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Haematology > Week 3 > Flashcards

Week 3 Flashcards

1
Q

How are platelets formed?

A

Budding off from megakaryocytes

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2
Q

What is the lifespan of platelets?

A

7-10 days

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3
Q

What causes platelet adhesion after vessel wall injury in primary haemostasis?

A

Exposure of collagen and releasing of vWF

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4
Q

What are the two stages of haemostasis?

A

Primary - formation of platelet plug

Secondary - formation of fibrin clot

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5
Q

What 3 things can use failure of platelet plug formation?

A

Vascular - loss of collagen
Platelets - decrease in number or function (drugs)
Decrease in vWF

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6
Q

What symptoms would you see in primary haemostasis failure?

A

Spontaneous bleeding and purpura
Mucosal bleeding - epistaxis, gi, menorrhagia
Intracranial haemorrhage

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7
Q

How can you screen for primary haemostasis failure?

A

Platelet count

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8
Q

What causes production of megakaryocytes and platelets?

A

Thrombopoietin

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9
Q

What causes conversion of prothrombin to thrombin?

A

V/Xa

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10
Q

What causes conversion of fibrinogen into fibrin?

A

Thrombin

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11
Q

What affect does thrombin have on IX?

A

Activates it

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12
Q

What 3 things could case failure of secondary haemostasis?

A

Single clotting factor deficiency
Multiple clotting factor deficiency
Increased fibrinolysis

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13
Q

What 2 tests can you do for fibrin clot formation and what factors do they represent?

A

Prothrombin time - TF, VIIa

Activated partial thromboplastin time - VIII/IXa

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14
Q

What breaks down fibrin to fibrin degradation products?

A

Plasmin

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15
Q

What does antithrombin do?

A

Inactivates Xa and thrombin

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16
Q

What do protein C and S do?

A

Inactivate Va and VIIIa

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17
Q

What is the commonest cause of platelet plug formation failure?

A

Thrombocytopenia

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18
Q

What are the 2 causes of thrombocytopenia?

A

Increased destruction - DIC, immune thrombocytpoenic purpura, hyersplenism
Reduced production

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19
Q

Name 2 causes of reduced platelet function?

A

Drugs - aspirin, NSAIDS

Renal failure

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20
Q

What mode of inheritance if von willebrands disease?

A

Autosomal dominant

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21
Q

Name 1 vascular cause of platelet plug formation failure?

A

Henoch schonlein purpura

22
Q

What are the 3 causes of multiple clotting factor deficiencies?

A

Liver failure
Vitamin K deficiency
Complex coagulopathy

23
Q

What does liver failure cause clotting factor deficiencies?

A

Because clotting factors are produced in hepatocytes

24
Q

Which clotting factors are carboxylated by vitamin K?

A

II, VII, IX, X

25
Q

What is required for vitamin k absorption?

A

Bile salts

26
Q

Name the 3 steps of disseminated intravascular coagulation?

A

Excessive activation of haemostasis
Microvascular thrombus
Clotting factor consumption

27
Q

Which types of haemophilia is more common?

A

A

28
Q

What factors are involved in haemophilia A and B?

A

A - VIII

B - IX

29
Q

What is the normal PT time?

A

10-14 seconds

30
Q

Where is the abnormality of PT is prolonged?

A

Extrinsic pathway

31
Q

Causes of prolonged PT?

A

Liver disease, warfarin, DIC

32
Q

What is the normal APTT time?

A

30-40 seconds

33
Q

Where is the abnormality if the APTT is prolonged?

A

Intrinsic pathway

34
Q

Causes of prolonged APTT?

A

Liver disease
Heparin
Haemophilia
DIC

35
Q

How does Heparin work?

A

It potentiates anti thrombin

36
Q

What is the benefit of LMWH over unfractionated?

A

Less monitoring needed

37
Q

Name 2 LMWH’s?

A

Fragmin, dalteparin

38
Q

How do you monitor unfractionated heparin?

A

APTT

39
Q

What can be used to reverse heparin?

A

Protamine Sulphate

40
Q

How does warfarin work?

A

Block ability of vitamin K to carboxylate

41
Q

How is INR calculated?

A

Patients PT/Mean normal PT

42
Q

How does dabigatran work?

A

Thrombin inhbitor

43
Q

How to rivaroxiban and apixiban work?

A

Xa inhbitors

44
Q

What sort of drugs are needed to treat an arterial thrombosis?

A

Anti platlets

45
Q

What sort of drugs are needed to treat a venous thrombosis?

A

Anti-coagulants

46
Q

Name 4 risk factors for arterial thrombosis?

A

High cholesterol
Diabetes
Hypertension
Smoking

47
Q

Name 2 conditions caused by a stable atherosclerotic plaque?

A

Stable angina and intermittent claudication

48
Q

Name 2 conditions caused by an unstable atherosclerotic plaque?

A

MI or stroke

49
Q

How does clopidogrel?

A

ADP receptor antagonist

50
Q

What type of dipyridamole?

A

Phosphodiesterase

51
Q

When should anti platelets be stopped before elective surgery?

A

7 days

Haematology (5 decks)

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