Hem Test 1: Hemostasis Disorders

Front 1

What activates GpIIb-GpIIIa?

Back 1

binding of GPIb to vWF

Front 2

What does vWF play in secondary hemostasis?

Back 2

taxi of factor VIII in plasma

Front 3

Which is indicative of prolonged initial bleeding?

Back 3

Platelet problem

Front 4

Which is indicative of late re-bleeding?

Back 4

factor problems

Front 5

symptoms of petechiae, mucosal bleeding, and bruising more symptomatic of what problem?

Back 5

platelets

Front 6

symptoms of hemarthroses, ecchymoses, and UT bleeding more symptomatic of what?

Back 6

factor problem

Front 7

symptoms of vWD

Back 7

muco-cutaneous bleeding
-menorrhagia
-epistaxis
-easy bruising

excessive bleeding with trauma
-post-op bleeding
bleeding following tooth extraction

Front 8

Prevalence of Hemophilia A v. B

Back 8

A is 1:10,000 males
B is 1:60,000 males

Both X-linked

Front 9

Why does VW disease demonstrate prolonged aPTT?

Back 9

less stable VIII transport (secondary)

Front 10

What is more indicative of vWF disease?

Back 10

response to VW factor antigen/activity

Front 11

What % conc of FVIII/IX can have spontaneous bleeds?

Back 11

<1; <30 can have trouble after surgery

Front 12

Classic bleeding locations for hemophilia

Back 12

hemarthroses
muscle
CNS
retroperitoneum
mouth/nose bleeds

Front 13

Role of desmopressin acetate (DDAVP)

Back 13

causes release of endogenous FVIII and VW factor

Front 14

3 components of Virchow's triad

Back 14

blood flow
vessel walls
composition of blood

Front 15

2 triggers of arterial thrombosis

Back 15

plaque disruption
turbulent flow

(white thrombus)

Front 16

3 triggers for VTE

Back 16

venous stasis
vessel wall injury
thrombophilia

(red thrombus)

Front 17

2 types of Inherited thrombophilias

Back 17

gain of function from prothrombin 20210 mutation

loss of function from def of protein C/S/antithrombin
-inherited resistance to aP C

Front 18

Protein C target

Back 18

Va and VIIIa

Front 19

Resistance to activated Protein C indicates which test?

Back 19

inc aPTT

Front 20

What is changed to affect the Protein C/ FVa complex?

Back 20

changes Arg to Gln on FVa, which was the 1st cleavage site by aPC

Front 21

5 inherited thrombophilias

Back 21

protein C def.
protein S def.
antithrombin def.
Factor V Leiden
Prothrombin 20210

Front 22

2 components of clinico-path diagnosis of antiphospholipid antibody syndrome

Back 22

thrombosis/recurrent miscarriage

persistence of:
Lupus inhibitor
anticardiolipin antibody

Front 23

Steps to identify Lupus inhibitor presence

Back 23

1. prolonged aPTT more sensitively than PT
2. failure of 1:1 mix correction
3. corrects with addition of excess phospholipid

Front 24

Environmental risk factors for thrombosis

Back 24

estrogens
surgery
trauma
prolonged immobilization
long distance travel
indwelling venous catheters
cancer (Trousseau's)

Front 25

Which BCPs are better for those predisposed to thrombophilia?

Back 25

progestin only

Front 26

When to screen for thrombophilia?

Back 26

neonatal purpura fulminans (homozygous protein C or S def)
inprovoked VTE
VTE under 50yo
recurrent VTE
VTE w/ positive family hx

Front 27

Big three etiologies of DIC

Back 27

infection
cancer
obstetric emergencies

(think tissue factor release)

Front 28

syndrome of DIC with skin necrosis and secondary hemorrhage

Back 28

purpura fulminans (high grade DIC)

Front 29

role of antithrombin

Back 29

serum protease inhibitor

Front 30

Targets for antithrombin

Back 30

thrombin, Xa

Front 31

Longer the chain, more likely to do what to thrombin?

Back 31

inhibit

Front 32

When does long chain v. short chain heparin compare?

Back 32

short chain more for FXa inactivation

Front 33

Role of warfarin

Back 33

inhibits recycling of vitamin K to reduced form

Front 34

Heparin v. LMWH

Back 34

LMWH have lower monitoring, more reliable

downsides-excreted, reversibility easier for heparin

Front 35

What does Dabigatran inhibit?

Back 35

Thrombin