Clotting Factors

Front 1

Factor I

Back 1

Fibrinogen

Source: Liver

Front 2

Factor II

Back 2

Thrombin

Source: Liver

Vitamin K Dependent

Front 3

Factor III

Back 3

Tissue factor or Thromboplastin

Source: Vascular wall & extravascular cell membranes; released from traumatized cells

Front 4

Factor IV

Back 4

Calcium

Source: Diet

Front 5

Factor V

Back 5

Proaccelerin

Source: Liver

Front 6

Factor VII

Back 6

Proconvertin

Source: Liver

Vitamin K dependent

Front 7

Factor VIII:C

Back 7

Antihemophiliac Factor

Source: Liver

Front 8

Factor VIII:V or VIII:R

Back 8

VonWillibrand's Factor

Source: vascular endothelial cells

Front 9

Factor IX

Back 9

Christmas Factor

Source: Liver

Vitamin K dependent

Front 10

Factor X

Back 10

Stuart-Prower Factor

Source: Liver

Vitamin K dependent

Front 11

Factor XI

Back 11

Plasma thromboplastin antecedent

Source: Liver

Front 12

Factor XII

Back 12

Hageman Factor

Source: Liver

Front 13

Factor XIII

Back 13

Fibrin-stabilizing factor

Source: Liver

Front 14

Protein C

Back 14

Source: Liver
Vitamin K dependent

Thrombin (Factor II) activates protein C which promotes fibrnolysis by causing release of tPA from endothelial cells

Front 15

Protein S

Back 15

Source: Liver
Vitamin K dependent

Front 16

Na+-K+ pump

Back 16

3Na+ out
2K+ in
Stimulated by insulin & beta agonist

Front 17

Extrinsic Pathway

Back 17

Factors 3, 7

Front 18

Intrinsic Pathway

Back 18

Factors 12, 11, 9, 8

Front 19

Common final pathway

Back 19

Factors 5, 10, 1, 2, 13

Front 20

Coumadin acts on which clotting pathway? Which lab value assesses?

Back 20

Extrinsic
PT

Front 21

Heparin acts on which pathway? Which lab value(s) assess?

Back 21

Intrinsic and common final
PTT/ACT

Front 22

VonWillibrand's Disease is a deficiency of what factor? How do you treat?

Back 22

Factor VIII:V or VIII:R
DDAVP, Cryoprecipitate, Factor VIII

Front 23

Cryoprecipitate contains what?

Back 23

Factors I, VIII, XIII

Note: both VIII:C & VIII:R/V

Front 24

Vitamin K dependent factors are what?

Back 24

Factors II, VII, IX, X

Front 25

Hemophilia A is associated with what factor? How do you treat?

Back 25

VIII:C
FFP, cryoprecipitate

Front 26

Hemophilia B is associated with what factor? How do you treat?

Back 26

IX
Treatment with Factor IX

Front 27

What is DDAVP? What is the dose? What is a side effect in children?

Back 27

d-amino-d-arginine vasopressin
Causes endogenous release of stores of vWF
Dose: 0.3mcg/kg IV over 15-20min; Wears off 4-6hrs
Hyponatremia in children

Front 28

How do ASA & NSAIDS work? How long does their effect last?

Back 28

Cause acetylation of cyclooxygenase (COX) which is the rate-limitin enzyme in conversion of arachidonic acid to thromboxane A2;
Aspirin is life of platelet (8-12 days)
NSAIDS 24-48hrs

Front 29

What are the steps in Thrombin activating platelet thru aggregation?

Back 29

Thrombin-phospholipid-arachidonic acid-cyclooxygenase-prostaglandin G2 (PGG2)-prostaglandin H2 (PGH2)- variety of prostaglandins and thromboxane A2-aggregation

Front 30

What is the most common inherited blood clotting defect? What is the most common acquired?

Back 30

VonWilibrand's Dx-inherited
ASA/NSAIDS-acquired

Front 31

How does Protamine work?

Back 31

Combines with Heparin, Protamine is postively charged & Heparin is negatively charged so it is a "neutralization"

Front 32

How does Coumadin work?

Back 32

Coumadin binds to Vitamin K receptor in liver to inhibit Vitamin K = decreased production of Vitamin K factors

Front 33

Transfused blood is deficient of what?

Back 33

Platelets, Factor V, Factor VIII

Front 34

What 2 drugs inhibit plasmin?

Back 34

Amicar & aprotinin

(Plasmin degrades fibrin clot)

Front 35

When do platelets in stored blood become non-functional?

Back 35

1-2days

Front 36

1 unit of PRBC's raises Hgb & Hct how much?

Back 36

Hgb: 1g/dL
Hct: 3-4%; 1cc/kg will increase 1%

Front 37

One unit of platelets will increase the count by how much?

Back 37

5,000-10,000

Front 38

Where is erythropoietin made?
What stimulates it's release?
Once stimulated, what does it do?

Back 38

Kidneys (90%), Liver (10%)
Hypoxia
Stimulates bone marrow to produce & release RBC's

Front 39

What is the lifespan of a RBC?

Back 39

120 days

Front 40

Hgb is broken down into what?

Back 40

Iron & porphyrin (then bilirubin)

Front 41

What is the most important determinant of blood viscosity?

Back 41

Hct

Front 42

What is aplastic anemia?

Back 42

failure of bone marrow, usually from chemotherapy

Front 43

What is megoblastic/pernicious anemia?

Back 43

Vit B12 or folic acid deficiency, RBC's don't mature

Front 44

What is iron deficient anemia?

Back 44

Hypochromic, microcytic RBC's

Front 45

What is hemolytic anemia?

Back 45

Normal RBC production, shortened lifespan;
Types: hereditary spherocytosis (abnormal RBC membrane), enzyme defect (glucose-6-phosphate-dehydrogenase deficiency), abnormal Hgb (sickle cell)

Front 46

What do avoid in glucose-6-phosphate-dehydrogenese deficiency?

Back 46

Avoid: nitroprusside & prilocaine = increases risk cyandie toxicity; Also Avoid: ASA, PCN, streptomycin, sulfonamides, quinidine, doxorubicin, methylene blue; All may trigger hemolytic crisis

Front 47

What are some side effects of Protamine? How do you dose Protamine?

Back 47

hypotension, allergic reaction, pulmonary hypertension;
Dose: 1-1.3mg/100 units Heparin

Front 48

How does Antithrombin III work?

Back 48

Strongly inhibits/binds: Factor II & Factor X
Partially inhibits: IX, XI, XII

Front 49

If a patient is unresponsive to Heparin, how do you treat?

Back 49

Give FFP, FFP has all coagulation & anticoagulation factors that are made by the liver