Thrombosis

Question 1

most important step in vivo coagulation

Answer 1

VII -> IX

Question 2

antithombin

Answer 2

blocks II, IX, X, XI, XII amplified 1000x by heparin

Question 3

common hypercoaguable states

Answer 3

factor V mutation prothrombin mutation 5.10 methylenetetrahydrofolate reductase mutation increased factor VIII, IX, XI, or fibrinogen

Question 4

rare hypercoaguable states

Answer 4

antithrombin III deficiency protein C or S deficiency

Question 5

very rare hypercoagulable states

Answer 5

fibrinolysis defects homozygous homocyteinuria

Question 6

high risk for thrombosis

Answer 6

prolonged stasis MI atrial fibrillation tissue injury cnacer prosthetic cardiac valves DIC heparin induced thrombocytopenia antiphospholipid Ab syndrome

Question 7

lower risk for thrombosis

Answer 7

cardiomyopahty nephrotic syndrome hyperestogenic states oral contraceptives sickle cell smoking

Question 8

Things that block platelet coagulation

Answer 8

ADP Prostacyclin NO

Question 9

HSPG

Answer 9

blocks IIa IXa Xa XIa XIIa

Question 10

factor V leiden mutations

Answer 10

activated protein C resistance does not deactiate

Question 11

prothrombin G20210 A mutation

Answer 11

increased prothrombin levels which are converted to working thrombin

Question 12

heparin induced thrombocytopenia syndrome type II

Answer 12

unfractionated heparin induces autoAbs to molecular complex w/platelet factor 4 patients have thrombocytopenia and disseminated clots autoAb-heparin-platelet complexes cause endothelial injury, causing prothrombotic state

Question 13

Antiphospholipid autoAbs

Answer 13

affinity for bound phospholipids on platelet surace that are combinded w/coagulation facotrs lupus anticoagulant detected during aPTT testing false positive VDRL test recurrent venous or arterial thrombosis and/or fetal loss

Question 14

homocysteine

Answer 14

contributes to arterial and venous thrombosis and atherosclerosis marked elevations caused by homozygous deficiencies of CBS folic acid, pyridoxine, and/or vit B12 can reduce plasma homocysteine concentrations, but does not decrease risk ASCVD

Question 15

types of shock

Answer 15

disruptive (septic, neurogenic,, anaphylactic) cardiogenic shock hypovolemic shock (hemorrhagic) obstructive shock (saddle PE)

Question 16

inadequate production of platelets

Answer 16

leukemias aplastic anemia myelodysplaisa B12 or folate deficiency

Question 17

splenic sequestration of platelets

Answer 17

cirrhosis congestive splenomegaly

Question 18

increased platelet destruction or consumption

Answer 18

ITP DIC TTP HUS bleeding sepsis HIV

Question 19

drug induced destruction

Answer 19

quinidine sulfa rarely heparin/HIT

Question 20

increased platelets

Answer 20

platelet dysfunction bleeding

Question 21

platelet dysfunction

Answer 21

bernard-soulier syndrome vWD glanzmann thrombbasthenia drug induces (aspirin, NSAIDs) systemic disorders (uremia

Question 22

acquired coagulation disoreders

Answer 22

vit K deficiency liver disease anticoagulation w/warfain or heparin DIC

Question 23

hereditary coagulation disorders

Answer 23

hemophilia A (VIII) hemophilia B (IX) hemophilia C (XI) vWD

Question 24

acquired vascular disorders

Answer 24

collagen defects (scurvey, cushings) henoch-schonlein purpura amyloidosis

Question 25

hereditary vascular disorders

Answer 25

CT (ehlers-danlos, osteogensis imperfecta, marfans) hereditary hemorrhagic telangiectasia

Question 26

musculotaneous bleeding

Answer 26

petechiae, bruising, GI think disorders of platelets, vWD, or vasculature

Question 27

spontaneous or excessive soft tissues, mm and joints, delayed surgical bleeding

Answer 27

think coagulation disorders

Question 28

afibrognemia

Answer 28

umbilical cord stump bleeding coagulation defect

Question 29

factor XIII deficiency

Answer 29

males, deep hematomas, hemarthroses, chronic joint abnormalities, umbilical cord stump bleeding coagulation defect

