Question 25

Most common clinical manifestation of hemophila

Answer 25

hemarthrosis

Question 26

Symptoms of this bleeding disorder include: easy bruising, epistaxis, gingival bleeding, menorrhagia, post-partum hemorrhage, and bleeding post-dental extraction

Answer 26

von Willebrands

Question 27

Bleeding disorder that results from antiplatelet antibodies destroying platelets due to heparin administration

Answer 27

heparin induced thrombocytopenia (HIT)

Question 28

Always the initial even of disseminated intravascular coagulation

Answer 28

coagulation

Question 29

Laboratory results for this coagulation disorder include plt < 100,000, prolonged PT/PTT, positive D-dimer, and low levels of coagulation factors or inhibitors

Answer 29

DIC