Hemostasis - Unit 3 Flashcards

1
Q

What is hemostasis?

A

Blood stagnation/the process of clot formation.

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2
Q

In simple terms, how does this work?

A

Tissue injury —> Platelet Plug —> Biochemistry –> Clot

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3
Q

When an injury occurs, what factor affects the common pathway?

A

Factor 10

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4
Q

Factor 10 (X) - what happens after this?

A

Prothrombin –> Thrombin –> Fibrinogen –> Fibrin –> Clot

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5
Q

Why does the coagulation process matter?

A

Because lots of drugs we give affect this!

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6
Q

Bleeding & Clotting Disorders - Platelet Issue or Factor Issue - T/F?

A

True!

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7
Q

What are the platelets? How do they act in a bleed?

A

First responders, unstable platelet plug, they trigger clot formation, and repair microvascular injuries.

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8
Q

Is a platelet plug very stable?

A

Not at all - it tends to go away within an hour. It’s easy to break away - it does this because it signals the body to create a clot.

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9
Q

Thrombocytopenia - def

A

Low Platelet

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10
Q

Thrombocytosis/thrombocythemia - def

A

high platelet count - not general symptomatic.

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11
Q

Von Willebrand Factor (vWF) deficiency - what is it?

A

A platelet or factor problem.

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12
Q

What is Von Willebrand disease?

A

Typically, it gets platelets to adhere to site of injury. It activate them.

In this disease, inadequate/ineffective vWF reduces platelet adhesion, activation and aggregation.

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13
Q

What are some signs and symptoms of platelet problems?

A

Nosebleeds (epistaxis), Bleeding gums, Heavy menstrual bleeding, bruising, melena (black/bloody stool), symptoms of anemia.

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14
Q

What are some treatments for Thrombocytopenia/VWD?

A

SAFETY FIRST!!!

Prevent blood loss. We might need to do a transufsion, DDAVP, immunosuppresant drugs, plasmapheresis.

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15
Q

What does DDAVP (Desmopressin) do for blood?

At what level do we usually transfuse? Are we careful with it?

A

If you have any VWF, it releases it!

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16
Q

How do we treat thrombocytosis?

A

Platelet aggregation inhibitors - usually there isn’t even a need for treatment, though.

17
Q

Factor issues - are they more or less severe than platelet issues?

A

More severe!

18
Q

What’s Factor V Leiden?

A

Doesn’t degrade - so we have a prolonged clot.

19
Q

The liver - what does it do for blood?

A

Filters/produces many clotting factors. It also clears TPA and urokinase

20
Q

What are some signs and symptoms of factor problems?

A

Platelet-type bleeding plus excessive bleeding from minor injuries, muscle and joint bleeding, prolonged hemorrhage, prolonged bleeding

21
Q

How do we treat factor issues?

A

Factor concentrates - but these are expensive.
Only one good concentrate exists, but it works for factor 8 only.
Desmopressin, Platelet transfusion, plasma transfusion (FFP), Vitamin K

22
Q

What should a normal platelet count be?

A

150,000-420,000

23
Q

What do the PT, INR & PTT do?

A

Measure time from platelet activation to clot formation/how long it takes body to recognize need for formation.

24
Q

PTT - which drug? Normal levels?

A

Heparin - normally 25-35 seconds, but should be 1.5-2.5 times faster when on heparin.

25
Q

PT/INR - Drug? Normal Levels?

A

Coumadin. Should normally be 11-14 seconds (PT) and .8-1.2 for INR. With coumadin, INR should be about 2.5-3.5

26
Q

Do we usually start Coumadin before stopping heparin?

A

Yes!

27
Q

What does antithrombin do?

A

It prevents thrombin doing its work.

28
Q

What does fibrinolysis do?

A

Deals with plasminogen - binds to fibrinogen and the clot. It regulates.

29
Q

What is HIT?

A

Heparin Induced Thrombocytopenia - starts about 5-14 days after receiving heparin. It reduces the platelet count because antibodies attack the platelets. We need to stop heparin and give another anti-coagulant, because there will be both clotting and bleeding with this condition.

30
Q

What is DIC?

A

It is serious - it’s called Disseminated Intravascular Coagulation - it’s overactive clotting. Also causes depletion of platelets and clotting factors. Give clotting factors and transfuse.