Pics 1: coag/plt/throm Flashcards
Coag, platelets, thrombosis
Bethesda Assay
How it works
Differentiating causes of long aPTT
Congenital vs Acquired hemophilia
Congenital +inh
Lupus inhibitor
Heparin effect
Lupus inhibitor: what it acts on
Mechanisms of anticoagulants, and examples
Xa
IIa
Xa and IIa
VKA
Trials for APS, warfarin for triple positive
Half lives of Vit K dependent factors
Why it matters
Warfarin indications
DOACs pros/cons
DOAC reversal
Anticoagulant with altered GI anatomy
CAT: who can’t get DOAC
which societies?
Primary, secondary hemostasis and fibrinolysis
Testing for each part
Coagulation cascade
Clinical scenarios: Isolated long aPTT
Clinical scenarios: isolated long PT/INR
Scenarios with long aPPT and PT/INR
Coag testing abnormalities: summary table
Hemophilia genetics
Hemophilia complications
Hemophilia: percentage increase with doses of FVIII or FIX
Types of extended half life coagulation factor products
MOA emicizumab
Hemophilia rebalancing therapies
Gene therapies for hemophilia
MOA?
Rare factor deficiencies table
HHT therapies
Delta/Dense granule contents
PFA-100
what agonists?
Simple results?
Vascular bleeding disorders
Also EDS
Steps of platelet function
Alpha granule contents
Platelet aggregometry: types of agonists
Which are strong?
Example plt agg
P2Y12 inh
ASA effect
Example plt agg
VWD2B/plt type VWD
collagen issues [GPVI]
Possible inherited bleeding disorder flow sheet
Testing modalities for platelet disorders
Specific disorders of platelets
Plt count
smear
aggs
other tests
which gene
Specific disorders of platelets
Plt count
smear
aggs
other tests
which gene
Inherited plt disorders:
Schema of the platelet
Bernard soulier vs Glanzmann
Storage pool defects vs signalling defects
Acquired plt dysfunction: meds and foods
Acquired platelet dysfunction: meds
Qualitative platelet defects
Differential of Inherited vs Acquired
Qualitative platelet defects
Differential of Inherited vs Acquired
In picture form
VWD and lab values for each type
VWD and inheritance
Also blood groups and effect on VWF
Quantitative VWD subtypes
Qualitative VWD subtypes
VWD Dx summary
Use BAT
Use newer assay than Risto if have it
Level <50% and bleeding -> VWD
DDAVP with 1h and 4h for Type 1C Dx
VWD Treatment summary
VWD diagnosis flowsheet
Flowsheet diagnosis of suspected Type 2B VWD
Type 2 VWD diagnosis recommendations
Type 2 VWD treatments recommendations
VWD diagnosis summary from slides
Pneumonic for VWD types
Type 2 VWD treatments recommendations
fibrin formation and degradation
Mechanisms picture, quantitative VWD
VWD table ASH SAP
Mechanisms picture, qualitative VWD
Coag cascade and corresponding lab tests
VWF multiyear analysis examples
FVIII concentrates
FIX concentrates
Bypassing agents in bleeding: table from ASH SAP
Rare factor deficiencies ASH SAP table
Normal platelet function diagram
Schematic of platelet function [picture]
and where disorders are involved
List of all inherited plt disorders
Know main categories
Acquired defects in platelet function
TTP vs aHUS
iTTP diagnosis
Prediction tools for TTP
Treatment pillars of TTP
Treatment TTP, acute inpt, acute inpt/outpt, remission
aHUS manifestations by organ system
Risk of aHUS by mutation and triggers
aHUS pathogenesis: complement balance beam
Stopping terminal complement inhibitor flow chart
Conditions associated with DIC
aHUS summary
Mgmt DIC
TMA in cancer: etiologies, 3 types
TMA in cancer, workup and mgmt
Summary slide cancer associated TMA
HIT activation: multiple pan cellular mechanisms
TMA summary slide
Other TMAs that are/can be complement mediated
Catastrophic APS
D-ITP vs HIT: timeline and clinical picture
Thrombosis types in HIT
4Ts score in HIT
Treatment HIT: 2 dos, 2 donts, 2 diagnostics
Warfarin induced limb gangrene
Why happens [pathophys]?
HIT boards review pearls
Anti-PF4 disorders
There are 5!
Pathogenesis ITP
5 mechanisms
1L mgmt of ITP
drug/dose/time to response/side effects
MOA of steroids in ITP
Multiple effects on immune system
2L mgmt ITP
Rx, RR, longterm remission rates
Drug induced ITP summary
ITP boards summary slide
Treatments summary for ITP
DDX TMA flowsheet
Complement alternative pathway
iTTP pathogenesis picture
Classifications of TMAs
Known vs unknown etiologies
HIT incidence by population and which drug exposed to
Testing for ITP
from working group recommendations
ITP
Primary
secondary
phases
PE management flow sheet
Recurrence triangle
with percentages
Recurrence triangle
with modifiers of level on triangle
Test in thrombophilia:
which to do
Common/classic/acquired/other
who to consider thrombophilia testing
False testing of Protein C, S, AT
Why acquired deficiency and which ones?
New Sydney criteria for antiphospholipid syndrome diagnosis
Effects of DOACs on coag testing
Family members: who to test when family member has a thrombophilia
Conditional recommendations of when to maybe test for inherited thrombophilia
Inherited thrombophilias summary slide
Threshold model of thrombosis risk
Factors favouring extended or limited anticoagulant therapy in patients with unprovoked VTE
Main questions for unexplained arterial thrombosis in the young
4 main parts/sections
Reasons for and against thrombophilia testing
Inherited thrombophilias and estimated prevalence and RR for VTE manifestations
Management of supra therapeutic INR in pt on VKA
DOACs and their properties table
