Cvt - Path Exam 2 Alterations In Hemostasis And Blood Coagulation

Front 1

hemostasis:

Back 1

means arrest of bleeding or prevention of blood loss

Front 2

Stages of hemostasis:

Back 2

1st-vasoconstriction (immediate response)
2nd-formation of platelet plug
3rd-coagulation (fibrin clot)
4th-clot retraction (firm clot bc serum leaves clot)

Front 3

platelets:

Back 3

-norm: 250-400K
-come from megakaryocytes in marrow (platelets)
-70% circulate throughout the body
-30% located in the spleen
-10 day life span
-catalyze conversion of prothrombin to thrombin

Front 4

What are the blood coagulation factors?

Back 4

1. plasma proteins from liver
2. vitamin K necessary (from liver and bacteria)
3. calcium

Front 5

How many multiple factors are involved in the coagulation process?

Back 5

14

Front 6

What are the disorders of hemostasis and coagulation?

Back 6

1. vascular purpura
2. hereditary hemorrhagic telangiectasia
3. platelet disorders
4. coagulation disorders

Front 7

vascular purpura:

Back 7

-petichiae, ecchymoses
-caused by drug allergy, old age, vitamin C deficiency (poor collagen)

Front 8

ecchymoses:

Back 8

large hemorrhages into the skin

Front 9

What test can be performed to determine purpura?

Back 9

tourniquet test

Front 10

telangiectasias:

Back 10

-network of fine vessels
-congenital disorder
-a vascular lesion formed by dilation of a group of small vessels

Front 11

hemophilia:

Back 11

-congenital tendency to uncontrolled bleeding; usually affects males and is transmitted from mother to son

Front 12

petechiae:

Back 12

-pinpoint red spots from broken capillaries in the skin

Front 13

pallor:

Back 13

-extreme or unnatural paleness

Front 14

jaundice:

Back 14

-yellowish discoloration of the whites of the eyes, skin, and mucous membranes
-caused by deposition of bile salts in these tissues, occurring as a symptom of various diseases, such as hepatitis, that affect the processing of bile.

Front 15

Prothrombin time (PT) is associated with which pathway?

Back 15

extrinsic

Front 16

APTT is associated with which pathway?

Back 16

intrinsic

Front 17

Clinical assessment list:

Back 17

1. family and personal history
2. vascular and platelet defects usually after trauma
3. coagulation defects
4. systemic disease
5. medications as cause
6. petechiae
7. pallor or jaundice
8. ecchymosis (hematoma)
9. bleeding from body systems

Front 18

thrombocytopenia:

Back 18

Ex: ITP
-deficiency of platelets
-platelets are <150,000

Front 19

ITP stands for:

Back 19

Idiopathic Thrombocytopenia Purpura
-viral

Front 20

Causes of thrombocytopenia:

Back 20

virus, drugs, folate/B12 deficiency, radiation, chemotherapy, blood dyscrasias, AIDs

Front 21

4 mechanisms of thrombocytopenia:

Back 21

1. less platelet production
2. less platelet survival
3. splenic pooling (pooled platelets)
4. intravascular transfusion (massive transfusions)

Front 22

Symptoms of pts with multiple transfusions:

Back 22

decreased clotting ability, more subject to bleeding, BP will not go back to normal

Front 23

Diagnosis of thrombocytopenia:

Back 23

decreased platelets, increased bleeding time, history of drugs (ASA)

Front 24

1. What does heparin do?
2. What does coumadin do?
3. What does ASA do?
4. What do all 3 drugs have in common?

Back 24

1. decrease thrombin
2. decrease Vitamin K
3. decrease platelets
4. all are anticoagulants

Front 25

causes of thrombocytosis:

Back 25

polycythemia, hemorrhage, infection, malignancy

Front 26

Tx for thrombocytosis:

Back 26

anti-platelet therapy such as ASA

Front 27

List the 2 platelet disorders:

Back 27

thrombocytopenia and thrombocytosis

Front 28

List the 5 coagulation disorders:

Back 28

1. hemophilia
2. hemorrhagic disease of newborn
3. disseminated intravascular coagulation (DIC)
4. vitamin K deficiency
5. hepatic disease

Front 29

Causes of hemophilia:

Back 29

1. hereditary disease, affects mostly young males
2. 85% A disease (factor VIII deficiency)
3. 15% B diseaes (factor IX deficiency)

Front 30

Diagnosis of hemophilia:

Back 30

1. deficiency in factors VIII and IX
2. prolonged APTT

Front 31

Treatment for hemophilia:

Back 31

1. patient education
2. Factor VIII (type A)
3. Fresh plasma or factor concentrate in type B

Front 32

Hemorrhagic disease of newborn:

Back 32

-vitamin K deficiency causing a decrease in coagulation factors
-occurs 48-72 hrs after birth
-breast milk has less vitamin K than formula

Front 33

DIC:

Back 33

=Disseminated intravascular coagulation
-all abnormal coagulation studies

Front 34

Causes of DIC:

Back 34

sepsis, malignancy trauma (due to bleeding disorder), transfusions, burns, shock, severe liver disease

Front 35

Effects of DIC:

Back 35

1. clotting and bleeding occur simulaneously
2. clotting in small vessels
3. coagulation factors consumed and fibrinolysis occurs

Front 36

Clinical indications of DIC:

Back 36

1. bleeding
2. thrombi (causing pulmonary and renal shutdown)

Front 37

Tx of DIC:

Back 37

1. fresh frozen plasma
2. give pt more RBCs and platelets
3. Heparin (anti-coagulant may be possible)

Front 38

List the 4 fat soluble vitamins:

Back 38

Vitamin A, D, E, K

(means the vitamins need fat in order to be absorbed)

Front 39

Causes of vitamin K deficiency:

Back 39

1. malabsorption of fats
2. anticoagulant therapy (coumadin affects K+)
3. hepatic disease
4. PT is increased