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Hematology > Pharmacology/Transfusion > Flashcards

Pharmacology/Transfusion Flashcards

1
Q

_______ is a possible complication of any anticoagulation

A

bleeding

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2
Q

long term use of heparin is associated with what side effect?

A

reduced bone mineral density

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3
Q

What is the reversal agent for UFH or LMWH?

A

protamine sulfate

complete reversal for UFH only partial reversal for LMWH

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4
Q

What is the goal PTT for UFH?

A

1.5-2.5x the normal range

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5
Q

What lab test can you measure for LMWH?

A

anti-Xa level

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6
Q

Which of the following statements about fondaparinux is NOT true.

a. it is a reliable once-daily SQ injection
b. it is metabolized by the kidneys
c. there is no risk of HIT
d. the reversal agent is protamine sulfate

A

d. the reversal agent is protamine sulfate

* NO FDA-approved reversal agent*

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7
Q

Which of the following statements about Lovenox is NOT true.

a. dosage is weight-based
b. it has a longer half-life than UFH
c. it has an increased risk of HIT compared to UFH
d. it can be incompletely reversed with protamine sulfate

A

c. it has an increased risk of HIT compared to UFH

* DECREASED RISK*

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8
Q

Coumadin inhibits what Factors and Proteins?

A

II, VII, IX, X, PC, PS

2,7,9,10

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9
Q

What is the goal INR with Coumadin?

A

2.0-3.0

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10
Q

How often is monitoring required with Coumadin?

A

weekly!

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11
Q

How is coumadin metabolized?

A

liver

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12
Q

How is Coumadin reversed?

A

FFP for immediate treatment + Vitamin K for long term

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13
Q

What are the 3 approved DOACs?

A
  • dabigatran
  • rivaroxaban (Xarelto)
  • apixaban (Eliquis)
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14
Q

What is the reversal agent for factor Xa inhibitors?

A

andexanet alpha

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15
Q

What is the reversal agent for dabigatran?

A

Praxbind OR dialysis

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16
Q

What are the 2 common indications for IV direct thrombin inhibitors?

A
  • patients with HIT

- patients with MI

17
Q

What are the 2 IV direct thrombin inhibitors?

A
  • Argatroban

- Bivalirudin

18
Q

Bivalirudin is cleared by the _______, while argatroban is cleared by the _______.

A
  • bivalirudin = renal

- argatroban = hepatic

19
Q

What is the best lab test for HIT?

A

anti-platelet factor 4/heparin antibody test

20
Q

What agents can be used as an antidote for tPA?

A

Antifibrinolytic agents

21
Q

What are the 2 antifibrinolytic agents?

A
  • E-aminocaproic cid (EACA)

- Tranexamic acid (TXA)

22
Q

A patient undergoes a blood transfusion. He later develops hypotension, fever, chills and renal failure. What is the diagnosis?

A

acute hemolytic transfusion reaction

23
Q

What is the most common transfusion reaction?

A

febrile non-hemolytic transfusion reaction

24
Q

A patient undergoes a blood transfusion with FFP. He develops hypoxemia, respiratory failure, fever, and bilateral pulmonary infiltrates. What is the diagnosis?

A

Transfusion-related acute lung injury (TRALI)

25
Q

A patient undergoes a blood transfusion and develops heart failure. What is the diagnosis?

A

Transfusion-associated circulatory overload (TACO)

26
Q

In this test, patient’s serum is added to reference RBCs to identify antibodies directed against minor blood group antigens in the patient’s serum

A

Type and screen

27
Q

In this test, patient’s serum is added to a sample of the donor RBCs, checked for agglutination of RBCs

A

type and cross

28
Q

Each unit of PRBCs increases Hgb by ____ g/dL and Hct by ____%, on average

A 
Hgb = 1 g/dL
Hct = 3%
29
Q

In emergency situation, like a trauma, what type of blood do you give?

A

O negative

30
Q

One dose/unit of platelet is expected to bring Plt count up by about _____.

A

25-30 thousand

31
Q

Patients with ______________ are not expected to respond to platelet transfusion.

A

immune thrombocytopenia (ITP)

32
Q

When we want to replenish fibrinogen what do we give?

A

cryoprecipitate

33
Q

What is the treatment for ITP?

A

steroids

Hematology (10 decks)

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