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41 Cards in this Set

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Coag factor names:
x,xi,xii,xiii
stuart
plasma thromboplastin antecedent
hageman
fibrin stabilizing factor
Measures extrinisic factors that are K dependant
(i,ii,V,Vii,x)
Monitor warfarin
Prothrombin time
Drawn in blue top, have correct ratio of blood to anticoag, not older than 12 hours
Prothrombin time
INR of prothrombin
2-3
Interfere with Prothrombin time
Long-alcohol,diarrhea
Short-fat diet,benadryl
Used post hip/knee surgery,a fib,PE,DVT,TIA
Slow acting
Reversed with Vit. K
Warfarin(Coumadin)
Measures intrinsic system (all factors but iii and vii)
Monitor Heparin
Partial Thromboplastin time(PTT)
Interfere with PTT
short - malignancy
long - antihistamine,vit.c,salicylates
Short lived
Inactivates prothrombin by acceleration of antithrombin
Checked with PTT every 6 hours
Heparin
Inhibits conversion of fibrinogen to fibrin
Replaced by D-dimer
Inc'd in thromboembolic conditions
Fibrin Split Products
Most specific test of DIC
Inc'd in DIC,PE,DVT
Produced by the break down of fibrin by plasmin
Fibrin D-dimers
90min to 6 hours
Primary/secondary fibrinolysis detected
Euglobin Lysis Time
Associated with primary fibrinolysins-measured by euglobin lysis time
proteins in malignancies/shock/sepsis and secondarily work on fibrin thru fibrinogen
Associated with secondary fibrinolysins-measured by euglobin lysis tim
proteins in normal response to blood clotting and primarily work on fibrin
Adults 200-400
<100 results in spontaenous bleeding
Acute phase reaction protein
Part of common coagulation cascade
Fibrinogen
Low levels of this in large volume blood transfusions
Fibrinogen
NL 8-12 sec
Plasma sample + thrombin
Assesses final stage of cascade
Used to detect Heparin,dec'd fibrinogen, or evaluation of prolonged PTT
Thrombin time
Pt who easily bruises has a short or long prothrombin time?
Long
NL 18-22 sec
Pit viper venom used in Thrombin time test
Reptilase time
Natural occuring anticoagulant, inactivates thrombin
Deficiency may lead to thrombosis
Antithrombin iii
Deficiencies in these two proteins can lead to hypercoaguable states and thromboembolic disease.
S and C they are Vit k dependant
Involves excessive repetitive bleeded
Congenital or acuired
Bleeding disorders
Lab tests for bleeding disorders
CBC,platelet,bleeding time, PT,PTT,TT
Dec'd number of platelets
thrombocytopenia
Common in children with URI
Onset of petechiae/purpura
Dec'd platelets
Resolves spontaneously
Acute idiopathic thrombocytopenia purpura(ITP)
More common in women, autoimmunity present
Dec'd platelets
Tx:corticosteroids,gamma globulin
Chronic ITP
Prolonged PTT,PT,TT
Dec'd platelets,fibrinogen
Shistocytes on smear
Inc'd D-dimer
Widespread deposition of thrombi
Platelet consumption syndrome(DIC)
Key symptom is bleeding
Treat underlying cause
Use FFP to replace clotting factors
Ddimer test,Fibrin split products
DIC
rare,fatal
Severe thrombocytopenia with purpura
Hemolytic anemia
Neg. Coombs
Tx:corticosteroids,FFP,plasmapheresis
Thrombotic thrombocytopenia purpura (TTP)
Associated with Ecoli
In children,
Similiar to TTP, limited to kidney
Hemolytic uremic syndrome
Pregnancy induced-(preeclampsia/eclampsia,htn)
Abnormal prostaglandin metabolism
Reversed by delivery
Hemolysis, elevated liver enzymes, low platelets (HELLP)
Congenital or acquired
Acquired from ASA/NSAID use
Seen in alcoholism
NL platelet count with abnormal bleeding times
tx:dialysis,discontinue drug use
Platelet dysfunction
X-linked
Excessive bleeding everywhere
Prolonged PTT,PT
Factor viii reduced
HEmophilia A
Tx: for hemophilia A
FFP
DDAVP
cryoprecipitate
Less frequent than hemophilia A
Christmas disease
Hemophilia B
Congenital, autosomal dominant
Nasal,vaginal,Gi,sinus,hemarthroses bleeding
dec'd factor viii
Vonwillebrands disease
Tx: FFP,DDAVP,cryoprecipitate
Common aquired coagulopathy
Malnutrion/malabsorption
NL bleeding time
Vit k deficiency
Labs for platelets
count
bleeding time
Labs for coagulation
PT,aPTT,TT,fibrinogen
Labs for fibrinolysis
euglobin lysis time
Labs for clot degradation
D-dimer,FDPs