pom- bleeding disorders- unfinished Flashcards

1
Q

3 causes of hemostatic defects

A

platelet abnormalities
vessel abnormalities
coagulation factor abnormalities

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2
Q

virchow’s triad

A

reduction in blood flow
changes in the blood vessel wall
increased coag of blood

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3
Q

what does virchows triad indicate?

A

possible venous thrombosis

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4
Q

four phases of coagulation

A

vascular phase
platelet phase
coag cascade
fibrinolytic phase

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5
Q

three parts of coag cascade

A

intrinsic
extrinsic
common pathway

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6
Q

what phase occurs when you get an injury to the endothelium

A

vascular phase

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7
Q

describe vascular phase

A

immediate vasoconstriction caused by serotonin, histamine and pg

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8
Q

describe the platelet phase

A

platelets aggregate on the damaged vessel wall, create plug

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9
Q

what are 2 further components for aggregation and promotion of clotting?

A

adp, pf3

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10
Q

what are receptors for platelets- 2?

A

gp11b, gpiiia

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11
Q

what else is involved in migration of platelets to the site other than the receptors?

A

von willebrand factor in endothelium

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12
Q

where are clotting factors synth

A

liver

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13
Q

what is the coagulation cascade

A

converts fibrinogen to fibrin

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14
Q

what mediates coag cascade

A

thrombin

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15
Q

what is thrombin made from

A

prothrombin

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16
Q

what mediates change of prothrombin to thrombin

17
Q

defintion of intrinsic pathway of coag cascade

A

true cascade, initated by exposure of factor xii to surface agents ( like collagen)

18
Q

define extrinsic pathway

A

involves factor vii which complexes w calcium and tissue factor

19
Q

where do intrinsic and extrinsic pathways interact? exam

A

right in the middle of the cascade with factor V and X meeting each other

20
Q

tissue thromboplastin (tpa)

A

given to pt who had stroke, within 2 hr, to prevent further stroke

21
Q

normal platelet range

A

150,000-400,000 /uL

22
Q

thrombocytopenia

A

<50,000/uL

23
Q

spontaneous bleeding

A

<20,000/uL

24
Q

causes of thrombocytopenia

A

drug induced, immune thrombocytopenia purpura

25
what causes drug induced thrombocytopenia
marrow toxicity or platelet destruciton
26
what are the most common drugs that suppress megakaryocyte production
etoh and thiazide dieuretic
27
what are the most common drugs to cause platelet destruction
quinidine and quinin
28
what causes peripheral platelet destruction most commonly?
immune system problem
29
when does drug induced thrombo appear?
severlly and sudddenly
30
how do you treat drug induced thrombo?
corticosteroid or give iv platelets
31
2 types of immune thrombocytopenia purpura
acute, chronic
32
definition of immune thrombocytopenia purpura
autoab facil platelet destruction
33
acute itp is mostly a -- dz or assoc with --
pediatric, hivd
34
how to treat itp
gcs, iv ig, splenectomy, immunosuppressives
35
how does itp present?
petechiae, purpura, hepaomegaly and splenomegaly
36
chronic itp usually seen in
women- unknown cause
37
is chrnoic more or less severe than acute itp?
less
38
what is chronic itp usually seen w?
underlying dz like lymphoma, sarc, sle
39
what other broad thing can cause thrombocytopenia?
bone marrow failure