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B&L Unit 4 > Hemostasis Defects > Flashcards

Hemostasis Defects Flashcards

1
Q

What is the INR? What does an INR of 2 mean?

A

International Normalized Ratio. It is a measure of the PT. 1 is normal so 2 is twice normal.

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2
Q

A deficiency in which factors will cause a prolonged PT? What else could potentially cause a prolonged PT?

A
  • 2, 7, 5, 10
  • Vitamin K
  • liver disease
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3
Q

A deficiency in which factors will cause a prolonged PTT?

A

Anything except VII (especially VIII, IX, XI, XII).

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4
Q

What prolongs the thrombin Time (TT)?

A

heparin contamination, fibrinogen deficiency, increased fibrinolysis, or abnormal fibrinogen

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5
Q

T or F factor deficiencies prolong the bleeding time?

A

false.

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6
Q

What prolongs the bleeding time?

A
  • severely decreased platelet count
  • vWF disease
  • other abnormalities in platelet fxn.
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7
Q

What is the PFA-100?

A

in vitro bleeding time. Stands for the Platelet Function Analyzer

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8
Q

Hemophilia A and B have an abnormal _______ and a normal _____ and _____

A

PTT (elevated)
PT
BT
Think about what factors it affects

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9
Q

Hemophilia A affects factor ____ while hemophilia B affects factor _____

A

VIII (hemophilia AAAAyyyyeight)

IX

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10
Q

how are mild hemophiliacs (>10% factor activity) diagnosed?

A

usually after a bad traumatic injury or after a bad result from surgery

FYI:
carrier females- 30-100% activity
moderate hemo - 5-8% activity
Severe- less than 1% activity

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11
Q

Hematomas can cause what?

A

muscle damage. They can also cause calcified pseudotumors and atrophy.

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12
Q

What are you worried about in a knee joint bleed?

A

arthritis.

start treatment with adding factor as soon as you start feeling tingling.

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13
Q

Hemophilia C is also called what?

A

factor XI deficiency. Usually presents with post-operative hemorrhage (especially prostate, uterus, bladder surgery) since they probably won’t have bleeding disorders.

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14
Q

What is prolonged in a factor VII deficiency?

A

only the PT.

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15
Q

what are the functions of vWF?

From this can you guess what will be prolonged in vWF disease?

A
  1. adhere platelets to exposed collagen
  2. carry factor VIII

Prolonged Bleeding Time (BT) and PTT

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16
Q

What is an important finding in those with vWF disease?

A

bleed after surgery

17
Q

A patient with acquired factor VIII inhibitor will have a prolonged _____. Why will this not correct after mixing with normal plasma and incubating for 2 hours?

A

PTT
The patient is making antibodies against factor VIII (autoimmune disease) so the new factor VIII is destroyed and PTT remains prolonged.

18
Q

Causes of prolonged PTT?

A
  • heparin
  • Hemophilia (congenital or acquired)
  • Factor XI, XII deficiency
  • vWF disease
  • Lupus anticoagulant
19
Q

Causes of prolonged PT and PTT (PT longer than PTT)?

A
  • Liver disease
  • Vitamin K deficiency
  • warfarin or rat poison
20
Q

Causes of prolonged PT and PTT (PTT longer than PT)?

A

DIC

21
Q

In patients with Liver disease it is important to make sure there is not a component of ______ making it worse.

A

Vitamin K deficiency

22
Q

What are the most important laboratory findings in DIC?

A
  • fibrinogen level has decreased markedly
  • platelet count is low

Also will see increased D-dimer and fibrin split products

23
Q

What is the best way to treat DIC?

A

Have to treat the underlying disorder (i.e. APL)

24
Q

What causes Antiphospholipid Antibody syndrome and how does it work?

A

It is caused by the Lupus Anticoagulant, an antibody which binds to phospholipid. The result of this can be confusing because the patient presents with a prolonged PTT but an increased risk of thrombosis.

25
Q

What test results will allow you to diagnose the lupus anticoagulant?

A

Do PTT. Add plasma with factors. repeat PTT. If the results do not improve at all, its gotta be lupus anticoag.

FYI:
This syndrome can be caused by much more than lupus disease. thats just the name.

26
Q

What are the four most common familial congenital conditions which cause a hyoercoagulable syndrome?

A

deficiencies in antithrombin, protein C, protein S or resistance to protein C (also called Factor V Leiden)

B&L Unit 4 (20 decks)

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