SEE 2025 (Apex) > Coagulation > Flashcards

Coagulation Flashcards

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1
Q

Do platlets have DNA?

A

NO

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2
Q

Normal platelet value:
lifespan?

A

150,000-300,000

lifespan = 8-12 days

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3
Q

Which substance is responsible for adhering the platelet to the damged vessel?

A

Von Willenbrand factor

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4
Q

3 steps of platelet plug

A
  1. Adhesion (vWf)
  2. Activation
  3. Aggregation
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5
Q

Coagulation factor that affects all pathways?

A

Calcium

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6
Q

Mnemonic for Coagulation Cascade

A

Foolish
People
Try
Climbing
Long
Slopes
After
Christmas
Some
People
Have
Fallen

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7
Q

Intrinsic Pathway =

A

12, 11, 9, 8

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8
Q

Vitamin K dependent factors =

A

2,7,9,10

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9
Q

Factor __ (____) is the first factor acvtivated in the extrinsic pathway

A

3 (tissue factor)

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10
Q

Faster pathway =
includes factors?
measured by?
inhibited by?

A

extrinsic
3 and 7
PT amd INR
Warfarin

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11
Q

Intrinsic Pathway factors =

A

12, 11, 9, 8

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12
Q

Factor 6?

A

Doesnt exist!

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13
Q

Key facts about Intrinsic Pathway:
activated by?
Factors?
Speed?
Measured by?
Inhibited by?

A

blood trauma
12,11,9,8
slower than extrinsic
PTT and ACT
Heparin

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14
Q

Final Common Pathway steps:
1.
2.
3.

A
  1. Prothrombnin activator activates Thrombin
  2. Thrombin activates fibrin monomer
  3. Activated fibrin stabilizing factor crosslinks fibrin
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15
Q

What is the primary goal of both pathways?

A

to produce prothrombin activator (prothrombinase)

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16
Q

The final common pathway begins where ______ changes _____(2) to _____ (2a)

A

prothrombin activator (prothrombinase)
prothrombin
thrombin

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17
Q

___ inhibitor inhibits the conversion of plasminogen to plasmin

A

tPA

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18
Q

Where is plasminogen synthesized?

A

Liver

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19
Q

What is the BEST predictor of bleeding during surgery?

A

H & P

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20
Q

aPTT assesses the ____ and __ pathways.
Normal?

A

intrinsic and final common pathway

25-32 seconds

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21
Q

PT assesses the ____ and ____ pathways
Normal?

A

extrinsic and final common
12-14 seconds

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22
Q

ACT guides what?
Normal?

A

heparin dosing
90-120 seconds

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23
Q

D-Dimer measures?
normal?

A

monitors fibrinolysis
if it’s increased there is likely a thrombus somewhere

< 500 mg/mL

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24
Q

Hepain inhibits the….

A

intrinsic and final common pathways

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25
Warfarin inhibits factors:
2,7,9,10 (vitamin k antagonist) Also inhibits protein C and S
26
How can Warfarin be reversed?
vitamin K (slow) or FFP (fast)
27
Requires the presence of fat and bile for absorption
Vitamin K
28
ADP receptor antagonist --> GpIIb/IIIa receptor antagonist--> Vitamin K antagonist --> Antithrombin cofactor -->
Clopidrogrel Abciximab Warfarin Enoxaparin
29
Most common inherited disorder of platelet function:
Von Willenbrand
30
VWf function?
anchors platlet to vessel wall at the vascular injury also carries inactivated factor 8 in the plasma
31
VW disease: lab abnormalities
incresed PTT and bleeding time
32
vW disease: ____ stimlulates the release of endogenous vWF and increases factor 8 activity
Desmopressin
33
vW disease: respond best to desmopressin?
Type 1 vWF disease
34
Type 1 vWF disease =
mild-moderate reduction in amount of vWF produced
35
Type 2 vWF disease =
vWF produced doesnt work well
36
type 3 vWF disease =
severe reduction in amount of vWF produced
37
Desmopressin dose for vWF type 1 =
03 mg/kg IV
38
What does Cryo contain? used for?
factors 8, 13, fibrinogen and vWF used for type 1,2,3 disease
39
What does FFP contain?
all clotting factors
40
Adjuncts for vWF disease:
Amicar or TXA
41
Which coagulopathies present with a prolonged PTT and normal PT?
Hemophilia A Hemophilia B
42
Hemophilia A causes factor __ deficiency
8 A is more severe than B
43
Hemophilia A: Treatment
give factor 8 before surgery FFP and Cryo can be used DDAVP can help TXA or amicar to minimize bleeding ALWAYS get type and crossmatch before surgery
44
Hemophilia B affects factor __
9 same anesthetic considerations at A
45
"last ditch" effort for bleeding without identifiable cause? dose?
Recombinat factor 7 20-40 mcg/kg
46
labs for DIC:
^ PTT/PTT ^ D-Dimer decreased platelets decreased fibrinogen
47
DIC: _____ is released in absence of vascular injury
tissue factor (factor 3)
48
HIT =...... Type 1 --> Type 2 -->
clot formation throughout body 1-resolves spontaneously 2-hypercoagulable state --> amputation and death
49
Factor ___ _____ causes resitance to anticoagulant effect of protein C
Factor 5 Leiden
50
Triggers of sickle cell crisis:
-pain -dehydration -hypoxemia -acidosis -hypothermia
51
Which Factor deficiencies are Hemophilia A and B?
A = Factor 8 deficiency B = Factor 9 deficiency
52
Cryo is indicated for:
Hemophilia A von Willenbrand Congenital dysfibrinogenemia
53
Lab findings in DIC: platelets = fibrinogen = PT/PTT = D-dimer =
platelets = decreased fibrinogen = decreased PT/PTT = increased D-dimer = increased d/t increase clot breakdwn
54
Cryo contains:
Fibrinogen (1) von Willendbrand Factor 8 Factor 13 Fibronectin
55
3 greatest triggers for DIC
-Sepsis -Malignancy -Amniotic fluid embolism
56
Best treatment for Type 3 von Willenbrand?
-Factor 8 concentrate -Cryo They DO NOT respond to desmopressin
57
Desmopressin dose?
0.3 mcg/kg
58
vW: mild-moderate reduction in amount of vWF produced=
Type 1
59
vW: vWF produced doesnt work well=
Type 2
60
vW: severe reduction in vWF production =
Type 3
61
Indications for FFP =
urgent reversal of warfarin Antithrombin deficiency
62
What clotting factor has the shortest half-life?
VII
63
Most common comorbidity associated with sickle cell disease ?
Asthma
64
What drug reduces the incidence of vaso-occlusive crisis in the patientg with sickle cell disease?
Hydroxurea
65
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