Section 11: Fibrinolytic/Thrombic Disorders Flashcards
Fibrinolytic Disorders
increased plasmin activity
bleeding
Function of plasmin
lyses fibrin/fibrinogen
inactivates Va VIIIa
degrades XIIa
Fibrinogenolysis - primary fibrinolysis
Always pathological
overactivation of plasmin and or overwhelms plasmin inhibitors
Fibrinolysis - secondary
normal
pathological = overactivation of plasmin and or overwhelms plasmin inhibitors
Liver disease
overactivation of?
decreased
increased
decreased a
overactivation of plasmin
decreased inhibitors
increased fibrinolysis
decreased alpha 2 antiplasmin
Exogenous activators
overactivation of plasmin
strepto/urokinase, tPA
Factors in thrombosis
major
o
comp
oral
major tissue/surgery/trauma
obesity
complications of pregnancy
oral contreceptives
Anti Thrombin Deficiency
hered dom or co dom
thrombosis
family hxt of pathological thomboli/emboli
Protein C and S deficiency
thrombosis
Factors V VIII inactivation
Protein Z and ZPI deficiency
what factors?
causes?
thrombosis
Xa
ZPI = XIa
Heparin cofactor II
neutralizes thrombin
Activated Protein C resistance (APC-R)
also called?
mutation of?
causes?
FVL
mutation of V gene, resistant to lysis of APC
thrombosis
Factor V leiden (APC resistance)
lab tests
PT normal
APTT normal
doesnt affect clot lysis
Clot based assay - APC resistance
what rgnt + …. + depleated
what range indicates…
APC will inactivate?
APTT rgnt + pt plasma + V depleated plasma
<1.8 indicates Factor V leiden
APC will inactivate normal V
XII deficiency
needed for?
doesnt cause?
needed for activation of plasminogen to plasmin
DOESNT CAUSE BLEEDING
XI deficiency
bleeding, doesnt cause thrombosis
PK/HMWK deficiency
asymptomatic, may have thrombosis
Dysfibrinogenemia
mostly?
may be resistant to? clot resistant to? causes?
can also be?
mostly asympt
may be resistant to fibrinogenolysis/ clot is resistant to fibrinolysis = thrombosis
can also be a bleeding disorder
Plasminogen deficiency
ty 1
ty 2
Type 1 - decrease in activity/ Ag deficiencies
Type 2 - dysfunctional thrombosis
tPA deficiency
decreased
causes?
decreased plasminogen to plasmin
thrombosis
Prothrombin Mutation
increased prothrombin levels
gene mutation/single point
thrombosis
Homocystine
defect in metabolism of homocytine
increased levels
thrombosis
damage to endothelial cells
Ebola
thrombocytopenia bone marrow supression
Plt dysfunction
DIC
hepatic Coagulopathy
Covid 19
lymphopenia indicator that its getting worse
reactive lymphs abnormal morphology
hypercoagulopathy
stasis - decreased blood flow
Hypercoagulopathy state
in covid 19
Covid lab results
PT/APTT
PLTs
Fibrinogen
D dimer
monitor for?
PT/APTT norm or prolonged
Plt norm or increased
Fibrinogen increased
D dimer increased
monitor for renal impairment
Distinction of DIC from covid
Covid thrombosis rare bleeding
increased fibrinogen
VIII increased
DIC bleeding
decreased fibrinogen
Low VIII
