Surgical Bleeding And Blood Replacment

Question 1

What factors are involved in the intrinsic pathway?

Answer 1

XII
XI
IX
VIII

Question 2

What tests are involved with the intrinsic pathway?

Answer 2

PTT
APTT
Activated partial thromboplastin time

*P(I)TT-Intrinsic

Question 3

What factors are involved in the extrinsic pathway?

Answer 3

VII
III

Question 4

What tests are involved in the extrinsic pathway?

Answer 4

Prothrombin time
P(E)T

Question 5

What is the pre-op screening test for platelets

Answer 5

Platelet function (Aggregation) Assay

Question 6

What does platelet function (aggregation) Assay test for

Answer 6

Allows for assessment of platelet function

Question 7

What is normal for platelet function (aggregation) assay

Answer 7

Collagen/epinephrine <175 sec
Collagen <120 sec

Question 8

What are the components of platelet function (Aggregation) assay

Answer 8

1. Can differentiate ASA from other causes of platelet dysfunction
2. Stop NSAIDS 5-7 days prior

Question 9

What are some conditions that will have an abnl platelet function assay

Answer 9

1. Thrombocytopenia
2. Von willebrand disease
3. Defective platelet function
4. Drugs ASA/NSAIDs

Question 10

What is the normal range for platelet count? (Pre-op screening test)

Answer 10

150,000-450,000
*does not address function

Question 11

What will be causes of increased platelet count (thromboytosis)

Answer 11

1. After trauma
2. Bone fx
3. After surgery (splenectomy)
4. Acute hemorrhage
5. Cancer

Question 12

What are causes of decreased platelet count (thrombocytopenia)

Answer 12

1. DIC
2. TTP
3. Burns
4. Massive transfusion

Question 13

What does prothrombin time (PT) test for (pre-op screening test)

Answer 13

1. Measure ability of blood to form thrombi
2. Evaluates extrinsic and common coagulation pathway (P(E)T)

Question 14

What factors are involved in the extrinsic and common pathway

Answer 14

VII
X
V
II (prothrombin)
I (fibrinogen)

Question 15

What is the normal levels for prothrombin time

Answer 15

11.5-13.5
INR 0.8-1.4

Question 16

What does prothrombin time (PT) monitor

Answer 16

Oral anticoagulation by patients taking Coumadin
*therapeutic range is 2.0-3.0
*mechanical heart valves 2.5-3.5 range

Question 17

What causes increase prothrombin time?

Answer 17

1. Drugs (warfarin, Coumadin)
2. Vitamin K deficiency
3. Fat malabsorption
4. Prolonged tourniquet time prior to drawing blood
5. DIC

Question 18

What is the normal range for PTT, APTT

Answer 18

27-38 seconds

Question 19

What does PTT and APTT monitor / test for

Answer 19

1. Evaluates the intrinsic and common pathway (P(I)TT)
2. Monitor heparin therapy

Question 20

What factors are involved in the intrinsic and common pathway

Answer 20

XII
XI
IX
VII
X
V
I (fibrinogen)
II (Prothrombin)

Question 21

What will cause increased activated partial thromoplastin time (PTT)

Answer 21

1. Heparin and any defect in the instructions pathway
2. Prolonged tourniquet time prior to drawing blood
3. Lupus anticoagulant
4. DIC

Question 22

What is the normal range for Thrombin time?

Answer 22

10-14

Question 23

What dos thrombin time test for / monitors

Answer 23

1. Evaluates fibrinogen to fibrin conversion
2. Used to detect presence of heparin and hypofibrinogenemia
3. Used to evaluate DIC and chronic liver disease

Question 24

What causes increased thrombin time

Answer 24

1. Systemic heparin
2. DIC
3. Fibrinogen deficiency
4. Congenitally abnl fibrinogen molecules