Module 6 Flashcards
What % of blood is plasma
55%
What % of blood is formed elements
45%
Plasma is made of what components
water, proteins, electrolytes, and clotting factors
how do platelets react to a vessel injury
the cytoplasmic granules release adhesive proteins, coagulation, and growth factors
What is the normal platelet count
150,000 - 400,000
what is the number of platelets that constitute thrombocytopenia
< 100,000
what is the concern with thrombocytopenia
high risk of bleeding
where are additional platelets stored
spleen
where are platelets made
bone marrow
platelets circulate in their __________ state
unactivated
what are the 4 steps after platelets are activated
- increased platelet adhesion
- activation leading to platelet degranulation (release mediators)
- aggregation as platelet-vascular wall and platelet-platelet adherence increases
- activation of clotting system
what is antithrombin III
a circulating inhibitor of thrombin (which stops the clotting process)
what does tissue factor pathway inhibitor (TFPI) do
inhibits Xa
what do tissue plasminogen activator and urokinase like plasminogen activator do
activates plasminogen to turn into plasmin which then breaks down fibrin
what are the 5 goals of coagulation therapy
prevent clot formation
break apart an existing clot
can help increase circulation and perfusion
decrease pain
prevent further tissue damage
biggest concern with anticoagulation therapy
bleeding
what are later signs on bleeding evidenced by vital signs
decrease in BP, increased RR
what are later signs of bleeding evidenced by inspection of the skin
ashen / gray color
what do anti-platelet drugs do
prevent platelet plugs from forming by inhibiting platelet aggregation
what happens with heparin induced thrombocytopenia
low platelet count and increased development of thrombi
when looking at platelet count, when should you stop heparin
<100,000
IV heparin is based on what clotting time labs
anti-Xa or aPTTT (activated partial thromboplastin time)
what foods should you avoid on warfarin
high vitamin K foods - kale, brussel sprouts, pickled cucumber, kiwi fruit, green beans, broccoli, cabbage, asparagus, okra, lettuce
what is a thrombus
a blood clot that remains attached to a vessel wall
what is a thromboembolism
a blood clot that has become detached from a vessel wall
what is a venous thromboembolism
a blood clot that is located in the venous circulation
what is DVT
deep vein thrombosis - it is a blood clot located in one of the deep veins
what is the triad of virchow (definition and parts)
definition: three factors that promote formation of a venous thrombosis
factors:
1. venous stasis - old age, immobile, HF
2. venous endothelial damage - result of trauma, surgery, or some IV meds
3. hypercoagulability - increased clotting, can be genetic, pregnant, people who use oral contraceptives, surgery
what are the 13 risk factors for DVT
- clotting disorders
- immobility
- injury / surgery
- pregnancy
- oral contraceptives / hormone replacement therapy
- overweight / obese
- smoking
- cancer / chemo
- HF
- IBD
- hx of DVT or family hx
- age > 60
- varicose veins / spider veins
what are the 4 most serious complications of DVT / VTE
- PE
- chronic thromboembolic pulmonary hypertension
- post thrombotic syndrome
- phlegmasia cerula dolens
what is allostasis
dynamic process that supports / helps body return to set point
what are s/s of allostatic overload
hair loss, tension, mouth sores, tension headaches, palpitations, tics, digestive disorders, acne, irritable bladder, irregular menstrual cycle, impotence, sleep disturbances
what is the benefit of eustress
can help focus and motivate
what is the problem of distress
it is a negative reaction that can have long term negative consequences
what is coping and what does it focus on
strategies / action that are typically addressed towards the stressor
what are the 3 stages of general adaptation syndrome
alarm, resistance, exhaustion
in the stress response, when the hypothalamus is activated it can activate what two cascades
- sympathetic nervous system
- adrenal-cortical system
what does the adrenal medulla release
norepinephrine and epinephrine
what hormone actives the adrenal-cortical system
corticotropin releasing factor
what hormone does the pituitary gland secrete
ACTH, adrenocorticotropin hormone
where does ACTH go once it is released by the pituitary gland
adrenal cortex
what 2 things happen with the brain when it is exposed to stress that isn’t relieved and goes into the exhaustion phase
hypertrophy of adrenal cortex and atrophy of lymphatic tissue
what does norepinephrine
dilates pupils, decrease gastric secretion, inhibits insulin secretion
what does epinephrine
enhance heart contractility and heart rate, dilates airway, increase glycogenolysis, and inhibits insulin secretion
glucocorticoids promote the synthesis of what
epinephrine
glucocorticoids + __________ help develop memories
catecholamines
what does cortisol do
increase CO and blood pressure, decrease estradiol, progesterone, and testosterone, increase level of amino acids (by increasing the breakdown of proteins, lymph nodes, and adipose tissue), stimulates gluconeogenesis, suppresses immune response, and causes atrophy of lymph tissue
what is aldosterone an example of
mineralocorticoid
what does aldosterone do
absorb Na+, excrete K+, increase BP
what can happen is someone is sleep deprived
apathy, impaired memory, poor judgment, hallucinations
why would we use steroids
replacement for those that have a deficiency, for anti-inflammatory properties, for immunosuppression, for asthma, COPD exacerbation, chronic IBD, or post-transplant
