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14 Cards in this Set
- Front
- Back
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most common case of thrombohilia and its tx
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vactor v leiden mutation
tx - walfarin 2-6 months( A-Recessive) walfarin is anticoagulant agent that function by inhibiting the synthesis of vit K dep factors II VII IX X protein S and protein C and may give false positive results for pr S defec |
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hypercoagulable states
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most common is pregnanacy
obesity immobility malignancy0 adeno carcome- MCC |
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when it will be increased defect in thrombosis regulation
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protein S C def
antithrombin III def antiphospholipid antibodies vactor V leiden mutation |
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what are important components of the control mechanisms
that modulate coagulation |
Antithrombin III, protein C, and protein S .
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Protein S circulates in two forms:
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a free form, in which
it is active as an anticoagulant; and a bound, inactive form, in which it is complexed to C4b-binding protein of the complement system. |
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C4b-binding protein acts as
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an acute
phase reactant. The resultant increase in inflammatory state reduces the activity of free protein S, enhancing the likelihood of thrombosis. |
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in advanced HIV disease
what is the level of protein S |
decreased.
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is it any problem in
the measurement of the levels of protein C and protein S ( for assess for the possibility of an occult hypercoagulable state.) and why |
Because protein
C and protein S are vitamin K dependent, their measurement can be problematic in patients taking warfarin. |
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when is the best to measure protein C or protein S in patient who is taking the walfarin
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when P. is off the warfarin for 3 to 4 weeks.
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Protein C deficiency results in
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a loss of ability to inactivate factor VIIa and factor Va, two
major cofactors that regulate the clotting cascade. |
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Warfarin lowers
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protein C levels as well
as the levels of all the vitamin K-dependent clotting factors. |
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Because the half-lives of factor
Xa and prothrombin are longer than that of protein C, initiation of warfarin therapy can induce |
a paradoxical state of hypercoagulability.
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In patients
in whom protein C deficiency is suspected, |
heparin and warfarin should be initiated concomitantly.
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Heparin therapy is initially started on an inpatient
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basis; warfarin is indicated
for outpatient treatment. Another rare complication of warfarin therapy is skin necrosis, which can be severe. |
