secondary hemostasis - disorders

Question 1

Secondary hemostasis symptoms

Answer 1

much deeper bleeding, not superficial
- soft tissue bleeding

Question 2

hematomas

Answer 2

blood collection outside of vessel

Question 3

retroperitoneal bleeding

Answer 3

abdomen cavity

Question 4

hemarthrosis

Answer 4

joint cavity

Question 5

Factor I (fibrinogen –> fibrin)

Answer 5

common pathway

measured by PT, APTT, TT

hemostatic - substrate

physical properties - fibrinogen group (consumed in clot formation)

Question 6

afribrinogenemia

Answer 6

complete absence of fibrinogen

Question 7

hypofibrinogenemia

Answer 7

decreased fibrinogen

Question 8

dysfibrinogenemia

Answer 8

abnormal fibrinogen molecule

Question 9

hyperfibrinogenemia

Answer 9

increased fibrinogen (acute phase) –> possible increased thrombosis

Question 10

Factor II (prothrombin –> thrombin)

Answer 10

Vitamin K dependent

Question 11

hypoprothrombinemia

Answer 11

decreased prothrombin

Autosomal recessive
Vitamin K deficiency

Question 12

Vitamin K deficiency - common pathway

Answer 12

II, X

Question 13

Vitamin K deficiency - extrinsic pathway

Answer 13

VII

Question 14

Vitamin K deficiency - intrinsic pathway

Answer 14

IX

Question 15

Vitamin K deficiency can be due to

Answer 15

Surgery patients with parenteral feeding
Patients on high doses of IV antibiotics
Patients with liver disease

Question 16

Factor V (Labile factor)

Answer 16

common pathway
Measured by PT and APTT

Deficiency is called: Parahemophilia

Question 17

Factor VII (Stable factor) deficiency

Answer 17

Hypoproconvertinemia

Vitamin K dependent

Question 18

Factor VIII (Anti-hemophilic factor)

Answer 18

“Hemophilia A” or “classic hemophilia”
- 2nd to vWD in overall frequency of inherited blood disorders

On X chrom –> males are at greater risk.

Question 19

Factor IX (Christmas factor)

Answer 19

Vitamin K dependent

Deficiency is called: Christmas disease or Hemophilia B

On X chromosome –> males at greater risk

Question 20

Factor X (stuart power)

Answer 20

Vitamin K dependent

Deficiency: Stuart Power deficiency

Question 21

Plasma XI deficiency

Answer 21

Hemophilia C/ Rosenthal Syndrome

mild bleeding disorder

Question 22

Factor XII (Hageman Factor)

Answer 22

Deficiency: hagemen trait
- asymptomatic, no bleeding, rare
- has been linked to increased thrombosis

Question 23

Factor XIII (fibrin stabilizing factor)

Answer 23

Only enzyme in coagulation system that is not a serine protease (transaminase)

deficiency: “Factor XIII deficiency”

Question 24

Fitzgerald factor

Answer 24

high molecular weight kiniogen

Question 25

fletcher factor

Answer 25

prekllikrein –> kallikrein

Question 26

Cryoprecipitate

Answer 26

Concentrated plasma rich in Factors I, VIII, XIII

Question 27

Prothrombin Complex Concentrate (PCC)

Answer 27

Rich in II, IX, X

Question 28

Fresh Frozen Plasma (FFP)

Answer 28

• Rich in all soluble coagulation
• Required for factors V and XII

Question 29

DIC

Answer 29

Stimulus causes coagulation response to be intensified and normal inhibitory mechanisms overwhelmed

• Coagulation activated causes multiple thrombi to form at the site of damage and throughout microvasculature
  - consumes factors and platelets

Question 30

simultaneously, Fibrinolytic system activated

Answer 30

pathophysiology becomes a competition of
- fibrin deposition (action of thrombin)
- Fibrinolysis (action of plasmin)

Question 31

DIC three things

Answer 31

Coagulation activated

Inhibitors overwhelmed

Increased Fibrinolysis

Question 32

DIC Lab findings

Answer 32

Increased D Dimers

Question 33

DIC treatment

Answer 33

Septicemia –> antibiotics

Intrauterine Fetal Death –> deliver/remove fetus

Question 34

Maintenance of blood volume and hemostatic function

Answer 34

Coagulation treatments

Packed Red blood cells

Platelets