Liver Disease coagulopathy - Vitamin K Dieficiency and Hemorrhage Flashcards
Enlarged and collateral esophageal vessels are called
Esophageal varices
Occurs in liver disease–associated thrombocytopenia, often accompanied by decreased platelet function.
Mucocutaneous Bleeding
Consequence of procoagulant dysfunction and deficiency.
Anatomic Bleeding
May suppress the biosynthetic function of hepatocytes, reducing either the concentrations or activities of the plasma coagulation factors to less than hemostatic levels (<40 units/dL)
Hepatitis, cirrhosis, obstructive jaundice, cancer, poisoning, and congenital disorders of bilirubin metabolism
In liver disease these seven factors are produced in their des-y-carboxyl forms, which cannot participate in coagulation
Factors II (prothrombin), VII, IX, and X and control proteins C, S, and Z.
On the onset of liver dse, this factor has the shortest plasma half-life at 6 hours, is the first coagulation factor to exhibit decreased activity.
Factor VII
Is a more specific marker of liver disease than deficient factors II, VII, IX, or X because this factor is non-vitamin K dependent
Factor V
Acute phase reactant that frequently becomes elevated in early or mild liver disease.
Fibrinogen
A condition called __ is characterized by moderately and severely diseased liver produces fibrinogen that is coated with excessive sialic acid,
Dysfibrinogenemia
Causes generalized soft tissue bleeding associated with a prolonged TT and an exceptionally prolonged reptilase clotting time.
Dysfibrinogenemia
This condition will make the fibrinogen level fall to less than 100 mg/dL, a mark of liver failure
End-stage liver disease
Are acute phase reactants that may be unaffected or elevated in mild to moderate liver disease.
VWF and factors VIII and XIII
VWF is produced from
Endothelial cells and megakaryocytes
occurs in one-third of patients with liver disease. Platelet counts of less than 150,000/L may result from sequestration and shortened platelet survival associated with portal hypertension and resultant hepatosplenomegaly
Moderate thrombocytopenia
A significant complication of liver disease that is caused by decreased liver pro- duction of regulatory antithrombin, protein C, or protein S and by the release of activated procoagulants from degenerating liver cell
Chronic or compensated Disseminated Intravascular Coagulation
May also produce nonspecific procoagulant substances that trigger chronic DIC, leading to ischemic complications
Hepatocytes
T/F: The failing liver cannot clear activated coagulation factors.
TRUE
PT, PTT, and TT are pro- longed, the fibrinogen level is reduced to less than 100 mg/dL, and D-dimers are significantly increased
Acute, uncompensated DIC