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DD/BL unit 3 > hemostasis defect > Flashcards

hemostasis defect Flashcards

1
Q

PT = ?

A

prothrombin time

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2
Q

APTT / PTT = ?

A

activated partial thromboplastin time

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3
Q

TT = ?

A

Thrombin Time

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4
Q

BT = ?

A

bleeding time

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5
Q

PFA-100 = ?

A

Platelet function analyzer

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6
Q

PT measures?

A

1, 2, 5, 7, 10 (extrinisic)

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7
Q

PT uses _____ to start the rxn

A

Thromboplastin

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8
Q

INR = ?

A

international normalized ratio

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9
Q

PT used to monitor ___?

A

Warfarin therapy

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10
Q

APTT measures procaogulant activity of the ____ pathway, most sensitive to ____?

A

entire; higher number (8, 9, 10) NOT effected by 7

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11
Q

Prolonged PTT can mean ______ or ____

A

anticoagulant drugs/split products or defect in 8, 9, 10

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12
Q

Thrombin Time measures procoagulant activity of ___, sensitive to ____

A

Fibrinogen, anticoagulant effect of heparin/fibrin split products

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13
Q

BT measures what?

A

platelet/vessel interaction, number/fcn of plt - NO OTHER FACTOR AFFECTS THIS

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14
Q

PFA100 measures

A

in vitro bleeding time - plt response to agonists

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15
Q

Which tests are sensitive to heparin?

A

PTT/APTT, TT

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16
Q

Hemophilia A/B are factors ___/___?

A

8,9

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17
Q

Hemophilia is a ____ disorder

A

Xlinked

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18
Q

Hemophilia will have prolonged _____ ; Classifed by on ________

A

PTT; residual percentage of factor activity - relative to normal population

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19
Q

Classification cutoff for severe, moderate, mild

A

1, 2-5, 10

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20
Q

Severe Hemophilia will present with (without treatment)

A

spontaenous hemorrhaging to joints, muscles, soft tissues, retroperitoneal space, CNS; severe arthritis/join destruction

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21
Q

Moderate Hemophilia will present with:

A

Bleeding given trauma

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22
Q

Mild Hemophilia will present with:

A

bleed with trauma (ie. Surgery) - tho typ diagnosed after bad event

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23
Q

Treat hemophilia with:

