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;
24 Cards in this Set
- Front
- Back
What is DIC?
|
It is a disease of small thromboses everywhere in the body that does not cause a symptom per se, but because of the consumption of normal clotting components, a deficiency develops and the patient starts bleeding from various sites.
|
|
What symptom in the hands would make you think DIC?
|
Dark fingernails.
|
|
What two things could make DIC worse?
|
DIC is worsened by acidosis and massive transfusion (when the patient requires the approximate same volume of blood his/her blood in blood transfusions in a 24 hour period).
|
|
What is the main cause of DIC?
|
A. Some of the most common causes of DIC are related to the release of tissue factor or tissue factor-like substance (i.e., thromboplastic substances) in circulation.
|
|
What does tissue factor bind to?
|
Factor VIIa
|
|
What type of leukemia causes DIC?
|
APL
|
|
What does the initiation phase consist of?
|
Tissue Factor combining with Factor VII leading to the activation of Factor X.
|
|
What does the propagation phase consist of?
|
Factors VIII and IX activating Factor X to help activate thrombin to form a clot and to activate Protein C.
|
|
How does gram (-) bacteria cause DIC?
|
LPS causes increased expression of Tissue Factor on the surface of the cells via TNF and IL-1 along with decreased expression of Thrombomodulin.
|
|
When do you confirm DIC from laboratory tests?
|
1. High D-Dimers
2. Low Platelet count 3. Fragmented RBC (schistocytes) 4. Decreased Fibrinogen 5. Prolonged PT and PTT 6. Decreased levels of antithrombin, protein C, and protein S |
|
Does fibrinogen have to be decreased to diagnose DIC?
|
No
|
|
What is a D-Dimer? What creates it?
|
1. Small part of a clot that is cleaved off curing clotting. Elevated D-Dimers mean elevated clotting.
2. Plasmin |
|
What others things does plasmin do?
|
1. Makes D-Dimers
2. Cleaves Factors V, VII, IX, and high molecular weight kininogen 3. Activates platelets |
|
What D-Dimer level is indicative of DIC?
|
D-dimer level is much increased, >10,000ng/ml (normal range: 110-240ng/ml).
|
|
In a DIC patient, what is their level of RDW like?
|
It is elevated
|
|
Prothrombin test mimics what? What is the reactant in the tube?
|
The initiation phase of clotting. Basically adding Tissue Factor to see how long it takes to start clotting?
Sodium Citrate |
|
PT is really testing for activity in what factors?
|
It is testing to see how factor VII is activating II, V, X, XI.
|
|
PT is reliant on what factor the most?
|
Factor VII
|
|
PTT measures what phase? What factors are not involved in this?
|
Propagation (Intrinsic) phase
Factors VII |
|
What factor is involved with hemophilia A?
|
Factor VIII
|
|
What factor is involved with hemophilia B?
|
Factor IX
|
|
What factor is involved with hemophilia C?
|
Factor XI
|
|
Protein C and S are both dependent on what Vitamin?
|
K
|
|
Anithrombin inactivates what factors?
|
Antithrombin inactivates factors XIIa, XIa, Xa, IXa, IIa.
|