Thromboelastography

Question 0

Most of the strength of a clot comes from

Answer 0

Platelets

75-85%

Question 1

A thromboelastography analyzes measures the ability of a clot to

Answer 1

Mechanically impede hemorrhage

Question 2

What produces the final clot?

Answer 2

Fibrin strand and activated platelets which form fibrin-platelet bonding

Question 3

During vascular recovery, the clot gradually

Answer 3

Dissolves

Question 4

Look at all the pictures

Answer 4

Do it now

Question 5

R measures the time of latency between time that blood was placed in analyzer to

Answer 5

Initial fibrin formation

Question 6

What does a longer R mean?

Answer 6

It takes longer than normal for the first fibrin strand to be formed
Represents a factor deficiency

Question 7

An elongated R can be corrected using

Answer 7

Fresh frozen plasma

Question 8

Alpha measures the _________ of fibrin build up and crosslinking

Answer 8

Rapidity

The speed of clot strengthening

Question 9

K measures the rapidity of

Answer 9

Reaching a certain clot strength

Question 10

Where is the clot strength measured?

Answer 10

20 mm amplitude

Question 11

A direct function of the maximum dynamic properties of fibrin and platelet bonding via GPIIb/IIIa and represents the ultimate strength of the fibrin clot

Answer 11

Maximum Amplitude (MA)

Question 12

Determines the rate of clot build up

Answer 12

Fibrinogen

Question 13

Enables cross linking

Answer 13

Factor XIII (rarely deficient)
Platelets, to a lesser extent

Question 14

An elongated K and reduced alpha can be corrected by administering

Answer 14

CRYO (contains both platelets and factor XIII)

Question 15

Small MA represents ______ and can be corrected by

Answer 15

Thrombocytopenia (platelet dysfunction)

Administering platelets

Question 16

There is a compensatory effect between

Answer 16

Fibrinogen level and platelets

Question 17

Platelets are affected by most, if not all

Answer 17

Cardiac surgical procedures

So with small MA, infusion with platelets alone will correct the coagulopathy

Question 18

LY30 measures?

Answer 18

Stability of the clot

Rate of amplitude reduction 30 min after MA

Question 19

A linear combination of R, alpha, K, and MA is given by

Answer 19

Coagulation Index (CI)

Question 20

Mechanical bleeding is due to _______ and shows _______ TEG parameters

Answer 20

Vascular injury

Normal

Question 21

Pathophysiological bleeding is an imbalance between anticoagulant and _____ of the hemodynamics system

Answer 21

Prothrombotic

Question 22

Hyperfibrinolysis is represented by

Answer 22

LY30 greater than 7.5%

Can be corrected by antifibrinolytic drugs

Question 23

Probable causes of bleeding and their treatments

Answer 23

Vessel injury: suture
vWF deficiency: DDAVP
Presence of platelet inhibitor: run platelet mapping

Question 24

A bleeding patient with an abnormally long R value probably has

Answer 24

An enzymatic pathway abnormality

Can also cause abnormalities in angle and MA

Question 25

Inhibition or dysfunction of platelet receptors

Answer 25

Activation

Question 26

Inhibition or dysfunction of GPIb receptor, preventing adhesion of platelet to endothelium

Answer 26

Adhesion

Question 27

Inhibition or dys of GPIIb/IIIa receptors preventing the development of platelet plug

Answer 27

Aggregation

Question 28

Inhibition or dys of of secretory pathway resulting in reduced platelet activation

Answer 28

Secretion

Question 29

Reduction of thrombin generation on platelet surface

Answer 29

Procoagulant activity