Other Disorders Of Hemostasis

Question 1

Explain heparin induced thrombocytopenia and what is the major complication with it?

Answer 1

When heparin is given, it hooks up with PF4 and makes a complex that IgG destroys.
We are worried about fragments of platelets activated other platelets and causing clot

Question 2

What is the problem with DIC and what are sort of the two stages involved?

Answer 2

Abnormal activation of the coagulation cascade.

First, we clot all over and second we bleed because we have consumed so many of our clotting factors. Clot bleed.

Question 3

DIC is almost always the cause of what and explain each one?

Answer 3

Secondary to another disease.
Obstetric complication because TF in amniotic fluid
Sepsis, E. coli and n meningitis, because their toxins lead to TF
Adenocarcinoma, lung, mucin activates coag
Acute promyelocytic leukemia, primary granules activate
Rattlesnake bike, venom activates coag

Question 4

5 lab findings of DIC?

Answer 4

Platelets down
PT and PTT up
Low fibrinogen Because of clotting at first
Microangiopathic hemolytic anmeia
Elevated d dimers because fibrin is being lysed when the clot is broken down

Question 5

How do we treat DIC?

Answer 5

Treat the underlying cause and then give whatever products you need to give

Question 6

What disorder presents just like DIC, whats going on with that disorder, talk about some normal functions of the main players, 2 causes, and the big difference between DIC and it and how we treat it lab values?

Answer 6

Disorders of fibrinolysis present just like DIC. What’s goin on here is overactivity of plasmin cleaving fibrinogen everywhere.
Recall that clots are broken down by plasmin which is converted from plasminogen by TPA. Plasmin breaks down fibrin and fibrinogen, knocks out clotting factors and blocks platelet aggregation. Alpha 2 anti plasmin inactivates plasmin.
Taking out the prostate could release urokinase which activates plasmin
Liver failure can cause it because that’s where antiplasmin is made.
PTT and PT are up
Bleeding time is up
Obviously there is bleeding
No D dimers, only fibrinogen split products
Give aminocaproic acid to block activiation of plasminogen