Question 30

factor XIII deficency

Answer 30

poor wound healing, severe scar formation coagulation defect

Question 31

chediak-higashi syndrome

Answer 31

oculocutaneous albinism, infections, neutrophil peroxidase + inclusions platelet dysfunction

Question 32

wiskott aldrich syndomre

Answer 32

eczema, immunodeficiency thrombocytopenia

Question 33

digeorge syndrome

Answer 33

cleft palate, cardiac defects, facial anomalies, learning disabilities thrombocytopenia

Question 34

petechiae

Answer 34

\<0.3 cm

Question 35

purpura

Answer 35

.3-1cm

Question 36

ecchymoses

Answer 36

\>1cm

Question 37

vWD I and III

Answer 37

quantity defect

Question 38

vWD II

Answer 38

quality defect

Question 39

hem A

Answer 39

negative for epistaxis, bruising, petechiae, GI bleeding, menorrhagia, postpartum bleeding positive for hematoma, hemarthrosis, post-procedure bleeding

Question 40

vWD

Answer 40

positive for epistaxis, bruising, petechiae, GI bleeding, menorrhagia, hematoma (type 1), hemarthrosis (type 1), postpartum bleeding, post procedure bleeding

Question 41

adhesion defects

Answer 41

vWD bernard-soulier disease

Question 42

adhesion labs

Answer 42

ristocetin

Question 43

aggregation defects

Answer 43

glanzmann thrombasthenia

Question 44

aggregation labs

Answer 44

ADP/collage/epi/arachidonic acid

Question 45

gray platelet syndrome

Answer 45

empty platelet alpha granules mild bleeding autosomal dominant or recessive

Question 46

morphology of gray platelet syndrome

Answer 46

hypogranular platelets giant platelets thrombocytopenia myelofibrosis

Question 47

diagnosis of gray platelet syndrome

Answer 47

variably abnormal platelet aggregation abnormal platelet appearance on blood smear electron microscopy shoeing absent alpha granules

Question 48

uremia

Answer 48

defects in adhesion, granule secretion, and aggregation

Question 49

acquired platelet storage defects

Answer 49

SLE cardiopulmonary bypass platelet activation

Question 50

acute immune idiopathic thrombocytopenic purpura

Answer 50

ITP childhood disease w/acute onset (2 weeks post viral) self-limited (resolves w/in 6 months) autoAbs against platelet Ags

Question 51

chronic immune (refractory) thrombocytoenic purpura of adults

Answer 51

20-49 years 3F:1M spontaneous remissions rare primary or secondary to SLE, HIV, Leukemias/lymphomas autoAbs against platelet Ags

Question 52

Primary TTP

Answer 52

deficency of ADAMTS13 treated w/plasmaphoresis

Question 53

waterhouse-friderichsen syndrome

Answer 53

massive adrenal hemorrhages

Question 54

blue top

Answer 54

plasma add anticoagulant

Question 55

red top

Answer 55

serum no anticoagulant, fluid that does not clot

Question 56

vit K deficieny or warfarin

Answer 56

pronlonged PT prolonged aPTT platelet funx and platelet count unaffected

Question 57

DIC

Answer 57

prlonged PT prolonged aPTT unaffected platelet function decreased platelet count

Question 58

vWD

Answer 58

unaffected PT and platelet count prolonged aPTT decreased platelet fnx

Question 59

Haemophilia

Answer 59

unaffected PT, platelet count, platelet fnx prolonged aPTT

Question 60

Aspirin

Answer 60

unaffected PT, aPTT, platelet count decreased platelet function

Question 61

thrombocytopenia

Answer 61

unaffected PT and aPTT decreased platelet count

Question 62

early liver stage

Answer 62

prolonged PT unaffected aPTT and platelet count decteased platelet function

Question 63

end-stage liver disease

Answer 63

prolonged PT and aPTT decreased platelet count and function

Question 64

ureima

Answer 64

decreased platelet fnx

Question 65

congenital afibrogenemia

Answer 65

prolonged PT, aPTT

Question 66

factor V deficicency

Answer 66

prolonged PT and aPTT

Question 67

glanzmann's thrombocytopenia

Answer 67

decreasd platelet fnx

Question 68

bernard-soulier syndrome

Answer 68

decreased platelet function and count