Thrombotic Disorders

Question 1

Most common hereditary thrombotic disorder:

Answer 1

Factor V Leiden

VERY rare in non-caucasians

Question 2

Dx fro factor V Leiden?

Answer 2

genetic testing

**point mutation in factor V gene

Question 3

What’s the problem with defective factor V?

Answer 3

Can’t be cleaved by protein C

Question 4

Natural anticoagulant

inhibits IIa, VIIa, IXa, Xa, XIa

potentiated by heparin

Answer 4

antithrombin III

Question 5

Warfarin induced skin necrosis; think….

Answer 5

Protein C or S deficiency

**gets knocked out before clotting factors

Question 6

inactivates Va and VIIIa

promotes t-PA action

keeps cytokines low

Answer 6

protein C

Question 7

thrombotic state + vascular injury = ?

Answer 7

Purpura fulminans

Question 8

Super rare, same as protein C def?

Answer 8

protein S def

Question 9

Mutated gene makes too much thrombin:

Answer 9

Factor II mutation

rare in non-caucasians

Question 10

What is factor II?

Answer 10

prothrombin

Question 11

MTHFR gene mutation?

Answer 11

Homocysteinemia

Question 12

To bad things about homocyteine with regardds to thrombosis:

Answer 12

forms ROS –> endothelial damage

interferes with NO (vasodilator and antithrombotic)

Question 13

Other way to get homocysteinemia besides MTHFR?

Answer 13

B12/folate deficiency

**less worrisome

Question 14

Falsely prolonged INR

autoantibody involvement

Answer 14

Antiphospholipid Antibodies

Question 15

Inhibitors (antiphospholipid antibodies) in vivo _________ coagulation.

Answer 15

Promote

Question 16

Inhibitors (antiphopholipid antibodies) in vitro ________ coagulation.

Answer 16

Inhibit