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28 Cards in this Set
- Front
- Back
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PTT measures intrinsic or extrinsic?
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measures intrinsic pathway
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What triggers the extrinsic pathway to be activated?
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Tissue factor (released with exposed endothelium)
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Bleeding if lacking factor XII, HMWK or PK?
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no, long PTT but no bleeding
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Bleeding if lacking VIII or IX?
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Yes, long PTT and serious bleeding
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Acute onset of coagulation disorder indicative of what?
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an acquired disorder
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Longer duration of onset of clotting disorder indicative of what?
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congenital disorder
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What is DIC?
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disorder of hemostasis, usually a result of sepsis (so acquired), you get a lot of small clots throughout the body that consume clotting factors so you get tons of bleeding
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If you see petechiae, what do you think of in terms of bleeding?
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think platelet disorder or von Willebrand disease
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What is factor VIII def?
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Hemophilia A
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What is factor IX def?
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Hemophilia B
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What are "inhibitors" with respect to hemophilia?
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antibodies against FVIII or FIX
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Tx for "inhibitors"?
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Rcombinant factor FVIIa
FEIBA (activated factor everything) |
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What is the most common congenital bleeding disorder?
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von Willebrand disease
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Inheritance of von Willebrand?
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autosomal dominant
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What is the defect of von Willebrand's and what factor is decreased?
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No aggregation, also decreased factor VIII because the gene for vWf caries factor VIII as well
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What can alter the lab findings of vW dz?
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OCPs
less than 1 year old |
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What is tx for vW tx?
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DDAVP (releases vWF stored in endothelial cells and platelets)
Aminocaproic acid (Amicar) which is a plasminogen activator inh so inh breakdown of clots |
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Causes for hemorrhagic dz of newborn (Vit K def):
0-24 hours 1-7 days 2wks-6mos |
Early: maternal rx
Classic: lack of Vit K or maternal rx Late: dietary, diarrhea, liver dz |
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How does TPA work?
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activates plasminogen to plasmin which breaks up fibrin clots
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What is "lupus anticoagulant?"
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Antiphospholipid antibody syndrome
autoimmune disorder where abs bind to endothelial surface and tricks body into thinking there's injury there |
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Factor V Leiden = ?
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Protein C can't bind Factor V so you get clot
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Which factors are formed in the liver?
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2, 7, 9, 10
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What are these types of bleeding suggestive of?
mucosal/petechiae vs muscle/joint |
mucosal/petechiae: platelet disorder or von Willebrand disease
Muscle/joint: factor deficiency |
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What happens in terms of prolonged test time and bleeding iwth deficiency in prekalikrien, HK, FXII?
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prolonged PTT
no bleeding |
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Which factors in a prolonged PTT (nl PT) would also give bleeding if deficient?
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FXI
FIX FVIII |
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Which factors if deficient show prolonged PTT, and PT?
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FX
FV FII FI |
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What does heparin do?
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Binds and activates AT-III
AT-III activates serine proteases to break down clotting factors |
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What does coumadin/warfarin do?
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inhibits the recycling of vitamin K, so all vit K dependent factors (2, 7, 9, 10) can't work because they can't be gamma carboxylated
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