Ics-Heme-Pediatric: Hemostasis & D/o In Newborn

Front 1

Inhibitors of Coagulation--inc/dec/nl at birth??

Back 1

1. Direct Inhibitors (C1 esterase inh, alpha-2 macroglobulin): INC at birth
2. Protein C/S = VIT K DEPENDENT
-Thrombomodulin INC at birth until early childhood
-Protein C and S DEC at birth

3. Tissue Factor Pathway Inhibitor (TFPI) binds and inactivates Factor 7a-->prevents further generation of thrombin

Front 2

Fibrinolytic System: inc or dec at birth?

Back 2

1.t-PA and PAI are INC in newborn but DEC in cord blood at birth
2.alpha-2-antiplasmin (80% of adult level)
3.Plasminogen (50% of adult level)

Front 3

MCC causes of bleeding in healthy infants

Back 3

1.imm-mediated thrombocytopenia
2.vit K def
3.congenital factor def

Front 4

MC hemostatis abnormality in newbortns

Back 4

thrombocytopenia

Front 5

et of thrombocytopenia

Back 5

1.Inc destruction of platelets
2.Dec prod
3.hypersplenism (sequester platelets in spleen)

Front 6

how Tx bleeding infant

Back 6

platelet transfusion 10-20 ml/kg (regardless of cause of bleed in the infant!)

Front 7

Acquired Hemostatic D/O in newborn

Back 7

1.DIC
2.Liver Dz
3.Vit K def

Front 8

how Dx DIC in newborn

Back 8

dec Factor 5, 8, and fibrinogen (NOT ATIII/thrombin)

Front 9

how Dx DIC in neonates

Back 9

can't

Front 10

DECREASED prothrombin activity and INC PT on day 2 to 4 of life with return to normal by days 5 to 7 indicates

Back 10

Vit K def (need Vit K for Factors 2 (prothrombin), 7, 9, and 10)

Front 11

VK1 is called what and found where?

Back 11

phytonadione;
found in green leafy veggies

Front 12

VK2 is called what and found where?

Back 12

metaquinanone;
prod by intestinal flora

Front 13

VK3 is called what and found where?

Back 13

menadione;
synthetic, water-soluble

Front 14

how prevent decrease in prothrombin activiy during first 3-4 days of life

Back 14

administer Vit K