Step 2 - Heme Onc

Front 1

MOA of warfarin?

Back 1

inhibits epoxide reductase to decrease VitaK and thus the synthesis of Vitamin K dependent clotting factors

Front 2

Intrinsic pathway is monitored by what? What drug targets this?

Back 2

PTT; heparin, decreases fibrinogen levels

Front 3

Extrinsiv pathway is monitored by what? What drug affects this?

Back 3

PT, warfarin

Front 4

What is intrinsic and extrinsic pathways?

Back 4

They are the parts of the coagulation cascade either inidiated by collagen after vascular trauma or release of tissue factor from the endothelium

Front 5

Labs to order if suspecting a clotting deficiency?

Back 5

PT, PTT, thrombin time (ability for fibrinogen->fibrin) , fibrinogen level, and bleeding time.

Front 6

What lab test to determine if pt has a factor defieicny?

Back 6

mixing study, mix pt plasma with normal plasma. If PTT corrects itself, then pt has a factor deficiency. If not, they may have a clotting factor inhibitor.

Front 7

How is hemophilia characterizd?

Back 7

clotting factor <5% of normal, sever being <1%

Front 8

Tx of hemophilia bleeding episodes?

Back 8

transufsion of clotting factors or cryoprecipitate to at least 40%; daily or BID depedning of half life; also DDAVP (desmopressin) with fluid restriction to avoid hyponatremia

Front 9

MOA of DDAVP?

Back 9

desmopressin helps the body to release extra factor VIII

Front 10

Why might a pt require more and more clotting factor each subsequent time with Hemophilia A?

Back 10

they start to develop IgG to factor VIII

Front 11

What is vWF?

Back 11

a protein that factor VIII binds to which pprolongs half life.

Front 12

What is the most common inherited bleeding disorder?

Back 12

AD vWD

Front 13

What eacerbates vWD?

Back 13

ASA use

Front 14

diagnosis of vWD?

Back 14

ristocetin cofactor assay; if no agglutination with addition of ristocetin, there is no vWF

Front 15

Tx of vWD?

Back 15

DDAVP for bleeding episodes, menorrhagia controlled with OCPs, avoid ASAs/antiplatelets