passmed clotting Flashcards
Heparin Prevents activation factors of what 4 factors clot to 1972
2,9,10,11
warfarin affects what clotting factors
2,7,9,10
DIC affects what factors - 5 in total
1,2,5,8,11
liver disease affects what factors
1,2,5,7,9,10,11
Factor VIII is synthesised in the endothelial cells of the liver rather than the liver itself and therefore is less prone to the effects of hepatic dysfunction.
haemorrphial will present with what on APTT and PT and bleeding time compared to vWD and Vitamin k deficiency
all increased on APTT
APTT
APTT and bleeding
APTT and pT
Disorder APTT PT Bleeding time
Haemophilia Increased Normal Normal
von Willebrand’s disease Increased Normal Increased
Vitamin K deficiency Increased Increased Normal
what does haptoglobin do
mops up Hb
difference between APTT and PT
APTT (activated partial thromboplastin time) is a measure of the intrinsic and common clotting cascades (including clotting factors I, II, V, VIII, X). Note that this does not include factor IX, meaning that haemophilia B may not always have an abnormal APTT.
PT (prothrombin time) is a measure of the extrinsic and common pathways of the clotting cascade. Note that INR (international normalised ratio) which is commonly used for warfarin management is derived from PT. PT, therefore, is a measure of factors I, II, V, VII, X.
RF for PE ( blood, SOB , leg swelling and pain
General increased risk with advancing age obesity family history of VTE pregnancy (especially puerperium) immobility hospitalisation anaesthesia central venous catheter: femoral >> subclavian
Underlying conditions malignancy thrombophilia: e.g. Activated protein C resistance, protein C and S deficiency heart failure antiphospholipid syndrome Behcet's polycythaemia nephrotic syndrome sickle cell disease paroxysmal nocturnal haemoglobinuria hyperviscosity syndrome homocystinuria
