Thrombosis and AntiCoag Therapy

Question 1

What is produced in the liver, is vitamin K dependent, and circulates in the form of Zymogen?

Answer 1

Protein C

Question 2

What can Protein C be activated to do?

Answer 2

Activates in a serine protease
Deactivate Factors Va and VIIIa
Clot inhibitor

Question 3

What is an autosomal dominant disorder found in 1 in 2,000 - 5,000 people?

Answer 3

Antithrombin Deficiency

Question 4

Inherited risk factor for thrombosis and thrombotic episodes that also has a single point mutation?

Answer 4

Prothrombin Mutation

Question 5

What are the most common acquired risk factors associated with thrombosis?

Answer 5

Antiphospholipid Syndrome
Lupus Anticoagulant
Heparin Induced Thrombocytopenia (HIT)

Question 6

Independent autoimmune disorders, Systemic Lupus Erythematosus, and Venous and arterial thrombosis are all examples of what?

Answer 6

Thrombotic episodes of Antiphospholipid Syndrome/Lupus Anticoagulants

Question 7

What is immune mediated complication associated with heparin therapy?

Answer 7

Heparin Induced Thrombocytopenia (HIT)
Activates PLTs
Spleen filters out PLTs covered in antibody

Question 8

What is a long term anticoagulant drug that can be given orally and is known as the “Vitamin K antagonist”?

Answer 8

Coumadin
Inhibits Vitamin K dependent factors
Warfarin is a coumadin derivative

Question 9

How do we monitor Heparin Therapy?

Answer 9

Monitored by aPTT test
repeated every 4 to 6 hours
baseline aPTT and PLT count must be done before

Question 10

What is monitored by PT/INR tests and has a therapeutic range of INR = 2.0 - 3.0?

Answer 10

Coumadin (Warfarin) Therapy

Question 11

How do we test for Heparin Induced Thrombocytopenia (HIT)?

Answer 11

C serotonin release assay (C-SRA) by ELISA
ELISA detects Heparin PLT factor 4 antibodies

Question 12

How do we test for Antiphospholipid Syndrome/Lupus Anticoagulants (LA)?

Answer 12

Dilute Russel Viper Venom Test (DRVVT)