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54 Cards in this Set
- Front
- Back
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normal platelet count
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150 to 400 thousand
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where are platelets stored?
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spleen
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megakarocytes
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baby platelets
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where is thrombopoietin?
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liver, kidneys, smooth muscle and bone marrow
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steps of hemostasis (5)
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Vessel spasm (temp.)- reduces blood flow
Formation of platelet plug- platlets adhere to broken site and aggregate there blood coagulation- activation of intrinsic and extrinsic paths, fibrinogen to fibrin clot retraction- proteins pull platelets together, clot gets smaller clot dissolution |
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what contributes to vasoconstriction in 1st line of defense?
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thromboxane A2
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what factor contributes to platelet adherance to injured ares??
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von willebrand's factor
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what causes platelets to be sticky
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adenosine diphosphate
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platelet limiting functions
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keeps clotting under control
prostacyclin (limits plts) nitric oxide (vasodilator) |
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what helps convert fibrinogen to fibrin?
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thrombin
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what pathways is released first?
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extrinsic pathway
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what pathway is most powerful but slow?
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intrinsic pathway
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what factor causes prothrombin to convert to thrombin and thrombin to convert fibrinogen to fibrin?
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factor x
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coagulation requires what 2 nutrients?
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vitamin K and calcium
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what test measures heparin?
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aPtt
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what test mesures warfarin (coumadin)?
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PT
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which pathway does heparin help?
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intrinsic
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what is the antidote for heparin?
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protamine sulfate
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what is the antidote for coumadin?
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vitamin K
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what pathway does coumadin help?
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extrinsic
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what is the normal time for bleeding?
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2 to 8 minutes
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thrombocythemia
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lots of platelets
primary- tumors secondary- smoking, elevated lipids, cholesterol, DM, stress, ovulation |
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thrombolytic drugs end in?
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"ase"
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hereditary clotting problems
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factor V mutation- predisposes adults to DVT
Deficiencies of antithrombin 3 and protein C and S Increased Plaque adn damaged BVs |
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aquired clotting problems
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antiphospholipid (lupus)
thrombi cardiac valve vegetation dec plts |
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thrombocytopenia
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too few platelets d/t
dec. prod from bone marrow dec platelet survival time overconsumption of plts too many plts held in spleen |
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idiopathic throbocytopenic purpura
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kill own platelets
sudden onset of petechiae and purpura may follow viral infection splenogmegaly recover spontaneously |
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thrombotic thrombocytopenic purpura
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due to estrogen, pregnancy, drugs, infections, hemolytic uremic syndrome
vaginal bleeding petechiae purpura neuro hemolytic anemia jaundice |
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Drug indcued thrombocytopenia
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1st exposure takes longer than the second
Ag- Ab rxn platelets drop dramatically |
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platelet transfusion
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usually not necessary until less than 10.000
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Von willebrand's disease
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platelet disorder
von willebrand's factor deficiency platlets do not adhere often untreated |
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S and S of von willebrand's
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bruising
excessive menstruation nose bleeding Gi bleedign tx. oral contraceptives |
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Hereditary bleeding disorders (2)
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von willebrand's
hemophilia |
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hemophilia A
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factor 8 deficiency
intrinsic pathway disrupted affects males transmitted by females |
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s and s of hemophilia A
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nose bleed
blood in urine bruise bleed in airway bleeding into brain pain disability |
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tx. of hemophilia A
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give factor 8
cryoprecipitate |
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hemophilia B
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affects males
transmitted by females x linked clinically indistinguishable from hemophilia A factor 9 deficiency |
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hemophilia C
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factor 11 deficiency
affects males and females equally bleeding is less severe than A and B |
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Disseminated INtravascular coagulation
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clotting and bleeding at the same time
in microvessels clotting can lead to ischemia or infarction life threatening*** |
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causes of DIC
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venomous snake bite
trauma trnasfusion of incompatible blood shock graft rejection eclampsia |
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what is the most accurate test for DIC?
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D Dimer
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If fibrinogen level is increased?
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clot too much
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if fibrinogen level is decreased?
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dont clot well
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fibrin split products
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lots of broken pieces
increased in DIC |
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fresh frozen plasma replaces?
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clotting factor and prothrombin
may give it rapidly |
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cryoprecipitate replaces
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fibrinogen and factor 8
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Henoch Schonlein Purpura
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nonthrombocytopenic
vasculitis causes bleeding into tissues |
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S and S of Henoch Schonlein Purpura
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symmetric purpura on buttocks and lower extremeties
edema |
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1 unit of whole blood contains
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1 unit RBC
1 unit platelets 1 unit FFP |
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1 unit of packed RBC's contains
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~180ml RBC
100 ml optisol (extend shelf life) ~30ml plasma **no clotting factors** |
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factor 8 concentrate treats?
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hemophilia A
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factor 9 concentrate treats?
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hemophilia B
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1 unit of cryoprecipitate contains?
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100 units of factor 8 and von willebrand's factor
150 to 250 mg of fibrinogen some factor 8 and fibronectin **prepared from donated whole blood **no compatibility testing |
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IV volume expanders
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albumin
plasmanate treats shock, hypovolemia |
