Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
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/? |
Red/purple
Assoc. w/ VENOUS thromboembolism |
|
|
Color of a platelet rich clot
What type of thromboembolism are these assoc. w/? |
White
Assoc. w/ ARTERIAL thromboembolism |
|
|
What underlying disease is arterial thromboembolism often assoc. w/?
|
Arteriosclerosis
|
|
|
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 Homocysteine |
|
|
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 HYPOthyroidism |
|
|
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 HTN Endocarditis Pericarditis Aneurysm Bleeding disorder |
|
|
3 DIRECT thrombin inhibitors
|
Argatroban
Bivalirubin Lepirudin |
|
|
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?
|
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?
|
NO
|
|
|
What 2 drugs are approved for treating HITT?
How do they differ? |
---Argatroban---
Reversibly binds thrombin, hepatically excreted ---Lepirudin--- 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?
|
II, VII, IX, X
|
|
|
Why is 4-5 days of heparin given to start Warfarin therapy?
|
Helps prevent warfarin-induced transient hypercoagulability
(due to reduced Protein C levels) |
