Hockermanm Flashcards

1
Q

what is the substrate protein for factor IIa?

A

fibrinogen/fibrin

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2
Q

Hemophillia A is a deficiency in what

A

8

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3
Q

Hemophillia B is a deficiency in what

A

9

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4
Q

where are clotting factors produced?

A

liver (except von Willebrand)

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5
Q

where is von Willebrand produced?

A

endothelium, subendothelium, megakaryoctyes

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6
Q

liver disease can have a _____ effect on anticoag

A

unpredictable

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7
Q

recalcification (bleeding time)

A

2-4 minutes

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8
Q

aPTT time and use

A

26-33 seconds
test heparin efficacy

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9
Q

prothrombin time PT

A

11-14 seconds
test warfarin efficacy

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10
Q

warfarin inhibits factors __

A

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

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11
Q

drugs that increase warfarin effect
increase INR

A

broad spectrum antibiotics
metronidazole, amiodarone, fluconazole, bactrim, ciprofloxacin

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12
Q

drugs that decrease warfarin effect decrease INR

A

rifampin
vitamin K

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13
Q

warfarin overdose? no major bleeding

A

vitamin K if INR >10

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14
Q

warfarin overdose? major bleeding

A

prothrombin complex concentrate with vitamin K

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15
Q

heparin reversal agent

A

protamine sulfate

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16
Q

reversal agent for apixaban and rivaroxaban

A

andexanent alpha

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17
Q

black box warning andexanet alpha?

A

thrombolytic events

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18
Q

peptide of leach saliva gland

A

hirudin

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19
Q

lepirudin binding?

A

irreversible

20
Q

bivalirudin binding?

A

reversible

21
Q

argatroban binding

A

reversible

22
Q

dabigatran reversal agent

A

idarucizumab

23
Q

what kind of molecule is tPA

A

serine protease

24
Q

what does plasmin do?

A

proteolytic enzyme that digests fibrin and fibrinogen

25
Q

what is tPA inhibited by?

A

PAI-1 and PAI-2

26
Q

indications for thrombolytic therapy

A

MI, ischemic thrombolytic stroke, PE

27
Q

fibrinolytic drugs

A

alteplase, reteplase, tenecteplase

28
Q

which fibrinolytic has mutations

A

tenecteplase

29
Q

what do the mutations in tenecteplase do?

A

increase 1/2 life
reduce inhibition by PAI
enhance activity at thrombi

30
Q

which fibrinolytic does not bind fibrin directly?

A

reteplase

31
Q

antifibrinolytic drugs

A

aminocaproic acid
tranexamic acid

32
Q

three molecules secreted by platelets

A

TXA2
ADP
5 HT

33
Q

vasoconstricters?

A

TXA2 and 5 HT

34
Q

GP IIb/IIIa role

A

bind fibrinogen and then fibrinogen crosslinks platelets together to form a clot

35
Q

what does aspirin do

A

COX-1 inhibitor which decreases TXA2
irreversible inhibition
prophylaxis and treatment of arterial thromboembolic disorders

36
Q

selective cox 2 inhibitors have what risk

A

cardiovascular risk since they don’t prevent synthesis of TXA2

37
Q

prasurgel risks

A

bleeding, dont use in old

38
Q

ticagrelor binding

A

reversible

39
Q

clopidogrel and prasugrel binding

A

irreversible

40
Q

which adp inhibitros are prodrugs

A

clopidogrel and prasugrel

41
Q

prasugrel cyps

A

esterases and CYP 3A4/2B6

42
Q

absiximab increased risk of

A

bleeding

43
Q

absiximab half life

A

long

44
Q

vorapaxar

A

PAR inhibitor
reversible

45
Q

PDE3 inhibitors?

A

cilostazol, dipyridamole, oppose P2Y12 action