Section 10: disorders of 2nd hemostasis Flashcards
VIII:C Inhibitor
what complication? non…
usually?
ages?
formation of?
dependent on?
hemophilia patient complication
non hemophilia pts aquired
usually bleeding not severe
50-80yr old healthy pts
formation of Ab
time and temp dependent
Lab of VIII inhibitor
PT
APTT
MIX
PT norm
APTT prolonged
MIX prolonged
T/F you can produce a factor inhibitor for any coag factor (Ab)
true
Antiphospholipid Antibody
group of……
what % of the population are asympt? arise from? last?
what % of recurrent……have?
autoimmune?
group of igs that bind protein-phoph complex
1-2% of population have APL and are asympt, arise from infections/treatment
disapear in 12wks
5-15% of reccurent thrombosis pts have APL
Autoimmune: SLE, RA, Sjorgens
APS
t
p
c
thrombosis
pregnancy complications
circulatory issues
Lupus inhibitor
not specific for?
doesnt react w? reacts with?
ab?
not associated with? causes?
inhibits?
not specific for any coag factor
doesnt react w endogenous plt phospholipid
REACTS w test system phospolipid
Ab anti phospholipid
NOT assoc w bleeding (thrombosis)
inhibits plt adhesion
Labs for lupus inhibitor
what is affected
must determine?
all phospholipid tests affected, especially APTT
APTT prolonged
50:50 mix prolonged
(must determin inhibitor isnt heparin)
What neutralizes heparin
heparinase (hipzyme)
How to confirm Lupus inhibitor
what rgnt?
dependent on?
increase?
2-3 tests to confirm
low rgnt phospholipid
time/temp dependent
increase incubation
SCT
name
what test w what?
what rgnt/replaces
if LI is prolonged?
silica clotting time
APTT w low rgnt phosph
replaces kaolin/activator rgnt in APTT
if LI is prolonged, clotting increased
DRVVT
what kind of rgnt?
sensitive to?
results?
more dilute rgnt
sensitive to LI
if present, it is prolonged
KCT
initiates?
results?
initiates contact factors
LI inhibits, KCT increased
DTIA
lupus inhibitor inhibits….
diluting PT rgnt?
Li inhibits highly dilute thromboplastin
diluting PT rgnt prolongs PT
PNP
confirms?
washed…
in
rerun what test? what do results mean?
confirms DRVVT/KCT
washed donor plts, freeze-thaw
incubate
rerun DRVVT/KCT, shortened by >10% = lupus inhibitor
ACL
what coexists in 60% of cases?
….+…..
ab
anti cardiolipin ab and LI coexist in 60% of cases
Ab-bovine heart + plasma
Ab
