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54 Cards in this Set

  • Front
  • Back
normal platelet count
150 to 400 thousand
where are platelets stored?
spleen
megakarocytes
baby platelets
where is thrombopoietin?
liver, kidneys, smooth muscle and bone marrow
steps of hemostasis (5)
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
what contributes to vasoconstriction in 1st line of defense?
thromboxane A2
what factor contributes to platelet adherance to injured ares??
von willebrand's factor
what causes platelets to be sticky
adenosine diphosphate
platelet limiting functions
keeps clotting under control
prostacyclin (limits plts)
nitric oxide (vasodilator)
what helps convert fibrinogen to fibrin?
thrombin
what pathways is released first?
extrinsic pathway
what pathway is most powerful but slow?
intrinsic pathway
what factor causes prothrombin to convert to thrombin and thrombin to convert fibrinogen to fibrin?
factor x
coagulation requires what 2 nutrients?
vitamin K and calcium
what test measures heparin?
aPtt
what test mesures warfarin (coumadin)?
PT
which pathway does heparin help?
intrinsic
what is the antidote for heparin?
protamine sulfate
what is the antidote for coumadin?
vitamin K
what pathway does coumadin help?
extrinsic
what is the normal time for bleeding?
2 to 8 minutes
thrombocythemia
lots of platelets
primary- tumors
secondary- smoking, elevated lipids, cholesterol, DM, stress, ovulation
thrombolytic drugs end in?
"ase"
hereditary clotting problems
factor V mutation- predisposes adults to DVT
Deficiencies of antithrombin 3 and protein C and S
Increased Plaque adn damaged BVs
aquired clotting problems
antiphospholipid (lupus)

thrombi
cardiac valve vegetation
dec plts
thrombocytopenia
too few platelets d/t

dec. prod from bone marrow
dec platelet survival time
overconsumption of plts
too many plts held in spleen
idiopathic throbocytopenic purpura
kill own platelets
sudden onset of petechiae and purpura
may follow viral infection
splenogmegaly
recover spontaneously
thrombotic thrombocytopenic purpura
due to estrogen, pregnancy, drugs, infections, hemolytic uremic syndrome

vaginal bleeding
petechiae
purpura
neuro
hemolytic anemia
jaundice
Drug indcued thrombocytopenia
1st exposure takes longer than the second

Ag- Ab rxn
platelets drop dramatically
platelet transfusion
usually not necessary until less than 10.000
Von willebrand's disease
platelet disorder
von willebrand's factor deficiency
platlets do not adhere
often untreated
S and S of von willebrand's
bruising
excessive menstruation
nose bleeding
Gi bleedign

tx. oral contraceptives
Hereditary bleeding disorders (2)
von willebrand's
hemophilia
hemophilia A
factor 8 deficiency
intrinsic pathway disrupted
affects males
transmitted by females
s and s of hemophilia A
nose bleed
blood in urine
bruise
bleed in airway
bleeding into brain
pain
disability
tx. of hemophilia A
give factor 8
cryoprecipitate
hemophilia B
affects males
transmitted by females
x linked
clinically indistinguishable from hemophilia A
factor 9 deficiency
hemophilia C
factor 11 deficiency
affects males and females equally
bleeding is less severe than A and B
Disseminated INtravascular coagulation
clotting and bleeding at the same time
in microvessels clotting can lead to ischemia or infarction
life threatening***
causes of DIC
venomous snake bite
trauma
trnasfusion of incompatible blood
shock
graft rejection
eclampsia
what is the most accurate test for DIC?
D Dimer
If fibrinogen level is increased?
clot too much
if fibrinogen level is decreased?
dont clot well
fibrin split products
lots of broken pieces

increased in DIC
fresh frozen plasma replaces?
clotting factor and prothrombin
may give it rapidly
cryoprecipitate replaces
fibrinogen and factor 8
Henoch Schonlein Purpura
nonthrombocytopenic
vasculitis causes bleeding into tissues
S and S of Henoch Schonlein Purpura
symmetric purpura on buttocks and lower extremeties
edema
1 unit of whole blood contains
1 unit RBC
1 unit platelets
1 unit FFP
1 unit of packed RBC's contains
~180ml RBC
100 ml optisol (extend shelf life)
~30ml plasma

**no clotting factors**
factor 8 concentrate treats?
hemophilia A
factor 9 concentrate treats?
hemophilia B
1 unit of cryoprecipitate contains?
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
IV volume expanders
albumin
plasmanate

treats shock, hypovolemia