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🩸Hema🎀 > Thrombosis > Flashcards

Thrombosis Flashcards

1
Q

Is the inappropriate formation of a platelet or fibrin clot that obstructs a blood vessel

A

Thrombosis

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2
Q

Is a multifaceted disorder resulting from circulatory stasis and abnormalities in the coagulation system, coagulation control mechanisms, platelet function, the blood vessel wall, or leukocyte activation molecules

A

Thrombosis

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3
Q

Or hypercoagulability

A

Thrombophilia

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4
Q

Is the predisposition to thrombosis secondary to a congenital or acquired condition

A

Thrombophilia

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5
Q

Thrombosis Risk Factors

A
  1. Acquired Thrombosis Risk Factors
  2. Thrombosis Risk Factors Associated with Systematic Disease
  3. Congenital Thrombosis Risk Factors
  4. Thrombosis Double Hit
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6
Q

Thrombosis Risk Factors Associated with Systematic Disease

A
  1. Chronic Antiphospholipid Antibodies (APLAs)
  2. Malignancies
  3. Myeloproliferative neoplasms
  4. Paroxysmal Nocturnal Hemoglobinuria (PNH)
  5. Chronic inflammatory diseases
  6. Nephrotic Syndrome
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7
Q

Confer a risk of venous/arterial thrombosis (a condition called antiphospholipid syndrome or APS

A

Chronic Antiphospholipid Antibodies (APLAs)

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8
Q

Often accompany autoimmune connective tissue disorder

A

Chronic Antiphospholipid Antibodies (APLAs)

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9
Q

Tumor production of tissue factor analogues

A

Malignancies

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10
Q

A cardinal sign of APML is DIC secondary to the release of procoagulant granule contents from malignant promyelocytes

A

Myeloproliferative neoplasms

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11
Q

Caused by stem cell mutation that modifies membrane-anchored platelet activation suppressors

A

Paroxysmal Nocturnal Hemoglobinuria (PNH)

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12
Q

Such as elevation of fibrinogen and factor VIII, suppressed fibrinolysis, promotion of atherosclerotic plaque formation, and reduced free protein S activity secondary to raised C4b-binding protein (C4bBP) levels

A

Chronic inflammatory diseases

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13
Q

Creates protein imbalances that lead to thrombosis through loss of plasma proteins such as antithrombin

A

Nephrotic Syndrome

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14
Q

Congenital Thrombosis Risk Factors

A
  1. FVL gene mutation
  2. Prothrombin G20210A gene mutation
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15
Q

most common inherited thrombosis risk factor

A

FVL gene mutation

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16
Q

second most common inherited thrombophilia in patients with a personal and family history of deep vein thrombosis

A

Prothrombin G20210A gene mutation

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17
Q

Thrombosis is often associated with a combination of genetic defect, disease, and lifestyle influences

A

Thrombosis Double Hit

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18
Q

Many heterozygotes experience no thrombotic event during their lifetimes, whereas others experience clotting only when two or more risk factors converge

A

Thrombosis Double Hit

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19
Q

Laboratory Evaluation of Thrombophilia

A
  1. Antiphospholipid antibodies (LAC, ACL, and Anti-B2-GPI)
  2. Activated protein C resistance and Factor V Leiden mutation
  3. Prothrombin G20210A
  4. Antithrombin
  5. Protein C control pathway
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20
Q

Comprise a family of immunoglobulins that bind protein-phospholipid complexes

A

Antiphospholipid antibodies

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21
Q

Antiphospholipid antibodies arise as

A

IgM or IgG

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22
Q

Antiphospholipid antibodies Are sometimes called

A

nonspecific inhibitors

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23
Q

the plasma protein most often bound to APLAs

A

B2-GPI

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24
Q

Most APLAs arise in response to a bacterial, viral, fungal, or parasitic infection or to treatment with one of a variety of drugs

A

Transient alloimmune APLAs

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25
Q

Part of the autoantibodies that arise in collagen vascular diseases, SLE, RA, scleroderma, and Sjogren’s syndrome

A

Autoimmune APLAs

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26
Q

Detection & Confirmation of Antiphospholipid Antibodies (LAC)

A
  1. Mixing Study
  2. Lupus Anticoagulant Test Profile
  3. Dilute thromboplastin time (DTT)
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27
Q

Detection & Confirmation of Antiphospholipid Antibodies (LAC):

Important first step

A

Mixing Study

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28
Q

Detection & Confirmation of Antiphospholipid Antibodies (LAC):

Can differentiate an LAC from a factor deficiency

A

Mixing Study

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29
Q

Lupus Anticoagulant Test Profile Two commonly used test and both are required:

A

A. Dilute Russell viper venom time (DRVVT)
B. Silica-based PTT or Silica clot time (SCT)

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30
Q

Detection & Confirmation of Antiphospholipid Antibodies (LAC):

Also named tissue thromboplastin inhibitor (TTT)

A

Dilute thromboplastin time (DTT)

31
Q

Mixing Study

If corrected:

A

coagulation factor deficiency

32
Q

Mixing Study

If it fails to correct:

A

could be an LAC or a specific inhibitor (such as Factor VIII inhibitor)

33
Q

considered the more specific of the LAC assay

34
Q

DRVVT Screening uses

A

uses low-phospholipid reagent

35
Q

DRVVT Confirmatory uses

A

high-phospholipid reagent

36
Q

In DRVVT, If ratio is ______, LAC is confirmed

37
Q

In DRVVT, If ratio is ______, proceed to ______

A

<1.2

silica-based low phospholipid LA-sensitive PTT

38
Q

In silica-based reporting (in seconds), a difference of ______ is the threshold used to confirm an LAC.

