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29 Cards in this Set
- Front
- Back
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mucocutanous bleeding (post surgical –tonsillectomy/dental extraction, ecchymosis, menorrhagia-poor fibrin clot, + FH of bleeding; dental exraction bleeding; # 1 bleeding diz
-? dx |
dx Nl- Hi PTT; Hi BT
(intrinsic pathway)-PT NL -low vWF; low ristocetin cofacor;-Factor VIII nL- low -Von Willebrands*** |
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Defic of GP IIB/IIIa,
-impaired plt aggregation ; Severe bleeding |
Glanzman’s Thromabsthenia
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Def of GP1b -severe bleeding/ GI bleeding Giant plt
-Hi BT |
Bernard Soulier Syndrome
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Uremia,
Meds: aspirin – irreversible-inhibits plt ; NSAIDS - transient |
Plt dysfunx
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d/o DNA repair; affects all cell lines;
-see plt decrease first Short, renal probs, radial ray anomolies |
Fanconi Anemia
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Severe low plt @ birth—tx: Bone marrow
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Cong amegakarysocityic thmoboctyponeia
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2-4 yo; post infx, self limitied; Isolated thrombocytopenia; -petechiae, purpura, epistaxis, gingival bleeding;
- chronic > 6 mo; |
ITP
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only one cell line down; low plt. what's tx?
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ITP,
Tx: IVIG; steroids |
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? what are vit K dependent cofactors?
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2, 7, 9, 10, prot C/S
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- what deficiency leads to prolonged PT and PTT;
-? |
-vitamin K deficiency
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examples of causes leads to prolonged PT/PTT ?
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causes of defieincy: dieeray insufficiency; atnbx, malabsorption; warfaring, INH, rifampin, Phb
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what's normal PT ?
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PT 9-13
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what's normal value of PTT?
-what's normal value in NB? |
23-32/
NB: 23-45 |
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which factors are intrinsic and which one ~ with intrinsic: PT or PTT?
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12, 11, 9, 10; 8, ~ vWF;
-intrinsic ~ PTT (PiTT) |
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which factors are extrinsic and which one ~ with : PT or PTT?
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PT (PeT); ; 7, 10
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NB w/ Bleeding, GI, intracnatial; purpura, oozing, bleeding w/ circs; h/o maternal ingest of vit K antagonists (anticonvulsants) or failure to give Vit K @ birth
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hemorrgic diz of NB
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Deep soft tissue/joint bleeding; NL PT; Hi PTT in a boy; due to what? what's tx ? what's genetics?
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Hemophilia 8,9; -x linked;
low 8 or 9; Tx: Replace factor; cryo; FFP; DDAVP; aminocaproic acid |
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Vit K dependent-warfarin sensitive;
-Homozygous: neonatal purpura fulminans; -heterozygous: neonatal purpura fulminans : massive microthrombosis, skin necrosis, DIC ~ wat def? |
PROTEIN C /S DEFIENCY – factor 2, 7, 9, 10
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Aq’d: DIC, liver dysfxn, nephritic syndrome; IBD; L –asparginase;
-when heparin fails to anticoagulate |
Antithrombin III deficiency
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tx of ANtithrombin III def?
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warfarin
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mutation → ? this becoming resistant to cleavagee by Protein C;
-late onset thrombosis; OCPs can confer APC resistance |
Factor V leiden: activated protein C resistance:
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G20210A increases prthrombin conc
-DVT; promotoes enhanced thrombin generation |
Hyperthrombinenemia- prothrombin gene mutation
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Defect in converting homocysteine to methione;
-defect in ? what gene? -increased risk of areterial DVT; Hi levels of homocysteine; what's tx? |
MTHF gene;
Tx: folate |
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prolongs PTT,but not a bleeding disorder!!!;
-h/o mom w/ recurrent miscarriages; -inflamm/autoimmune disease, infx, meds; recurrent DVT; stroke in young pts; recurrent pregnancy loss |
Antiphospholipd syndrome-lupus like anticoagulant
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Binds to ATIII and inhibits thrombin, 9, 10, 11, 12;
what do you follow? Pt/or PTT? -how do you reverse? |
Heaprin/LMWH
-follow PTT? -reverse w/ Vit K |
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Inhibits gamma carboxylatino of F 2, 7, 9, 10, Prot C; vit K dependent factors
- follow w/ PT - what's it reversible with ? |
warfarin;; reversible w/ Vit K
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10 yo boy w/ RLQ pain, palpable mass in RLQ, pain on mcburney’s point; hip externally rotated in flexed position;
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Hemophilia A or b; send for factor levels
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deep delayed bleeding, males, Hi PTT, low Factor 8; Nl vWF; Nl ristocetin cofactor
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hemophilia
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superficial immediate bleeding; males/females; Nl or hi PTT, nl or low F 8; No or low v WF **; decreased ristocetin cofactor
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vWD
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