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12 Cards in this Set
- Front
- Back
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What genetic causes of an increased tendency toward clot-forming may appear on the Step 2 exam?
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The list keeps on growing. Watch for factor V Leiden mutation (or activated protein C resistance), prothrombin G20210A multation, or deficiencies in protein C, protein S, or antithrombin III (all autosomal dominant except protein C deficiency) as causes of an increased tendency toward thrombosis.
All are treated with anticoagulant therapy to prevent deep venous thrombosis and pulmonary embolus. Suspect these conditions if a person under age 35 develops recurrent closts or has no risk factors for clot development. |
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True or False: The lupus anticoagulant causes a clotting tendency.
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True. Although the lupus anticoagulant may cause a prolonged PTT, the patient has a tendency toward thrombosis.
Look for associated lupus symptoms, positive results on the VDRL or RPR (rapid plasma reagin) tests for syphilis, and/or a history of miscarriages to help you recognize this condition. |
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Which clotting tests measure which portions of the coagulation cascade? Which medications affect these tests?
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PT (prothrombin time) measures the function of the extrinsin clotting pathway, prolonged by wafarin.
Activated PTT (partial prothrombin time) measures the funciton of the intrinsic clotting pathway, prolonged by heparin. BT (bleeding time) measures platelet function, prolonged by aspirin. |
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Disease: vWF disease
PT PTT BT Platelet Count RBC Count Other |
Disease: vWF disease
PT: normal PTT: high BT: high Platelet Count: normal RBC Count: normal Other: autosomal dominant (look for family history) |
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Disease: Hemophilia A/B
PT PTT BT Platelet Count RBC Count Other |
Disease: Hemophilia A/B
PT: normal PTT: high BT: normal Platelet Count: normal RBC Count: normal Other: X-linked recessive, A = low factor 8, B = lower factor 9 |
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Disease: DIC
PT PTT BT Platelet Count RBC Count Other |
Disease: DIC
PT: high PTT: high BT: high Platelet Count: low RBC Count: normal or low Other: appropriate history, low level of factor 8 |
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Disease: Liver Failure
PT PTT BT Platelet Count RBC Count Other |
Disease: Liver Failure
PT: high PTT: high BT: normal Platelet Count: normal/low RBC Count: normal/low Other: jaundice, normal factor 8 level; do not give vitamin K (ineffective); use FFP |
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Use of heparin
PT PTT BT Platelet Count RBC Count Other |
Use of heparin
PT: normal PTT: high BT: normal Platelet Count: normal or low RBC Count: normal Other: watch for thrombocytopenia and thrombosis |
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Use of warfarin
PT PTT BT Platelet Count RBC Count Other |
Use of warfarin
PT: high PTT: normal BT: normal Platelet Count: normal RBC Count: normal Other: vit K antagonist (vit K helps make factors 2, 7, 9, 10) |
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Disease: ITP (idiopathic thrombocytopenic purpura)
PT PTT BT Platelet Count RBC Count Other |
Disease: ITP
PT: normal PTT: normal BT: high Platelet Count: low RBC Count: normal Other: watch for preceding URI, antiplatelet antibodies and increased megakaryocytes |
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Disease: TTP (thrombotic thrombocytopenic purpura)
PT PTT BT Platelet Count RBC Count Other |
Disease: TTP
PT: normal PTT: normal BT: high Platelet Count: low RBC Count: LOW Other: hemolysis (smear shows schistocytes), CNS symptoms, treat with plasmapheresis; do not give platelets |
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Disease: Scurvy
PT PTT BT Platelet Count RBC Count Other |
Disease: Scurvy
PT: normal PTT: normal BT: normal Platelet Count: normal RBC Count: normal Other: fingernail and gum hemorrhages, bone hemorrhages, caused by vitamin C deficiency |
