tutorial Flashcards
what does prothrombin test?
extrinsic pathway - something happens outside the body
what is the extrinsic pathway?
TF + 7 form complex
10–>10a
prothrombin —> thrombin
fibrinogen –> fibrin
what does the activated partial thromboplastin time testing?
the intrinsic pathway.
repairing blood-flow in the body
12–> 12a
11—> 11a
9—-> 9a
8—>8a
10—> 10a(catalysed by 5a)
common pathway.
time for the sample to go from transparent to opaque.
what does the thrombin time tell you?
test of fibrinogen - how it is working and if there is enough.
when there is a pre-longed APTT there is a 50-50 mix why?
takes plasma and will add normal donor plasma.
if low factor level the normal plasma the APTT would be normal or correct.
if there is an inhibitor in his plasma then the APTT will not correct.
why can haemoarthritis lead to anaemia?
they are bleeding into their knee and so losing blood.
how would you narrow down a factor deficiency?
add the factor till the APTT is restored.
unlikely to be 12 or 11
what is a deficiency in factor 8 or 9 and how is it treated?
factor 8 - haemophilia A (more likely)
factor 9 - haemophilia B
replace the factor
can be prophylactic or on demand - this is in moderate and mild but in severe you would give it every two days
where can the issues in jaundice arise?
lots of breakdown in the rbc -> pre hepatic (haemolysis and glucoronyl transferase deficiency)
hepatic - cannot conjugate billrubin
post hepatic –> it cannot leave the liver (
lab will check if it is conjugated or not
what does pale stools, dark urine, jaundice show?
POST HEPATIC JAUNDICE.
obstruction by the gall bladder which leads to the bilirubin leaking out and stools become pale due to the lack of stercobilogen and dark urine due to it increasing urobillogen)
Gall stones (would be painful). If unpainful then it is a cancer of the head of the pancreas.
what factors the liver make?
factor 2,7,9 and 10.
these need to be activated by vitamin K which is lipid soluble which means that there needs to bile salts as these allow absorption —> do not give IM as this will lead to more bleeding.
what does normal fibrinogen levels show?
liver synthesising function is normal.
why is there no issue in giving an A or B blood group people type A?
anti-antibodies are in the plasma and you’re only giving red blood cells(these have the H stem with the antigen hence why you cant give A B or B A)
if someone is rhd +ve what can be given?
positive or negative there is no issues
if there is rhd -ve never give +ve.
NEVER GIVE A WOMAN OF CHILD BEARING AGE RHD +VE.
what causes macrocytic anaemia?
vitamin B12 and folate deficiency
thyroid issues
certain drugs
