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Clin Med II - Exam 5 > Schoenwald - Lab Review/Coagulation > Flashcards

Schoenwald - Lab Review/Coagulation Flashcards

1
Q

are abnormal labs called in to the provider/nursing staff

A

no!

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2
Q

what labs are called into the provider/nursing staff

A

critical lab values

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3
Q

what are critical labs

A

values that are potentially life threatening to the pt

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4
Q

what med can have major ddi w. Warfarin

A

Bactrim

also Rifampin

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5
Q

critical values for platelets

A

< 2,000 → brain hemorrhage

>1,000,000 → clots

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6
Q

critical value for INR

A

>400

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7
Q

critical value for bands

A

>30%

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8
Q

bands >10%

A

left shift

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9
Q

critical value for HCT

A

<14%

>60%

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10
Q

critical value for WBC

A

<2.0

>35.0 x 103

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11
Q

critical value for serum glucose

A

< 40

>500

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12
Q

critical value for K+

A

<2.5

>6.5

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13
Q

what antibiotic can cause hyperkalemia

A

bactrim

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14
Q

critical values for Na

A

< 120

>160

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15
Q

critical value for pO2

A

40 mm Hg

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16
Q

critical pH value

A

<7.2

>7.6

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17
Q

critical value for CO2

A

<20

>70

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18
Q

critical microbiology labs

A

(+) blood culture

gram stains on CSF/body fluids

(+) strep screen

(+) flu

(+) COVID

positive cdiff

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19
Q

for COVID, antivirals/monoclonal abs need to be started w.in

A

5 days

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20
Q

antivirals for flu need to be started w.in

A

48 hr

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21
Q

prothrombin time (PT) depends on

A

vitamin K dependent factors:

II

V

VII

X

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22
Q

clotting factor deficiencies can be caused by (3)

A

inherited

acquired

meds

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23
Q

8 conditions that may result in factor deficiency

A

liver dz

DIC

fibrinolysis

congenital deficiency

heparin

warfarin

AI

vit K deficiency

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24
Q

PT measures __ pathways (2)

A

extrinsic

common

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25
Q

what lab is used to monitor warfarin

A

PT

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26
Q

therapeutic range for pt on Warfarin (w. no prosthetic valve)

A

2.0-3.0

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27
Q

PTT measures __ pathways (2)

A

common

intinsic

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28
Q

PTT is used to measure __ therapy,

but not __ therapy

A

heparin

lmwh

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29
Q

d-dimer is a fragment of __ degradation

30
Q

Ddimer has a high negative predictive value for __

31
Q

3 major rf for clotting

A

pregnancy/recent childbirth

antiphospholipid syndrome

factor V Leiden

32
Q

2 main sx of DVT

A

unilateral leg pain/swelling

discoloration of leg

33
Q

2 major sx of PE

A

SOB

chest pain worse w. taking deep breath or coughing

34
Q

what do you think when you see lowe platelets in someone on heparin

A

heparin induced thrombocytopenia (HIT)

35
Q

what do you think when you see autoimmune cardiolipin abs

A

antiphospholipid syndrome

36
Q

abs associated w. antiphospholipid syndrome (3)

A

lupus anticoagulant

anticardiolipin

anti B2GPI

37
Q

lab criteria for antiphospholipid syndrome

A

positive for 1 autoantibody on 2 or more occasions 12 weeks apart

38
Q

tx for antiphospholipid syndrome

A

lifelong coagulation

39
Q

tx for antiphospholipid in pregnant pt

40
Q

warfarin is a class __ in pregnancy

41
Q

t/f: NOACS are contraindicated in pregnancy

42
Q

mc hereditary blood coagulation d.o in US

A

factor V leiden

43
Q

other inherited clotting d.o

A

prothrombin 20210 mutation

MTHFR mutation

protein C

protein S

44
Q

only anticoagulant that prevents activation of new clotting factors

45
Q

3 indications for Warfarin

A

prophylaxis and tx for:

DVT

PE

afib

46
Q

warfarin inhibits __ clotting factors

47
Q

what lab value is used to monitor warfarin

48
Q

con of warfarin

A

many DDI’s

49
Q

method of administration for unfractionated heparin

A

IV only → used for bridging

50
Q

monitoring for unfractionated heparin

A

PTT

CBC (for HIT)

51
Q

reversal agent for unfractionated heparin

A

protamine sulfate

52
Q

other names for LMWH

A

fragmin

lovenox

53
Q

3 indications for LMWH

A

prophylaxis of DVT/PE

unstable angina

nonQ wave MI

54
Q

LMWH is used as a bridge w. __ until INR is therapeutic

55
Q

t/f: LMWH is contraindicated in pregnancy

56
Q

reversal agent for LMWH

A

protamine sulfate

57
Q

black box warning for LMWH

A

epidural catheter, lumbar puncture, or spinal hematoma cam result in permanent paralysis at the level of the procedure

58
Q

you must wait __ after spinal procedure to administer LMWH

59
Q

t/f: the NOACs/DOACs do not have risk for paralysis if used < 24 hr after spinal procedure

A

F! → must also wait 24 hr after procedure to administer

60
Q

what are the DOACs

A

bivalirudin (angiomax)

dabigatran (pradaxa)

apixaban (eliquis)

rivaroxaban (xarelto)

edoxaban (savaysa)

61
Q

which of the NOACs are direct thrombin inhibitors

A

bivalirudin (angiomax)

dabigatran (pradaxa)

62
Q

which NOACs are factor Xa inhbitors

A

apixaban (eliquis)

rivaroxaban (xarelto)

edoxaban (savaysa)

63
Q

andexxa is the reversal agent for

A

apixaban

rivaroxaban

64
Q

3 sx of von willibrand dz

A

frequent nosebleeds

easy bruising

excessive bleeding w. procedures

65
Q

pharm for von willibrand dz

A

DDACP → synthetic vasopressin

66
Q

labs for von willibrand

A

prolonged bleeding time

+/- PTT elevation

normal PT

67
Q

inappropriate clotting mechanism → futile clotting AND bleeding

68
Q

tx for DIC

69
Q

labs for DIC

A

everything out of whack!

70
Q

only value that is decreased in DIC

A

platelets → they are getting used up quicker than they can be produced

Clin Med II - Exam 5 (23 decks)

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