section 11 Flashcards
Fibrinolytic disorders
Increase plasmin activity
Leads to Bleeding
Primary Fibrinolysis
Always pathological
over activation and/or overwhelming inhibitors
Secondary fibronolysis
Normal
Over activation and/or overwhelming inhibitors
Liver disease
Over activation of plasmin
Decreased inhibitors -> alpha 2 anti-plasmin
Exogenous activators: streptokinase, urokinase, tPA
Monitor w/ euglobulin clot lysis
Thrombus vs embolism
Thrumbus: stationary clot in major vessel
embolism: broken free and lodged in capillaries of organs
Conditions implicated in thrombosis
Tissue trauma/surgery
Obesity
complications of pregnancy
oral contraceptives
Anti-thrombin deficiency
Hereditary
often fam. history of thrombi/emboli
Heparin cofactor II deficiency
Decreased neutralization of thrombin
Activated protein C resistance
Also see: factor V leiden
Factor V resistant to APC
20% new thrombosis
APC resistance lab results
Added APC will not prolong APTT -> suggests FV Leiden
PT/APTT normal
doesn’t effect clot based tests
Factor XII deficiency
needed to activate plasminogen to plasmin
causes thrombosis
Contact factor deficiencies
Factor XI: bleeding, not thrombosis
PK/HMWK: asymptomatic. APTT prolonged; PT normal
Dysfibrinogenemia
clot resistant to fibrinolysis
resistant to fibrinogenolysis
just not working right
Plasminogen deficiency
type I: decrease in activity and antigen
Type II: dysfunctional
Thrombosis
tPA deficiency
Decrease activation of plasminogen to plasmin
