Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Pathology Exam 1 > Lecture 10 - coagulation abnormalities > Flashcards

Lecture 10 - coagulation abnormalities Flashcards

1
Q

__ disorders of coagulation are more common than congenital disorders of coagulation

A

aquired (DIC, hypercoagulable states, liver dz, vitamin K antagonism or deficiency, snake envenomation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most common coagulation abnormality

A

von willebrand’s dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

__ is seen in critically ill patients and is ALWAYS secondary to another dz

A

DIC (must treat BOTH primary dz and DIC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

DIC is uncontrolled continued activation of __ and __

A

BOTH coagulation and fibrinolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

why does DIC lead to uncontrolled bleeding

A

depletes coagulation factors and platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

why does DIC lead to microvasculare obstruction

A

produces excess intravascular clots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

phase 1 of DIC

A

Hypercoagulable phase (organ dysfucntion due to lack of O2/perfusion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

During the hypercoagulable phase death may occur before hemorrhage bc

A

multiple organ dysfunction (ischemia/low perfusion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

outward clinical signs of DIC are limited an may go unrecognized with out doing __ test

A

coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

hypercoagulable phase (phase 1 DIC) is characterized by __ leading to organ dysfunction

A

thromboses (many thrombi from primary site)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Phase 2 DIC is the __ phase

A

consumptive phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Consumptive phase (Phase 2 DIC) is characterized by uncontrolled consumption of __ and __

A

platelets and coagulation factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the consequences of Phase 2 DIC

A

Bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the consequences of Phase 1 DIC

A

organ dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Consumptive phase (phase 2) is a mixture of __ and __ bleeding

A

platelet type and coagulopathy type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

platelet type bleeding is characterized by

A

petichea and ecchymosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

coagulopathy type bleeding is characterized by

A

bleeding into cavities (abdomen, thorax, joints)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

4 pathologies that can cause DIC

A
  1. tissue factor and procoags released from dead or cancerous tissue
  2. vasculitis
  3. proteolytic enzymes activate coag factors (envenomation, pancreatitis)
  4. stagnant blood flow
19
Q

severe tissue damage and inflammation can cause

A

DIC

20
Q

Be on the lookout early for DIC in __

A

ill patients (lots of causes for DIC)

21
Q

__ is a common blood film finding for DIC

A

Fragmentation hemolysis (microangiopathic hemolytic anemia) - schystocytes, keratocytes

22
Q

5 lab findings for DIC

A
  1. Anemia
  2. thrombocytopenia
  3. acanthocytes
  4. schistocytes (fragmentation)
  5. prolonged coagulation factors (PT, PTT, ACT)
  6. Decreased fibrinogen and AT3
  7. increased FDPs and d-dimers
23
Q

Coagulation tests can be __ due to the dynamic nature of DIC

A

Variable (typically prolonged)

24
Q

will see increased ___ due to plasmin breaking down fibrin

A

FDPs

25
Q

__ is helpful in early recognition of DIC but is a send out test that is not readily available

A

thromboelastography

26
Q

__promotes clot formation by stimulating platelet aggregation

A

thrombin

27
Q

__ activates multiple coagulation factors (1, 5, 8, 11, 13)

A

thrombin

28
Q

thrombin promotes clot persistence via __ and also decreases clot formation via __ activation.

A

TAFI (thrombin-activatable fibrinolysis inhbitor), activates protein C and TFPI

29
Q

Check and balance coagulation factor is __

A

antithrombin 3 (anticoagulant factor, if lose this can become hypercoagulable)

30
Q

In protein losing nephropathy proteins leak out of kidneys, lose __ causing hypercoagulability (prone to forming clots)

A

antithrombin 3 (small protein, anticoagulation factor)

31
Q

petechiation and mucosal hemorrhages are __ type bleeding

A

platelet

32
Q

coagulation factors are made in the __ so need to screen for coagulation abnormalities prior to biopsy or surgery with dz

A

liver

33
Q

vitamin K deficiency causes coagulopathy (clotting issues) due to decreased production of __. What is a good test to screen for this?

A

vitamin k dependent factors 2, 7, 9, 10. TP (7 has shortest half life)

34
Q

5 Causes of vitamin K def or antagonism

A
  1. anticoagulant rodenticide intoxication
  2. moldy sweet clover
  3. gut sterilization
  4. fat malabsorption or maldigestion (bile obstruction)
  5. dietary def (rare)
35
Q

vitamin K def will see __ coagulation tests

A

prolonged (PT first)

36
Q

coagulopathic patients with vitamin K def will need __ and __ STAT and __ if severe hemorrhagic anemia. If bleeding into cavities may need __. Avoid __. Will need to be put on __ for at least a month

A

fresh frozen plasma and fresh whole blood.
O2 cage.
thoracocentesis
traumatic things and drugs that inhibit platelet function
vitamin K replacements

37
Q

__ is a very large, multimeric protein important to platelet adhesion and aggregation (primary hemostasis)

A

von Willebrand factor

38
Q

von willebrand dz is the most common hereditary bleeding disorder effecting

A

primary hemostasis/platelet function = bleeding tendency

39
Q

vWD have various types that relate to degree of bleeding. Name some predisposed breeds

A

dobermans, german pointers, scottish terriers, shelties

40
Q

a __ state has vWF concentration around 30-70%

A

vWD carrier

41
Q

a __ state has a vWF concentration less than 35%

A

vWD symptomatic

42
Q

vWD clincal signs

A

petechiae and mucosal bleeding
cutaneous bruising
prolonged hemorrhage and BMBT

43
Q

Test of choice for vWD is

A

BMBT (if BMBT is normal can send out for vWF test)

Clinical Pathology Exam 1 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions