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26 Cards in this Set

  • Front
  • Back
Description of venous vs. arterial thrombosis
Venous - red, warm

Arterial - blue, cold
Color of a fibrin rich clot

What type of thromboembolism are these assoc. w/?
Assoc. w/ VENOUS thromboembolism
Color of a platelet rich clot

What type of thromboembolism are these assoc. w/?
Assoc. w/ ARTERIAL thromboembolism
What underlying disease is arterial thromboembolism often assoc. w/?
What is the consequence of high levels of homocysteine?
They increase the likelihood of clotting
4 most common congenital defects contributing to thrombosis
(in terms of molecules)
Factor V Leiden
Factor II mutation
MTHFR defect
What is the most common cause of primary elevated homocysteine?
MTHFR deficiency/defect
4 causes of secondary homocysteine elevation
B12 deficiency
Folate deficiency

Renal insufficiency
How is streptokinase different from other tPAs?
NOT a direct plaminogen activator

Complexes w/ plasminogen to activate others
When is thrombolytic therapy not as routinely used in PE?
When there is NO hemodynamic compromise
3 situations in which thrombolytic therapy is well accepted
Acute MI
Acute peripheral occlusive disease
Massive PE WITH hemodynamic instability
Contraindications to thrombolysis (8)
Internal bleeding in past 6 months
Intra-cranial/spinal disease
Operation in past 10 days
Bleeding disorder
3 DIRECT thrombin inhibitors
What does LMWH preferentially bind in order to inhibit clotting?
Factor Xa

Anti-factor Xa : Anti-thrombin activity is (2-4):1
Why does LMWH "prefer" Factor Xa over thrombin?
Factor Xa binding only requires a binding site
(ATIII binding req. 5 oriented residues)

Heparin chain my be less than 18 units
What are 3 main advantages of LMWH over UFH?
Better bioavailability --> predictable effect
Longer plasma half-life
Decreased hemorrhagic potential
What pts. still need monitoring while using LMWH (4)?
Decreased kidney function
Very large pts.
Very small pts.
Pregnant pts.
Which does protamine work better against, LMWH or UFH?
What is fondaparinux?
A synthetic inhibitor of Factor Xa
What is fondaparinux used for?
Prophylaxis ONLY

Given in knee/hip fractures/replacements
Is protamine sulfate effective in treating HITT?
What 2 drugs are approved for treating HITT?

How do they differ?
Reversibly binds thrombin, hepatically excreted

Irreversibly binds thrombin active site, renally excreted
Which effect PT values?

Indirect thrombin inhibtors, or Direct
Direct thrombin inhibitors
What does warfarin inhibit (2)?
Vit K epoxide reductase
Vit K reductase
What coagulation cascade factors are Vit K dependent?
Why is 4-5 days of heparin given to start Warfarin therapy?
Helps prevent warfarin-induced transient hypercoagulability
(due to reduced Protein C levels)