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Apex Review > Coagulation 7 > Flashcards

Coagulation 7 Flashcards

1
Q

Which coagulopathies present with a prolonged PTT and normal PT? (select 2)
a. hemophilia A
b. hemophilia B
c. factor 10 deficiency
d. factor 2 deficiency

A

a & b

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2
Q

Hemophilia A is

A

factor 8 deficiency

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3
Q

Hemophilia A is most common in

A

males

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4
Q

Severe hemophilia A is associated with

A

spontaneous bleeding in the joints, muscles, and vital organs

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5
Q

________ is prolonged with hemophilia A

A

PTT

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6
Q

Treatment options for hemophilia A include

A

factor 8 concentrate, FFP, cryo, and DDAVP

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7
Q

Hemophilia _ is usually more severe than hemophilia _

A

A; B

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8
Q

Hemophilia B is a _______ deficiency

A

factor 9

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9
Q

Anesthetic considerations for hemophilia B are

A

the same as with hemophilia A

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10
Q

________ is prolonged with hemophilia B

A

PTT

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11
Q

_____________ can be used to replace factor 9 in hemophilia B

A

factor 9 prothrombin complex

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12
Q

Factor-9 prothrombin complex concentrate is associated with

A

thromboembolic complications

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13
Q

____________ is a treatment option for hemophilia A & B

A

recombinant factor 7

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14
Q

Risks for recombinant factor 7 include

A

MI
embolic stroke
PE
DVT

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15
Q

Recombinant factor 7 is used as a

A

last ditch tx. for bleeding without an identifiable cause

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16
Q

The dose of recombinant factor 7 is

A

20-40 mcg/kg

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17
Q

Hemophilia A is a __________ chromosomal disorder

A

X linked

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18
Q

Mild disease of hemophilia A

A

does not cause spontaneous bleeding but is associated with increased surgical bleeding

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19
Q

The half-life of factor 8 is

A

8-12 hours so redosing may be required

20
Q

All of the following can be used to reduce bleeding in the hemophilia A patient

A

factor 8
FFP
cryo
DDAVP (mild-moderate dx.)
antifibrinolytics

21
Q

Factor 9 has a half-life of

A

18-24 hours

22
Q

The dose of recombinant factor 7 for hemophilia patients is

A

90-120 mcg/kg

23
Q

For a patient with severe form of hemophilia, what should always be performed before surgery?

A

Type and cross

24
Q

A septic patient undergoing exlap has developed bleeding from the wound and around his IV sites. He has a platelet count of 40,000, fibrinogen of 95, and an elevated D-dimer. What is the BEST treatment for this patient?
a. heparin infusion
b. tranexamic acid
c. FFP
d. albumin

A

c. FFP

25
Q

DIC is characterized by

A

disorganized clotting and fibrinolysis that leads to the simultaneous occurrence of hemorrhage and systemic thrombosis

26
Q

Conditions with the highest risk of developing DIC include

A

sepsis
obstetric complications
malignancy

27
Q

the definitive treatment for DIC is

A

reversing the underlying cause
supportive- treat hypovolemia with fluids, replaced consumed blood products with FFP, platelets, and Cryo, and consider IV heparin or LMWH for severe microvascular thrombosis

28
Q

Signs of DIC include

A

ecchymosis, petechiae, mucosal bleeding, bleeding at IV puncture sites, prolonged PT & PTT, increased D-dimer and fibrin split products

29
Q

Lab values for patients with DIC will include

A

increased PT/PTT
increased D-dimer
decreased platelets
decreased fibrinogen

30
Q

The highest risk of sepsis related DIC is

A

gram-negative bacilli

31
Q

The highest risk of obstetric related DIC is

A

preeclampsia

32
Q

Highest risk of malignancy related DIC is

A

adenocarcinoma

33
Q

A patient with a history of type 2 heparin-induced thrombocytopenia requires anticoagulation for cardiopulmonary bypass. What is the BEST treatment?
a. enoxaparin
b. heparin test dose
c. warfarin
d. bivalirudin

A

d. bivalirudin

34
Q

Thrombotic disorders include

A

antithrombin deficiency
heparin-induced thrombocytopenia
protein C & S deficiency
Factor 5 Leiden mutation

35
Q

Antithrombin inactivates factors

A

9a, 10a, 11a, and 12a which ultimately leads to thrombin factor 2a inhibition

36
Q

Patients with antithrombin deficiency are unresponsive to

A

heparin

37
Q

Treatment for antithrombin deficiency includes

A

AT concentrate & FFP

38
Q

Heparin-induced thrombocytopenia causes

A

clot formation throughout the body

39
Q

How many types if HIT are there?

A

2 types

40
Q

Type 1 HIT resolves

A

spontaneously

41
Q

Type 2 HIT causes

A

a hypercoaguable state

42
Q

Complications of type 2 HIT include

A

amputation and death

43
Q

Protein C and S work as a team to

A

inhibit factors 5a and 8a

44
Q

A deficiency of protein C or S can produce

A

a hypercoaguable state, increasing the risk of thrombosis

45
Q

For the patient with protein C and S deficiency, thromboembolism is treated with

A

heparin and the patient is transitioned to warfarin

46
Q

Factor 5 Leiden causes a

A

resistance to the anticoagulant effect of protein C

47
Q

____________________ is unwarranted with Factor 5 Leiden mutation unless

A

lifelong anticoagulation; the patient experiences recurrent thrombotic events

Apex Review (224 decks)

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