Other Disorders of Hemostasis Flashcards
What PLT surface marker can HEP bind to?
PF4
What causes PLT destruction in heparin induced thrombocytopenia?
IgG binding to HEP-PF4
What activates the PLTs in HIT?
the fragments of the destroyed PLTs, leading to thrombosis
DIC can lead to (blank) of downstream tissue
infarction and ischemia
Where do you see bleeding in DIC?
IV sites and mucosal surfaces
How does pregnancy cause DIC?
TT from the amniotic fluid may initiate coag cascade
Sepsis from what two bugs can cause DIC?
E. coli and N. meningitidis
Macrophages release what two cytokines during sepsis that can lead to DIC?
TNF-a and IL-1
What is is about infx with E. coli and N. meningitidis that leads to DIC?
release of endotoxins
(blank) from adenocarcinoma can lead to DIC
mucin
Primary granules that go on to form Auer rods in (blank) can cause DIC
Acute promyelocytic leukemia
what kind of snake bite can cause DIC?
rattlesnake
What are the lab values for DIC? PLT PT/PTT fibrinogen what type of anemia
LOW PLT (lots of little clots)
INCREASED PT AND PTT (consumption of cascade)
decreased fibrinogen (making clots)
MAHA
What is the best test to screen for DIC?
D-dimer
Are d-dimers formed from the splitting of fibrin or fibrinogen?
fibrin; FROM LYSIS OF ALREADY PRESENT CLOT
Besides addressing the underlying condition causing the DIC, what supportive care can you give the patient?
transfusion of cryoprecipitate
What converts plasminogen to plasmin?
tPA
Plasmin cleaves (blank) and serum (blank), destroys coagulatoin factors, and blocks platelet (aggregation/adhesion)
cleaves fibrin and serum fibrinogen
blocks PLT aggregation
What inactivates plasmin?
a2-antiplasmin
A radical prostatectomy resulting in large releases of urokinase or cirrhosis of the liver resulting in decreased a2-antiplasmin can both result in increased (blank)
bleeding
What other disorder do issues of fibrinolysis resemble clincally?
DIC
Describe the labs for fibrinolytic disorders: PT/PTT bleeding time PLT D-dimers (present/absent)
increased PT/PTT
increased bleeding time
NORMAL PLTS; THERE ARE NO CLOTS, JUST ACTIVATION OF CLOT BUSTER
NO D-DIMER BECAUSE NO ACTUAL CLOTS
What is the Tx for issues of tPA overdose or fibrinolytic disorders?
aminocaproic acid, blocks activation of plasminogen
