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Valley Need to knows > Hemostsis > Flashcards

Hemostsis Flashcards

1
Q

Von Willebrands factor promotes what

A

platelet Adhesion

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2
Q

Von Willebrands factor is manufactured by and released from where

A

endothelial cells

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3
Q

Thrombin is also know as what factor

A

activated Factor II or IIa

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4
Q

what factor activates platelets

A

Thrombin IIa

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5
Q

Once activated via thrombin the platelet synthesizes and releases what?

A

Tromboxane A2

ADP

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6
Q

Both Thromboxane A2 and ADP promote platelet aggregation how?

A

by binding to receptors and activating signal transduction

uncover the fibrinogen I receptors BPIIb and IIIa

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7
Q

Fibrinogen ( Factor I) does what

A

aggregates platelets ( makes them stick together)

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8
Q

The most common acquired blood clotting defect is d/t what?

A

Inhibition of cyclooxygenase (COX) production by ASPIRIN or NSAIDs

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9
Q

What is factor I

A

Fibrinogen

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10
Q

What is factor II

A

Prothrombin

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11
Q

What is factor III

A

Tissue Factor (or Thromboplastin)

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12
Q

What is factor IV

A

Calcium

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13
Q

What is factor VIII

A

2 factors for VIII
VIII: vWF - is von Willebrands fctor
VIII: C - is anti hemophiliac factor
KNow vWF

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14
Q

What is factor XIII

A

Fibrin Stabilizing factor

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15
Q

All but 3 clotting factors are made from where?

A

liver

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16
Q

What are the 3 clotting factors not made from the liver? and where are they made from

A 
Calcium (IV) - Diet
Tissue Factor (III) - vascular wall
vWF VIII - endothelial cells
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17
Q

What is factors are Vitamin K dependent factors

A 
II- Prothrombin
VII- Proconvertin
IX- Christmas Factor
X- Stuart Power factor
C- Protein C
S- Protein S
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18
Q

What is factor XI

A

there is none

Never ever ever pick factor XI for anything

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19
Q

Coumadin (warfarin) interferes with what Pathway

A

Extrinsic (III, VII)

20
Q

Prothrombin time (PT) and INR assess what pathway

A

Extrinsic (III, VII)

21
Q

Heparin interferes with what pathway

A

Intrinsic (XII, XI, IX, VII)

22
Q

PTT and ACT assess what pathway?

A

Intrinsic Pathway

23
Q

The most important clue to clinically significant bleeding d/o in an otherwise healthy patient is what?

A

history

24
Q

one of the most important questions to ask preoperatively deals with what?

A

hemostatic responses to prior operations

25
Q

The most common reason for coagulopathy in pt’s receiving massive blood transfusions is what?

A

the lack of functioning platelets

26
Q

Platelets in Stored blood are inactive after how long

A

1-2 days

27
Q

The only acceptable clinical indication for transfusion of PRBCs is what

A

to increase the O2 carrying capacity of blood

28
Q

ALL procoagulants except ______ are present in FFP

A

Platelets

29
Q

Cryoprecipitate contains what factors?

A

VIII (both C and vWF)
I (fibrinogen)
XIII ( fibrin stabilizing factor)

30
Q

One unit of PRBCs will increase Hct what %? and what g/dL?

A

3-4%

1 g/dL

31
Q

One unit of Platelets will increase platelet count how much

A

5,000- 10,000/mm3

32
Q

Massive transfusion is defined as what?

A

1 complete blood volume in 24 hours

33
Q

A pt is scheduled for a CABG surgery is heparinized. The ACT is reported to be 210 seconds. After administration of more heparin, the ACT is 240 seconds.
Question: is the pt adequately heparinized? what should you do?

A
  • Not adequately heparinized; adequate is greater then 400 seconds
  • Give FFP. FFP contains all the coagulation and anticoagulation factors made by the liver, including antithrombin. then proceed with the case
34
Q

what is the normal Value?

Bleeding time

A

3-10 min

35
Q

what is the normal Value?

Platelet count

A

150,000-400,000 cells/mL

36
Q 
what is the normal Value?
prothrombin time (PT)
A

12-14 seconds

37
Q

what does the PT assess

A

Extrinsic and final pathways

38
Q

what is the normal Value?

PTT

A

25-35 sec

39
Q

What does the PTT assess

A

Intrinsic and Final pathways

40
Q

what is the normal Value?

Thrombin time?

A

< 30 sec

41
Q

what does the Thrombin time assess?

A

final common pathway

42
Q

what is the normal Value?

ACT

A

80-150 sec

43
Q

what does ACT assess?

A

adequacy of heparinization

44
Q

what is the normal Value?

Fibrinogen?

A

> 150 mg/dL

45
Q

Heparinization is adequate if ACT is what?

A

> 400-450 sec ( one book says 480)

46
Q

Aprotinin and Amicar work by how?

A

inhibiting plasmin

47
Q

Aprotinin and Amicar work by inhibiting plasmin, when Plasmin is inhibited what happens?

A

Fibrin that is formed breaks down slowly, so bleeding is decreased

Valley Need to knows (25 decks)

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