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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
Part of the autoantibodies that arise in collagen vascular diseases, SLE, RA, scleroderma, and Sjogren's syndrome
Autoimmune APLAs
26
Detection & Confirmation of Antiphospholipid Antibodies (LAC)
1. Mixing Study 2. Lupus Anticoagulant Test Profile 3. Dilute thromboplastin time (DTT)
27
Detection & Confirmation of Antiphospholipid Antibodies (LAC): Important first step
Mixing Study
28
Detection & Confirmation of Antiphospholipid Antibodies (LAC): Can differentiate an LAC from a factor deficiency
Mixing Study
29
Lupus Anticoagulant Test Profile Two commonly used test and both are required:
A. Dilute Russell viper venom time (DRVVT) B. Silica-based PTT or Silica clot time (SCT)
30
Detection & Confirmation of Antiphospholipid Antibodies (LAC): Also named tissue thromboplastin inhibitor (TTT)
Dilute thromboplastin time (DTT)
31
Mixing Study If corrected:
coagulation factor deficiency
32
Mixing Study If it fails to correct:
could be an LAC or a specific inhibitor (such as Factor VIII inhibitor)
33
considered the more specific of the LAC assay
DRVVT
34
DRVVT Screening uses
uses low-phospholipid reagent
35
DRVVT Confirmatory uses
high-phospholipid reagent
36
In DRVVT, If ratio is ______, LAC is confirmed
1.2
37
In DRVVT, If ratio is ______, proceed to ______
<1.2 silica-based low phospholipid LA-sensitive PTT
38
In silica-based reporting (in seconds), a difference of ______ is the threshold used to confirm an LAC.
8 seconds
39
an immunoassay that is NOT affected by anticoagulant therapy, current thrombosis, or factor deficiencies
Anticardiolipin Antibodies (ACL)
40
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
Anticardiolipin Antibodies (ACL)
41
An anti-B2-GPI result of ________ correlates with thrombosis more closely than the presence of ACL antibodies
greater than 20 IgG or IgM anti-B2-GPI units
42
APC hydrolyzes activated factors
factors V and VIII
43
A mutation in the factor V gene substitutes glutamine for arginine at position 506 of the factor V molecule (FV R506Q)
Factor V Leiden Mutation
44
Activated Protein C Resistance and Factor V Leiden Mutation Normal ratio: APC resistance:
Normal ratio: > or equal to 1.8 APC resistance: <1.8
45
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
Prothrombin G20210A
46
Is a serine protease inhibitor (SERPIN) that neutralizes factors IIa, IXa, Xa, XIa, XIIa, all of the coagulation system serine proteases except factor VIIa
Antithrombin
47
Antithrombin activity is enhanced through binding to
exogenous heparan sulfate
48
Is measured with a turbidometric microparticle immunoassay
Antithrombin Antigen Assay
49
In Antithrombin Antigen Assay, The AT concentration is ________ to the rate of light absorption change
directly proportional
50
the consequence of PC or PS deficiency
Recurrent venous thrombosis
51
● Detects both quantitative and qualitative PC deficiencies ● Is based on the ability of APC to prolong the PTT ● Prolongation is proportional to PC activity
Protein C Assays: Clot-Based Assays
52
Arterial thrombosis predictors
1. Lipoprotein A 2. CRP 3. Fibrinogen 4. Plasma Homocysteine and Factor VIII
53
A low-density lipoprotein that may contribute to thrombosis by its antifibrinolytic property
Lipoprotein A
54
Competes with plasminogen for binding sites on newly formed fibrin polymer
Lipoprotein A
55
An acute phase reactant whose plasma concentration rises 1000-fold 6 to 8 hours after the onset of an inflammatory event
CRP
56
becomes integrated into atherothrombotic lesions and contributes to their thrombotic potential
Fibrinogen
57
High concentrations can be used to predict hypercholesterolemia and identify patients who are at high risk for new coronary events
Fibrinogen
58
a naturally occurring sulfur-containing amino acid intermediate in the metabolism of dietary methionine
Homocysteine
59
Venous thromboembolic disease
1. Deep vein thrombosis (DVT) 2. Pulmonary embolism (PE)
60
the most prevalent VTE
Deep vein thrombosis (DVT)
61
caused by clots that form in the iliac, popliteal, and femoral veins of the calves and upper legs
Deep vein thrombosis (DVT)
62
Deep vein thrombosis (DVT) Cardinal symptoms:
- Edema - Erythema - Pain - Sensation of heat - Misidentified as muscle strain or a "charley horse"
63
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
Pulmonary embolism (PE)
64
Nicknamed "the great masquerader"
Pulmonary embolism (PE)
65
Diagnostic Tests for DVT & PE effective for most DVT cases
Ultrasonography
66
Diagnostic Tests for DVT & PE reference method for PE
Multislice or spiral chest computed tomography (CT) angiography
67
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
D-dimer assay
68
Also named defibrination syndrome or consumption coagulopathy
DIC
69
Is the Black Death of the Middle Ages
DIC
70
A term for tumor-induced DIC that generates DVT and migrating sub-epithelial thromboses causing ecchymosis and purpura fulminans
Trousseau syndrome
71
Is the consequence of an immune response to UFH (standard IV heparin), and LMWH that is reflected in a reduced platelet count
Heparin-Induced Thrombocytopenia
72
HIT antibodies are specific for
platelet factor 4 (PF4) complexed with heparin
73
is a hapten that triggers immune production of IgG isotype anti-H:PF4 antibodies that now bind the H:PF4
H:PF4

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