39
Q

an immunoassay that is NOT affected by anticoagulant therapy, current thrombosis, or factor deficiencies

A

Anticardiolipin Antibodies (ACL)

40
Q

Antibody immunoassay results are expressed using GPL or MPL units, where 1 unit is equivalent to 1 ug/mL of an affinity- purified standard IgG or IgM sample

A

Anticardiolipin Antibodies (ACL)

41
Q

An anti-B2-GPI result of ________ correlates with thrombosis more closely than the presence of ACL antibodies

A

greater than 20 IgG or IgM anti-B2-GPI units

42
Q

APC hydrolyzes activated factors

A

factors V and VIII

43
Q

A mutation in the factor V gene substitutes glutamine for arginine at position 506 of the factor V molecule (FV R506Q)

A

Factor V Leiden Mutation

44
Q

Activated Protein C Resistance and Factor V Leiden Mutation

Normal ratio:
APC resistance:

A

Normal ratio: > or equal to 1.8
APC resistance: <1.8

45
Q

A guanine-to-adenine mutation at base 20210 of the 3’ untranslated region of the prothrombin gene has been associated with mildly elevated plasma prothrombin levels

A

Prothrombin G20210A

46
Q

Is a serine protease inhibitor (SERPIN) that neutralizes factors IIa, IXa, Xa, XIa, XIIa, all of the coagulation system serine proteases except factor VIIa

A

Antithrombin

47
Q

Antithrombin activity is enhanced through binding to

A

exogenous heparan sulfate

48
Q

Is measured with a turbidometric microparticle immunoassay

A

Antithrombin Antigen Assay

49
Q

In Antithrombin Antigen Assay, The AT concentration is ________ to the rate of light absorption change

A

directly proportional

50
Q

the consequence of PC or PS deficiency

A

Recurrent venous thrombosis

51
Q

● Detects both quantitative and qualitative PC deficiencies
● Is based on the ability of APC to prolong the PTT
● Prolongation is proportional to PC activity

A

Protein C Assays: Clot-Based Assays

52
Q

Arterial thrombosis predictors

A
  1. Lipoprotein A
  2. CRP
  3. Fibrinogen
  4. Plasma Homocysteine and Factor VIII
53
Q

A low-density lipoprotein that may contribute to thrombosis by its antifibrinolytic property

A

Lipoprotein A

54
Q

Competes with plasminogen for binding sites on newly formed fibrin polymer

A

Lipoprotein A

55
Q

An acute phase reactant whose plasma concentration rises 1000-fold 6 to 8 hours after the onset of an inflammatory event

56
Q

becomes integrated into atherothrombotic lesions and contributes to their thrombotic potential

A

Fibrinogen

57
Q

High concentrations can be used to predict hypercholesterolemia and identify patients who are at high risk for new coronary events

A

Fibrinogen

58
Q

a naturally occurring sulfur-containing amino acid intermediate in the metabolism of dietary methionine

A

Homocysteine

59
Q

Venous thromboembolic disease

A
  1. Deep vein thrombosis (DVT)
  2. Pulmonary embolism (PE)
60
Q

the most prevalent VTE

A

Deep vein thrombosis (DVT)

61
Q

caused by clots that form in the iliac, popliteal, and femoral veins of the calves and upper legs

A

Deep vein thrombosis (DVT)

62
Q

Deep vein thrombosis (DVT) Cardinal symptoms:

A
  • Edema
  • Erythema
  • Pain
  • Sensation of heat
  • Misidentified as muscle strain or a
    “charley horse”
63
Q

fragments of thrombi (called emboli) may separate from the proximal end of a venous thrombus, move swiftly through the right chambers of the heart, and lodge in the arterial pulmonary vasculature, causing ischemia and necrosis of lung tissue

A

Pulmonary embolism (PE)

64
Q

Nicknamed “the great masquerader”

A

Pulmonary embolism (PE)

65
Q

Diagnostic Tests for DVT & PE

effective for most DVT cases

A

Ultrasonography

66
Q

Diagnostic Tests for DVT & PE

reference method for PE

A

Multislice or spiral chest computed tomography (CT) angiography

67
Q

Diagnostic Tests for DVT & PE

can not be employed to “rule in” DVT or PE but a normal result reliably rules out either condition without the need for imaging

A

D-dimer assay

68
Q

Also named defibrination syndrome or consumption coagulopathy

69
Q

Is the Black Death of the Middle Ages

70
Q

A term for tumor-induced DIC that generates DVT and migrating sub-epithelial thromboses causing ecchymosis and purpura fulminans

A

Trousseau syndrome

71
Q

Is the consequence of an immune response to UFH (standard IV heparin), and LMWH that is reflected in a reduced platelet count

A

Heparin-Induced Thrombocytopenia

72
Q

HIT antibodies are specific for

A

platelet factor 4 (PF4) complexed with heparin

73
Q

is a hapten that triggers immune production of IgG isotype anti-H:PF4 antibodies that now bind the H:PF4

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