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38 Cards in this Set
- Front
- Back
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What is the most commonly used Blood Product?
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Packed RBC's
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What is the expected hematocrit increase with each unit?
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3 points
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What is the impact on blood volume with each unit?
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250-300ml
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What is the Laboratory test that primarily detects deficiencies in factor II,V,VII, X
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PT (prothrombic time)
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Describe the Prothrombin Time test
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measure of the extrinsic pathway by adding commercial thromboplastin to plasma and waiting for fibrin formation
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What is the normal the PT time
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10-14 seconds
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Describe the Partial Thromboplastin Time test
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It is a measure of the intrinsic pathway by articficial stimultation of factor XII and XI
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Where is the majority of Von Willebrand's factor produced?
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Blood vessel endothelium
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What does Von Willebrand's factor mediate?
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platelet adhesion to the endothelial surface
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What deficiencies will the Partial Thromboplastin Time test detect?
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Deficiencies in factors 8-12 (X is common to both)
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What deficiencies will the Prothrombin Time test detect?
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vit k sol, factors 2,5,7,10 (X is common to both)
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What is the normal value of the PTT?
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25-40 seconds
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Name a conginital cause of Thrombocytopenia (reduced platelets)
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Von Willenbrand's DZ
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3 causes of elevated PT and PTT
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Excessive heparin, DIC, Severe liver DZ
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What is a manifestation of a true bleeding disorder?
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Bleeding from more than one site
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A good way to clarify inherited versus acquired bleeding disorder
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Determine if lifelong versus a recent onset
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A good tool to use when determining the origin of bleeding disorders in younger patients
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Family history
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"If a patient says to you, ""I've always been a bleeder"", what do you do?"
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Support that statement by a history of clinically significant bleeding
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"When determining whether a bleeding disorder is a plug or ""reinforcement problem"", what does it mean to have a plug problem?"
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That there is an issue with the platelets, themselves
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What are platelet d/o associated with?
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"small vessel ""oozing"" as opposed to gushing (normally from a mucous membrane-nose, mouth, GI tract)"
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A reinforcement problem is associated with what?
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Large vessel bleeding (bleed like stink), excessive ecchymosis, excessive bleeding with trauma.
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"What type of disorder is indicated with a ""reinforcement"" problem?"
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A coagulation factor disorder
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What is meant by quantitive, or qualitive bleeding disorders?
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Is there a problem with the amount of cells/coag factors, or is there something wrong with the platelets/coag factors
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When is a pt at risk for severe (grades 3 and 4) spontaneous bleeding?
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When their platelet count drops below 10,000
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When does spontaneous bleeding start to occur?
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At a platelet count of 40,000
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At what platelet count will a scheduled surgery be cancelled?
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50,000
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This d/o accounts for the majority of all chronic immune thrombocytopenia
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Idiopathic Thrombocytopenia Purpura
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How does ITP manifest?
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Episodic clinical course with a dropping platelet count as the flare continues
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Treatment for ITP
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Corticosteroids (prednisone-shuts down immune response)
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What is removed from circulation in the case of mild Heparin Induced Thrombocytopenia?
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the platelet-immune complex aggregate
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A platelet count of 100,000 within a day or two after treatment of a DVT would indicate what?
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Heparin Induced Thrombocytopenia
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What is the best marker for progressive liver dz?
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PT and PTT
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Which is the better marker for hepatic synthetic than LFT's?
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PT
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Major causes of DIC
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Severe head injury, massive soft tissue injury (MVA's, blast injuries, crush injuries, pregnancy)
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TTP is a result of…
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ADAMTS deficiency
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HUS is a result of…
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Shiga toxin from E. Coli
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TTP is more a __________________ manifestion
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Neurological
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HUS (hemalytic Uremic Syndrome) is more of a ______ manifestion
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Renal (may present with bloody diarrhea
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