Week 2 Flashcards
Which factors are vitamin K dependent?
II, VII, IX and X, C and S
Intrinsic pathway
9 - 12
Extrinsic Pathway
Tissue factor and factor VII.
Common meeting point for pathways?
X
Warfarin Inhibits….
Vitamin K dependent factors (2,7,9,10,)
tPA inhibits?
Plasminogen to plasmin
Heparin inhibits?
Xa and IIa (thrombin)
Antithrombin acts on?
X and thrombin
Protein C acts on?
VIIIa and Va
Prothrombin Time (PT) Measures?
Extrinsic pathway (VII), and warfarin.
PTT Measures?
Both pathways, and heparin.
Acquired protein C deficiency
Is caused by warfarin. This leads to warfarin-induced protein C deficiency, and skin necrosis.
Bridging
Heparin should be bridged with warfarin during the initial days of therapy to avoid skin necrosis.
Protamine sulfate
Reverses Heparin
What is amicar?
An antifibrinolytic agent. AKA ECA (aminocaproid acid)
Used for acute bleeding
What can reverse bleeding in a pt on pradaxa?
Autoplex T
What factors does DDAVP promote?
vWF and VIII
What is used during percutaneous cardiac intervention?
GPIIb/IIIa inhibitors
What is used as a hemostatic agent during CABG surgery?
Aprotinin
Which disease do you see a rouleaux formation in?
MM, you will also see fractures
What does CRAB stand for?
Calcium (elevated) Renal failure Anemia Bone lesions indicative of MM
What drug will help in spinal cord compression from MM?
Corticosteroids (SWELLING!)
Which serum antibody will you see elevated in Waldenstroms Macroglobulinemia (WM)
IgM
Having MM puts you at risk for?
Amyloidosis, the deposit of antibodies in organs and joints causing pathology.
Cast neuropathy is seen in?
MM
A plasmacytoma can progress to?
MM
Which age group is MM seen in?
65 and older
If you see marked leukocytosis and Auer rods, what would you suspect?
Acule Myeloid Leukemia
What is gout common in?
Myeloid leukemias
What is lymphadenopathy common in?
Lymphocytic Leukemias
A child presenting with leukocytosis and bone pain , organomegaly and lymphadenopathy most likely has?
Acute lymphocytic leukemia
Which leukemia is the philadelphia chromosome associated with?
Chronic Myeloid Leukemia
If you see leukemia cutis, soccer balls and smudge cells, what would you suspect?
Chronic Lymphocytic Leukemia
In which disorder is the bone marrow replaced with fibrous connective tissue?
Primary Myelofibrosis
If a patient complains of pruritis post-showering, and burning in the hands an feet, what would you suspect?
Polycythemia Vera
In which leukemia would you expect to see normal Hct and Platelets?
CLL
A presence of CD20 and absence of CD56 indicates that It is MM or PML?
It indicates Plasma Cell Leukemia
A markedly elevated platelet count and history of thrombosis indicates?
Essential Thrombocytosis
What would you suspect with a normo/normo anemia, Normal WBC count, 0% Retic, and no RBC precursors in the BM?
Pure Red Cell Aplasia
When the BM is “displaced” into other tissues and many immature, nucleated RBC’s, Dacrocytes (tear-drop), and Blasts are seen in the periphery, what do you suspect?
Myelophthisic Anemia
Neoplasm =
Tumor
“Pre-leukemia”
Myelodysplastic Syndrome
An acutely ill patient presents with severe anemia, pancytopenia, NO spleno or hepatomegaly. What do you suspect?
Aplastic Anemia
What is the most common etiology of inherited BM failure? MCC and DEB fragility tests are used to Dx.
Fanconi’s Anemia.
Developmental abnormalities are also common in this disorder.
Platelets being marked by antibodies and being destroyed by the spleen indicate?
ITP
Occurs after infection in children and is fleeting. Is often chronic in adults. Purpura.
ITP
Microangiopathic hemolytic anemia, with schistocytes, bleeding and clotting, Elevated liver enzymes, Clots in brain and kidneys, death.
TTP
Caused by endothelial damage secondary to infxn (E. coli most common). Bloody diarrhea.
HUS
A child with IgA Vasculitis, palpable purpura, arthralgias.
Henoch-Schonelin Purpura HSP
A man with bleeding in joints and a hx of bleeding after surgeries and tooth extractions, Prolonged PTT.
Hemophilia
A women with prolonged bleeding, easy bruising, bleeding from gums. She needed a transfusion post-delivery 2 years ago.
vWD
A septic patient who is now simultaneously bleeding and clotting. Every lab is prolonged and he is dying.
DIC
in vWD, what can you treat bleeding with?
DDAVP
What should you give to treat gout?
Allopurinol
How is erythromelalgia best treated, and which disease do you see it in?
Aspirin, Polycythemia Vera
Hydroxyurea and Alpha interferon are?
Myelosuppressive agents
What is ADAMTS associated with?
TTP
