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Hospital Dentistry - ABGD Oral Boards > Hemostasis > Flashcards

Hemostasis Flashcards

1
Q

What is the difference between the Primary and Secondary phases in Hemostasis?

A

Primary

  • Vascular phase = immediate response
  • Platelet phase = 1-2 seconds

Secondary

  • Coagulation phase = 10-20 seconds
  • Fibrin formation = 1-3 minutes
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2
Q

What platlet count defines Thrombocytopenia?

A

< 150,000 MicroL

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3
Q

What are some Acquired Quantitative Platelet Disorders?

A
  • Liver Disease
  • Bone Marroe Disease
  • Alcohoic Suppression of Marrow
  • Medications
  • Idiopathic
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4
Q

What is an Inherited Disease that is both Quantitative and Qualitative in regards to Platelet Disorders?

A

Von Willebrands Disease

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5
Q

What is Von Willderand’s Disease?

A
  • Most commone inherited bleeding disorder
  • Autosomal dominant; 1:1000 people
  • Qualitative or Quantitative defect of vWF
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6
Q

What are the 3 tyeps of Von Willebrand’s Disease?

A
  1. Most common; quantitative, 70-80%
  2. Has subyptes; qualitative
  3. Most Severe; quantitative, < 5%
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7
Q

Define Bleeding Time…

A
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8
Q

What is aPTT (Active Partial Thromboplastin Time)?

How is it different than PT?

A
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9
Q

Describe the clotting cascade…

A
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10
Q

How do you treat Von Willdebrand’s Disease?

A
  • DDAVP (Desmopressin Acetate)
  • Cryo Therapy
  • Factor VIII
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11
Q

What is PFA?

A
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12
Q

What is a CBC?

A

Packed Cell Volume…% of whole blood that are RBCs…

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13
Q

What is a normal platelet count?

A

150,000 - 400,000/ml

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14
Q

What are 3 Inherited Coagulation Disorders?

A
  • Hemophilia A - Factor VIII
  • Hemophilia B - Factor IX
  • Hemophilia C - Factor XI
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15
Q

What are 2 Acquired Coagulation Disorders?

A
  • Liver Disease
  • Vit K Deficiency
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16
Q

What are 7 drugs that cause therapeutic anticoagulation?

A
  1. Coumadin
  2. Pradaxa
  3. Eliquis
  4. Xarelto
  5. Heparin
  6. Levenox
  7. Arixtra
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17
Q

What is the most common cause of prolonged bleeding?

A

Acquired Coagulation Disorders

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18
Q

What are some indications for Therapeutic Anticoagulation?

A
  • Mechanical heart valves
  • Atrial fibrillation
  • Hx of thromboembolic stroke, TIA
  • Hx of deep venous thrombosis
  • Hx of pulmonary embolism
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19
Q

Describe Coumadin…

A
  • Half life - 2.5 days
  • Taken PO
  • Inhibits Vit K
  • Inhibits Factors: II, VII, IX, X
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20
Q

Describe Heparin…

A
  • Half life - 60-90 minutes
  • Given IV
  • Inhibits the Intrinsic Pathway
21
Q

Describe Lovenox…

A
  • Half life - 4-7 hours
  • Given SQ (Sub-Cutaneous Injection)
  • Inhibits Intrinsic Pathway
22
Q

Describe Lepirudin…

A
  • Half life - 1-2 hours
  • Given IV
  • Direct Thrombin Inhibitor
23
Q

Describe Arixtra…

A
  • Half life - 17-21 hours
  • Given SQ (Sub-Cutaneous)
  • Direct Thrombin Inhibitor
24
Q

Describe Pradaxa…

A
  • Half life - 12-17 hours
  • Given PO
  • Direct Thrombin Inhibitor
25
Q

Describe Xarelto/Eliquis…

A
  • Half life - 8-15 hours
  • Given PO
  • Activated F 10 inhibitor
26
Q

What is the average PT?

A
  • Prothrombin Time
  • 10-12 seconds
27
Q

What is the average aPTT?

A
  • Activated Partial Thromboplastin Time
  • 25-30 seconds
28
Q

Describe the critical role of fibrin…

A
29
Q

What is INR?

A
30
Q

What are normal values of INR?

A
31
Q

What are some ways you can medically manage a patient with bleeding disorders regarding Blood or Blood Products?

A
  • FFP (Fresh Frozen Plasma) - Coagulation Factors
  • Factor VIII
  • Cryoprecipitate - Factors: 1, 5, 8, vWF
32
Q

What vitamin is critical in medical management of coagulation chalenged patients?

A

Vitamin K

33
Q

Where do you manage a pt on Heparin?

A

In patient

34
Q

Where can you manage a patient on Lovenox?

A

Out patient

35
Q

Describe different dental procedures you can do in respect to low/high INR ranges…

A
36
Q

When is Post-Op Hemorrage reported for Coumadin under what INR ranges?

A
  • 4.4% (7 cases of 162)
  • INR 1.5 - 1.99 - 2 cases of 80
  • INR 2.0 - 2.49 - 5 cases of 50
  • INR 2.5 - 2.99 - 0 cases of 27
  • INR > 3.0 - 0 cases of 5
37
Q

What are 3 things a dentist can do to achieve hemostasis?

A
  1. Presure
  2. Excellent Surgical Technique
  3. Primary Closure if Possible
38
Q

What are 5 chemo therapeutic agents you can use to help achieve hemostasis?

A
  • Microfibrillar Collagen
  • Gelfoam
  • CollaPlug
  • Surgicel
  • Topical Thrombin
39
Q

What is Microfibrillar Collagen?

A
40
Q

What is Gelfoam?

A
41
Q

What is CollaPlug?

A
42
Q

What is Surgicel?

A
43
Q

What is Topical Thrombin?

A
44
Q

What is plasminogen?

A

The inactive precursor of the enzyme plasmin present in blood

45
Q

Describe Fribrinolysis…

A
46
Q

What are 2 drugs that counteract Fibrinolysis?

A
  • Transexamic Acid
  • Amicar (episilon aminocaproic acid)
47
Q

If you order a CBC, what values can you expect to see?

A
48
Q

What is a CHEM 7 Lab Test?

A

This test can be used to evaluate kidney function, blood acid/base balance, and your levels of blood sugar, and electrolytes. Depending on which lab you use, a basic metabolic panel may also check your levels of calcium and a protein called albumin.

49
Q

If you order a COAGS lab test, what are you ordering?

A

Hospital Dentistry - ABGD Oral Boards (10 decks)

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