hemostasis surgical bleeding and transfusion Flashcards
4 steps in hemostasis
- vascular constriction
- platelet plug formation
- fibrin formation
- fibrinolysis
It is a potent constrictor of smooth muscle and is produced locally at the site of injury
thromboxane A2
it is a potent vasoconstrictor and is synthesized by injured endothelium and serotonin
endothelin
these are capable of contracting vascular smooth muscle
- bradykinin
2. fibrinopeptides
What is the most common abnormality of hemostasis
thrombocytopenia
This is the defect of bernard soulier syndrome
- glycoprotein Ib/IX/V receptor for vWF
- defective platelet adhesion
- low platelet count
This is the defect in Glanzmann thrombasthenias
- glycoprotein IIb/IIIA complex
- defective platelet aggregation
- normal platelet count
how much is the expected rise in platelet in 1 unit of platelet concentrate
10,000
What are the cytochrome P450 inducers
Ethyl Booba takes phen phen and refuses greasy carb shakes
7 drugs
What are the cytochrome P450 inhibitors
inhibitors stop cyber kids from eating grapefruit Q
9 drugs
What is the most common complication of warfarin therapy
abdominal cavity bleeding
What is the most common cause of abdominal pain in patients receiving anticoagulation therapy
intramural bowel hematoma
It is a cytokine that stimulates proliferation of hematopoietic stem cells and megakaryocytes
IL - 11
most common bacteria seen in contamination of infused blood
gram negative organisms
- yersinia enterocolitica
- pseudomonas
Most bacterial contamination of infused blood is seen in what blood product
platelet
TRALI occurs how many hours after transfusion
1 - 2 hours and ALWAYS before 6 hours
What is the etiology of TRALI
related to anti HLA anti human neturophil antigen antibodies in transfused blood that pries neutrophils in the pulmonary circulation
What is the characteristic of acute hemolytic reaction
- administration of ABO incompatible blood
- intravascular hemolysis
- monitor urine output and maintain adequate hydration
What is the characteristic of chronic hemolytic reaction
- occurs 2 to 10 days after transfusion
- extravascular hemolysis
- does not require specific treatment
What percentage of platelets are sequestered by the spleen
30%
what is the percent of the population that is Rh negative
15%
What are the values that indicate that there is NO NEED for reversal of heparin or warfarin therapy
- aPTT < 1.3
2. INR < 1.5
