Hemostasis, bleeding, transfusions

Question 1

4 phases of hemostasis

Answer 1

Vascular phase
Platelet phase
Coagulation phase
Fibrinolytic phase

Question 2

Vascular phase

Answer 2

Vasoconstriction and vasospasm

Question 3

Platelet phase

Answer 3

Platelets adhere to damaged surface and form a platelet plug

Question 4

Coagulation phase

Answer 4

Intrinsic and extrinsic pathway

Conversion on fibrinogen to fibrin

Question 5

Both pathways meet at

Answer 5

Conversion of X to Xa

Question 6

Fibrinolytic phase

Answer 6

Anticlotting mechanisms activated to allow clot disintegration and repair of damaged vessel

Question 7

Fibrinolysis converts?

Answer 7

Plasminogen to plasmin by use of tPA.

Question 8

What does bleeding time assess?

Answer 8

Platelet count and function

Bleeding should stop in 2-8 mins

Question 9

Prothrombin time

Answer 9

Protime
Measures extrinsic pathway
Generally converted to INR
Warfarin

Question 10

PTT

Answer 10

Partial thromboplastin time
Intrinsic pathway
Heparin

Question 11

Thrombin time

Answer 11

Measure of fibrinolytic pathway

Question 12

Drugs causing thrombocytopenia

Answer 12

ETOH, Thiazide diuretics

Question 13

Hemophilia A

Answer 13

Factor 8

PTT

Question 14

Hemophilia B

Answer 14

Factor 9

PTT

Question 15

What is always the initial event of DIC?

Answer 15

Coagulation

Question 16

What is most likely to cause a transfusion related acute lung injury?

Answer 16

FFP

Question 17

Most common adverse rxn of massive transfusion

Answer 17

Dilutional thrombocytopenia