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CV Perf Tech III > TEG- Exam 3 > Flashcards

TEG- Exam 3 Flashcards

1
Q

What three processes are involved in hemostasis?

A

Activation
Clot formation
Clot lysis

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2
Q

Clot: Platelet-fibrin network

A

Platelets form plug
Clotting factors reinforce platelets
Fibrin acts as a glue
Clot strength

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3
Q

What is a clot composed of?

A

Platelets 80-90%

Fibrin 10-20%

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4
Q

What tests are available for component measurements?

A

PT/INR
PTT
Fibinogen concentration
Platelet Count

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5
Q

PT/INR Test

A

Measures extrinsic clotting (VIIa, Xa, IIa)

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6
Q

PTT

A

measures intrinsic clotting (XIIa, Xia, iXa, IIa)

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7
Q

Measurement of component interactions

A

TEG (shows the net effect “whole picture” of hemostasis

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8
Q

What is TEG?

A

A whole blood hemostasis analyzer

Point of care test

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9
Q

What is TEG?

A

A whole blood hemostasis analyzer

Point of care test

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10
Q

How does TEG work?

A 
Cup oscillates
Pin is attached to torsion wire
Clot binds pin to cup
Degree and magnitude of pin motion are functions of the clot kinetics and mechanical properties
System generates a hemostasis profile
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11
Q

How does TEG work?

A 
Cup oscillates
Pin is attached to torsion wire
Clot binds pin to cup
Degree and magnitude of pin motion are functions of the clot kinetics and mechanical properties
System generates a hemostasis profile
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12
Q

R

A

time of latency from the time that the blood was placed in the TEG analyzer until the initial fibrin formation

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13
Q

Alpha

A

The alpha value measures the rapidity (kinetics) of fibrin build-up and corss-linking, that is, the speed of clot strengthening

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14
Q

K

A

K time is a measure of the rapidity to reach a certain level of clot strength

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15
Q

MA

A

Max amplitude, direct function of the maximum dynamic properties of firbin and platelet bonding via GPIIb/IIIa and represents the ultimate strength of the fibrin clot

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16
Q

GI

A

coagulation index is linear combination of the above parameters

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17
Q

LY30

A

rate of amplitude reduction 30 minutes after MA. This measurement gives an indication of the stability of the clot

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18
Q

R

A

time of latency from the time that the blood was placed in the TEG analyzer until the initial fibrin formation; reaction time (time to clot formation)

19
Q

Alpha

A

The alpha value measures the rapidity (kinetics) of fibrin build-up and cross-linking, that is, the speed of clot strengthening; speed of fibrin accumulation

20
Q

K

A

K time is a measure of the rapidity to reach a certain level of clot strength; time elapsed until clot reaches a fixed strength

21
Q

MA

A

Max amplitude, direct function of the maximum dynamic properties of firbin and platelet bonding via GPIIb/IIIa and represents the ultimate strength of the fibrin clot; highest vertical amplitude of TEG tracing

22
Q

CI

A

coagulation index is linear combination of the above parameters

23
Q

LY30

A

rate of amplitude reduction 30 minutes after MA. This measurement gives an indication of the stability of the clot; % of amplitude reduction 30 min after its max

24
Q

LY30

A

rate of amplitude reduction 30 minutes after MA. This measurement gives an indication of the stability of the clot; % of amplitude reduction 30 min after its max

25
Q

R Likely Variable

A

Coagulation Factors

26
Q

Alpha Likely Variable

A

Fibrinogen

27
Q

K LIkely Variable

A

Fibrinogen

28
Q

MA Likely Variable

A

Platelets

29
Q

Ly30 likely variable

A

Fibrinolysis

30
Q

Ly30 likely variable

A

Fibrinolysis

31
Q

TEG Assays

A

Standard (Kaolin)
Rapid TEG
Heparinase
Platelet Mapping

32
Q

Standard (Kaolin)

A

Uses parameters listed above

33
Q

Rapid TEG

A

uses tissue factor in place of kaolin to speed up the rxn
R-value is replaced by TEG-ACT value
Other parameters the same

34
Q

Heparinase

A

Use on bypass or post bypass alongside a standard TEG

35
Q

Platetlet Mapping

A

Determines to what degree platelet function is inhibited due to pharmacological inhibition of either the arachidonic acid (AA) or ADP pathways
AA: Aspirin
ADP: Clopidrogel
Run alongside a standard TEG and a TEG with added AA or ADP
Calculates platelet inhibition as a percentage

36
Q

Platelet Mapping

A

Determines to what degree platelet function is inhibited due to pharmacological inhibition of either the arachidonic acid (AA) or ADP pathways
AA: Aspirin
ADP: Clopidrogel
Run alongside a standard TEG and a TEG with added AA or ADP
Calculates platelet inhibition as a percentage

37
Q

Platelet Mapping

A

Determines to what degree platelet function is inhibited due to pharmacological inhibition of either the arachidonic acid (AA) or ADP pathways
AA: Aspirin
ADP: Clopidrogel
Run alongside a standard TEG and a TEG with added AA or ADP
Calculates platelet inhibition as a percentage

38
Q

What does platelet mapping measure?

A

Measures the effect of antiplatelet agents on platelet function
Measures the patient’s maximum platelet function as a reference point
Measures the percentage of inhibition relative to the patient’s reference point

39
Q

What does platelet mapping measure?

A

Measures the effect of antiplatelet agents on platelet function
Measures the patient’s maximum platelet function as a reference point
Measures the percentage of inhibition relative to the patient’s reference point

40
Q

Platelet Mapping: What drugs are monitored?

A

Antiplatelet Drugs

  • ADP receptor inhibitors
  • Arachidonic acid pathway inhibitiors
  • GPIIb/IIIa inihibitors
41
Q

ADP receptor inhibitors

A

clopidogrel, ticlopidine

42
Q

Arachidonic acid pathway inihibitors

A

aspirin

43
Q

GPIIb/IIIa inhibitors

A

abciximab, tirofiban, eptifibatide

44
Q

Rotational Elastometry (ROTEM)

A

Stationary cup, rotating spindle
Clot impedes rotation of the pin
Additional tests available

CV Perf Tech III (16 decks)

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