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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
Q

Factor XI Deficiency is a ____ disease common in ______ (population)

A

AR; Ashkenazi Jews

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26
Q

Factor XI Def. Presentation ________; test show prolonged ____?

A

Post operative hemorrhage; PTT

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27
Q

Factor VII def labs shows ____

A

Only PT is prolonged; PTT is normal

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28
Q

von Willebrand disease tests:

A

Bleeding time, vWF antigen, vWF activity, Factor 8 activity, Multimeric analysis, RIPA (ristocetin induced platelet aggregation)

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29
Q

RIPA used to diagnose which type of vWD?

A

Type 2 b - abnormal clearance by platelet

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30
Q

Type 1 vWD = ?

A

partial quantitative deficiency

31
Q

Type 2 vWD = ?

A

Quality deficiency

32
Q

type 2b vWD = ?

A

abnormal clearance (vWF) by plt

33
Q

Type 3 vWD = ?

A

severe/total quantitative deficiency

34
Q

acquired factor 8 inhibitor because makes _______ - typically concurrent with

A

antibody against factor - autoimmune illness, post partum, old

35
Q

Acquired factor VIII inhibitor shows abnormal ___

A

abnormal PTT - remains prolonged even after mixing

36
Q

Mixing test refers to

A

mixing normal plasma with pt plasma - PTT corrected?

37
Q

Causes of prolonged PTT:

A 
Heparin in sample
Hemophilia A/B
Factor XI def
Factor XII def*
Acquired hemophilia
vWD
lupus anticoagulant*
38
Q

PT&raquo_space; PTT

A

Liver disease, vit K deficiency, Warfarin/rat poison

39
Q

PTT»PT

A

DIC - disseminated intravascular coagulation

40
Q

Live disease affects clotting because most factors are synthesized in the _____, especially affects _____?

A

liver

V and vit K (2, 7, 9 10 - CS)

41
Q

Liver disease labs will show:

A

Severely prolonged PT; prolonged PTT

Low fibrinogen, TT prolonged, decreased plt count

42
Q

Vit K deficiency is typically caused by:

A

No oral intake - diet or gut flora taken out via antibiotics

Warfarin/rat poison

43
Q

Vit K deficiency will show:

A

prolonged PT> PTT

44
Q

DIC can be caused by:

A

massive trauma, hemorrhagic, septic shock, aminontic fluid embolism, burns, acute leukemia, transfusion, drug reaction

45
Q

What happens in DIC?

A

COagulation cascade activated (Fibrin/plt microthrombi + plug capillary - tissue infarction
Hemorrhage - factors/plt consumed

46
Q

DIC lab results

A

Low platelet, very low fibrinogen, PTT> PT; D dimer

47
Q

Hypercoagulable state risk factors - people who have thrombosis for:

A
  1. No apparent reason
  2. Recurrent/early age/unexpected
  3. Life threatening/unusual sites
  4. family history
48
Q

Hypercoagulable state exist when:

A

chronic damage vessel, excess procoagulant factor, deficiency of anticoagulant factors/fibrinolytic activity

49
Q

Lupus anticoagulant is a ____ disorder

A

Hypercoagulable state/disorder = thormbotic syndrome

50
Q

APS

A

antiphospholipid antibody syndrome APS

51
Q

Lupus anticoagulant lab:

A

Prolonged PTT
MIxing - no correction. long PTT
dRVVT = long clotting time
Extra phospholipid - correct the time

52
Q

Lupus anticoagulant lab reasoning

A

antibody to platelet membranes/phospholipids so reaction cannot start

53
Q

dRVVT = ? and what does it do?

A

dilute Russell’s Viper Venom Test = directly activates factor X

54
Q

Familial hypercoaguable state/thrombophilia: 4 most common ones:

A

Antithrombin
Protein C
Protein S
Resistance to protein C (Factor V Leiden)

55
Q

Virchow’s triad includes:

A
  1. Decreased blood flow (venous stasis)
  2. INflammation of/near blood vessel (altered vessles)
  3. Intrinsic alteration of blood - altered coagulability
56
Q

Arterial vs Venous thrombi

A

A: mostly aggregated platelets - “white”
V: large amount of fibrin + RBC - “red”

57
Q

Diagnosis of venous thrombosis

A

D-Dimer assay
Ultrasound doppler
Spiral CT/Ventilation/perfusion (PE)

58
Q

Ventilation/perfusion - what two types of imagine done?

A

gaseous radionuclide inhaled - areated
Radionuclide injected - circulating blood in lungs
Look for mismatched

59
Q

D-Dimer result suggests:

A

negative: no PE/DVT
Positive: Hm…

60
Q

Treatment of venous thrombosis

A

inhibit coagulation - heparin (unfractionated/LMWH - 5 days) + Warfarin

61
Q

Treatment of arterial thrombosis

A

Heparin + fibrinolytic agent (tPA) + antiplatelet agents (aspirin, Ticlid, clopidogrel, Reopro)

62
Q

Asprin does _____

A

inhibit COX1 irreversibly

63
Q

Ticlid is a

A

thienopyridines

64
Q

Plavix/Clopidogrel works as

A

ADP receptor antagonists

65
Q

Reopro/Abciximab works by

A

GPIIb/IIIa inhibitor

66
Q

Factor V Leiden

A

APC resistant - hypercoagluable

AD

67
Q

Prothrombin G20210A

A

AD - elevated prothrombin in Cp

68
Q

Protein C deficiency

A

Cannot inactivate Va/VIIIa - hypercoagulable state
Vit K deficiency = exacerbate problem
Prophylaxis for surgery
Warfarin induced skin necrosis

69
Q

Protein S deficiency

A

AD - hypercoagulable

Warfarin induced skin necrosis, neonatal purpura fulminans

70
Q

Antithrombin deficiency

A

AD (Homo = fatal)
Heparin resistant
Cannot inactivate thrombin, Xa, IXa, XIa, and XIIa

71
Q

Hyperhomocyteinemia

A

causes injury to endothelial cell lining = increase risk of thrombosis

72
Q

Increase factor 8 = ?

A

hypercoagluable

73
Q

Impaired fibrinolysis (plasminogen/tPA def) leads to

A

risk thrombosis

DD/BL unit 3 (16 decks)

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