The Clotting System

Front 1

how many days do platelets last in circulation

Back 1

4-7days

Front 2

where will bleeding occur if there's a problem with the platelets?

Back 2

skin and mucosal surfaces

what if it's a clotting factor problem?

Hint 2

will bleed into cavities

Front 3

MCC thrombocytopenia

Back 3

viral infection
drugs

what will you see?

Hint 3

petechiae, purpura, ecchymoses

Front 4

viruses that cuase thrombocytopenia

Back 4

parvo b19
hep C
hep E

Front 5

drugs that cause thrombocytopenia

Back 5

AZT
Vinblastine
Chloramphenicol
Benzene

Front 6

occurs 2 wks after URI
may precede SLE

Back 6

ITP

cause?

Hint 6

autoimmune attack against platelets

Front 7

signal for platelet aggregation?

Back 7

exposing basement membrane

why?

Hint 7

reveals glycoproteins 2b and 3a

Front 8

what brings platelets together?

Back 8

glycoprotein 1B

Front 9

after platelets show up, what else appears?

Back 9

serotonin (fxn?)
thomboxane (fxn?)

Hint 9

serotonin will vasoconstrict
thromboxane will cause platelet aggregation

Front 10

bleeding from skin and mucosal surfaces w/ inc bleeding time and big platelets on peripheral smear

Back 10

bernard-soulier

problem?

Hint 10

defective glycoprotein 1B

Front 11

bleeding from skin and mucosal surfaces and inc bleeding time w/ NL sized platelets

Back 11

glanzman's thrombesthenia

problem?

Hint 11

congenital absence of glycoproteins

Front 12

which drug blocks 2b/3a?

Back 12

absuxamab

uses?

Hint 12

acute PE, stroke, acute MI

Front 13

MOA of ticlopidine?

Back 13

blocks ADP receptors

uses?

Hint 13

decr clotting b/c need ADP for the process

Front 14

ADP receptor blockers

Back 14

ticlopidine
dipyridamole
clopidogrel

uses?

Hint 14

Rx MI when aspirin can't be tolerated

Front 15

Side effects of ticlopidine

Back 15

agranulocytosis/seizures

of clopidogrel?

Hint 15

causes TTP in first 2 wks

Front 16

MOA of glastozole?

Back 16

decr PDE so inc cAMP

Front 17

MOA of aspirin

Back 17

inhibits thromboxane

what else has the same MOA?

Hint 17

NSAIDS

Front 18

members of the NSAIDs?

Back 18

ibuprofen
indomethacin
phenylbutazone
baclofen
kerorelac
ketoprofen/diclophenad
suledac

Front 19

which factor can you be missing and not even know?

Back 19

factor 12

why?

Hint 19

b/c factor 11 can also be activated by kallikrein

Front 20

what do platelets release to attract vit K dependent factors?

Back 20

Calcium

what are the factors?

Hint 20

2, 7, 9, 10, protein C and S

Front 21

what do you give for a venous clot?

Back 21

heparin, then warfarin

what do you follow for both?

Hint 21

heparin: PTT
warfarin: PT and INR

Front 22

fxn of protein C

Back 22

inhibits factor 5 to stop clot extension

Front 23

MCC of spontaneous clot formation?

Back 23

factor 5 leiden defect

Front 24

what factors are made/released by the endothelium

Back 24

made: F5, 8, vWF
released: prekallikrein

Front 25

fxns of vit K

Back 25

cofactor for gamma carboxylation
anchors factors to calcium on surface of platelets
factors dependent on it

Front 26

when give warfarin, what's the first thing to disappear?

Back 26

protein C

why?

Hint 26

warfarin blocks vit K and protein C has the shortest half life of the vit K dependent factors

Front 27

how do you reverse warfarin toxicity?

Back 27

give vit K

what if bleeding?

Hint 27

FFP

Front 28

female comes in bleeding from skin and mucosal surfaces and complains of heavy bleeding during menses - has inc PTT and bleeding time - how do you confirm your suspicion of dx?

Back 28

ristocetin aggregation (vWF dz)

fxn of vWF?
Rx?

Hint 28

anchors F7 to platelets

rx: mild = DDAVP
moderate = cryoprecipitate
severe= FFP

Front 29

pt comes in bleeding into cavities, but all factor levels are normal - dx?

Back 29

hemophilia A

problem?

Hint 29

factor 8 ACTIVITY deficiency

Front 30

pt comes in bleeding into cavities, elevated PTT and a factor deficiency - dx?

Back 30

hemophilia B

rx?

Hint 30

FFP to stop bleeding

Front 31

of all transfusions, which one has the highest risk for HIV?

Back 31

factor 7 concentrate

why?

Hint 31

b/c need to get it from 100 volunteers for 1 unit of bld - ie, will need lots of diff ppl to collect enough for transfusion

Front 32

what growth factors are released during clotting?

Back 32

PDGF (from platelets)
EDGF (from endothelium)

fxn?

Hint 32

stimulates fibroblasts to make collagen 4 and 3

Front 33

fxn of bradykinin during clotting process?

Back 33

provides energy for fibroblasts and is a vaso and veno dilator so will inc bld flow to the area

Front 34

mother brings newborn baby in b/c she's been cleaning the area around the belly button, but the baby keeps bleeding - dx?

Back 34

factor 13 deficiency

fxn?

Hint 34

pulls platelets and fibrin together in the end to make clot

Front 35

fxn of plasmin

Back 35

breaks clot

drugs that work here?

Hint 35

streptokinase
urokinase
tPA

Front 36

how to rx tPA toxicity?

Back 36

aminocaproic acid