A

recombinant/purified factor products

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24
Q

Carrier females with bleeding are ______

A

symptomatic carriers

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25
Factor XI Deficiency is a ____ disease common in ______ (population)
AR; Ashkenazi Jews
26
Factor XI Def. Presentation ________; test show prolonged ____?
Post operative hemorrhage; PTT
27
Factor VII def labs shows ____
Only PT is prolonged; PTT is normal
28
von Willebrand disease tests:
Bleeding time, vWF antigen, vWF activity, Factor 8 activity, Multimeric analysis, RIPA (ristocetin induced platelet aggregation)
29
RIPA used to diagnose which type of vWD?
Type 2 b - abnormal clearance by platelet
30
Type 1 vWD = ?
partial quantitative deficiency
31
Type 2 vWD = ?
Quality deficiency
32
type 2b vWD = ?
abnormal clearance (vWF) by plt
33
Type 3 vWD = ?
severe/total quantitative deficiency
34
acquired factor 8 inhibitor because makes _______ - typically concurrent with
antibody against factor - autoimmune illness, post partum, old
35
Acquired factor VIII inhibitor shows abnormal ___
abnormal PTT - remains prolonged even after mixing
36
Mixing test refers to
mixing normal plasma with pt plasma - PTT corrected?
37
Causes of prolonged PTT:
``` Heparin in sample Hemophilia A/B Factor XI def Factor XII def* Acquired hemophilia vWD lupus anticoagulant* ```
38
PT >> PTT
Liver disease, vit K deficiency, Warfarin/rat poison
39
PTT>>PT
DIC - disseminated intravascular coagulation
40
Live disease affects clotting because most factors are synthesized in the _____, especially affects _____?
liver | V and vit K (2, 7, 9 10 - CS)
41
Liver disease labs will show:
Severely prolonged PT; prolonged PTT | Low fibrinogen, TT prolonged, decreased plt count
42
Vit K deficiency is typically caused by:
No oral intake - diet or gut flora taken out via antibiotics | Warfarin/rat poison
43
Vit K deficiency will show:
prolonged PT> PTT
44
DIC can be caused by:
massive trauma, hemorrhagic, septic shock, aminontic fluid embolism, burns, acute leukemia, transfusion, drug reaction
45
What happens in DIC?
COagulation cascade activated (Fibrin/plt microthrombi + plug capillary - tissue infarction Hemorrhage - factors/plt consumed
46
DIC lab results
Low platelet, very low fibrinogen, PTT> PT; D dimer
47
Hypercoagulable state risk factors - people who have thrombosis for:
1. No apparent reason 2. Recurrent/early age/unexpected 3. Life threatening/unusual sites 4. family history
48
Hypercoagulable state exist when:
chronic damage vessel, excess procoagulant factor, deficiency of anticoagulant factors/fibrinolytic activity
49
Lupus anticoagulant is a ____ disorder
Hypercoagulable state/disorder = thormbotic syndrome
50
APS
antiphospholipid antibody syndrome APS
51
Lupus anticoagulant lab:
Prolonged PTT MIxing - no correction. long PTT dRVVT = long clotting time Extra phospholipid - correct the time
52
Lupus anticoagulant lab reasoning
antibody to platelet membranes/phospholipids so reaction cannot start
53
dRVVT = ? and what does it do?
dilute Russell's Viper Venom Test = directly activates factor X
54
Familial hypercoaguable state/thrombophilia: 4 most common ones:
Antithrombin Protein C Protein S Resistance to protein C (Factor V Leiden)
55
Virchow's triad includes:
1. Decreased blood flow (venous stasis) 2. INflammation of/near blood vessel (altered vessles) 3. Intrinsic alteration of blood - altered coagulability
56
Arterial vs Venous thrombi
A: mostly aggregated platelets - "white" V: large amount of fibrin + RBC - "red"
57
Diagnosis of venous thrombosis
D-Dimer assay Ultrasound doppler Spiral CT/Ventilation/perfusion (PE)
58
Ventilation/perfusion - what two types of imagine done?
gaseous radionuclide inhaled - areated Radionuclide injected - circulating blood in lungs Look for mismatched
59
D-Dimer result suggests:
negative: no PE/DVT Positive: Hm...
60
Treatment of venous thrombosis
inhibit coagulation - heparin (unfractionated/LMWH - 5 days) + Warfarin
61
Treatment of arterial thrombosis
Heparin + fibrinolytic agent (tPA) + antiplatelet agents (aspirin, Ticlid, clopidogrel, Reopro)
62
Asprin does _____
inhibit COX1 irreversibly
63
Ticlid is a
thienopyridines
64
Plavix/Clopidogrel works as
ADP receptor antagonists
65
Reopro/Abciximab works by
GPIIb/IIIa inhibitor
66
Factor V Leiden
APC resistant - hypercoagluable | AD
67
Prothrombin G20210A
AD - elevated prothrombin in Cp
68
Protein C deficiency
Cannot inactivate Va/VIIIa - hypercoagulable state Vit K deficiency = exacerbate problem Prophylaxis for surgery Warfarin induced skin necrosis
69
Protein S deficiency
AD - hypercoagulable | Warfarin induced skin necrosis, neonatal purpura fulminans
70
Antithrombin deficiency
AD (Homo = fatal) Heparin resistant Cannot inactivate thrombin, Xa, IXa, XIa, and XIIa
71
Hyperhomocyteinemia
causes injury to endothelial cell lining = increase risk of thrombosis
72
Increase factor 8 = ?
hypercoagluable
73
Impaired fibrinolysis (plasminogen/tPA def) leads to
risk thrombosis

DD/BL unit 3 (16 decks)

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