Thrombosis Flashcards

1
Q

most important step in vivo coagulation

A

VII -> IX

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2
Q

antithombin

A

blocks II, IX, X, XI, XII amplified 1000x by heparin

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3
Q

common hypercoaguable states

A

factor V mutation prothrombin mutation 5.10 methylenetetrahydrofolate reductase mutation increased factor VIII, IX, XI, or fibrinogen

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4
Q

rare hypercoaguable states

A

antithrombin III deficiency protein C or S deficiency

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5
Q

very rare hypercoagulable states

A

fibrinolysis defects homozygous homocyteinuria

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6
Q

high risk for thrombosis

A

prolonged stasis MI atrial fibrillation tissue injury cnacer prosthetic cardiac valves DIC heparin induced thrombocytopenia antiphospholipid Ab syndrome

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7
Q

lower risk for thrombosis

A

cardiomyopahty nephrotic syndrome hyperestogenic states oral contraceptives sickle cell smoking

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8
Q

Things that block platelet coagulation

A

ADP Prostacyclin NO

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9
Q

HSPG

A

blocks IIa IXa Xa XIa XIIa

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10
Q

factor V leiden mutations

A

activated protein C resistance does not deactiate

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11
Q

prothrombin G20210 A mutation

A

increased prothrombin levels which are converted to working thrombin

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12
Q

heparin induced thrombocytopenia syndrome type II

A

unfractionated heparin induces autoAbs to molecular complex w/platelet factor 4 patients have thrombocytopenia and disseminated clots autoAb-heparin-platelet complexes cause endothelial injury, causing prothrombotic state

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13
Q

Antiphospholipid autoAbs

A

affinity for bound phospholipids on platelet surace that are combinded w/coagulation facotrs lupus anticoagulant detected during aPTT testing false positive VDRL test recurrent venous or arterial thrombosis and/or fetal loss

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14
Q

homocysteine

A

contributes to arterial and venous thrombosis and atherosclerosis marked elevations caused by homozygous deficiencies of CBS folic acid, pyridoxine, and/or vit B12 can reduce plasma homocysteine concentrations, but does not decrease risk ASCVD

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15
Q

types of shock

A

disruptive (septic, neurogenic,, anaphylactic) cardiogenic shock hypovolemic shock (hemorrhagic) obstructive shock (saddle PE)

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16
Q

inadequate production of platelets

A

leukemias aplastic anemia myelodysplaisa B12 or folate deficiency

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17
Q

splenic sequestration of platelets

A

cirrhosis congestive splenomegaly

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18
Q

increased platelet destruction or consumption

A

ITP DIC TTP HUS bleeding sepsis HIV

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19
Q

drug induced destruction

A

quinidine sulfa rarely heparin/HIT

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20
Q

increased platelets

A

platelet dysfunction bleeding

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21
Q

platelet dysfunction

A

bernard-soulier syndrome vWD glanzmann thrombbasthenia drug induces (aspirin, NSAIDs) systemic disorders (uremia

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22
Q

acquired coagulation disoreders

A

vit K deficiency liver disease anticoagulation w/warfain or heparin DIC

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23
Q

hereditary coagulation disorders

A

hemophilia A (VIII) hemophilia B (IX) hemophilia C (XI) vWD

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24
Q

acquired vascular disorders

A

collagen defects (scurvey, cushings) henoch-schonlein purpura amyloidosis

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25
Q

hereditary vascular disorders

A

CT (ehlers-danlos, osteogensis imperfecta, marfans) hereditary hemorrhagic telangiectasia

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26
Q

musculotaneous bleeding

A

petechiae, bruising, GI think disorders of platelets, vWD, or vasculature

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27
Q

spontaneous or excessive soft tissues, mm and joints, delayed surgical bleeding

A

think coagulation disorders

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28
Q

afibrognemia

A

umbilical cord stump bleeding coagulation defect

29
Q

factor XIII deficiency

A

males, deep hematomas, hemarthroses, chronic joint abnormalities, umbilical cord stump bleeding coagulation defect

30
Q

factor XIII deficency

A

poor wound healing, severe scar formation coagulation defect

31
Q

chediak-higashi syndrome

A

oculocutaneous albinism, infections, neutrophil peroxidase + inclusions platelet dysfunction

32
Q

wiskott aldrich syndomre

A

eczema, immunodeficiency thrombocytopenia

33
Q

digeorge syndrome

A

cleft palate, cardiac defects, facial anomalies, learning disabilities thrombocytopenia

34
Q

petechiae

A

<0.3 cm

35
Q

purpura

A

.3-1cm

36
Q

ecchymoses

A

>1cm

37
Q

vWD I and III

A

quantity defect

38
Q

vWD II

A

quality defect

39
Q

hem A

A

negative for epistaxis, bruising, petechiae, GI bleeding, menorrhagia, postpartum bleeding positive for hematoma, hemarthrosis, post-procedure bleeding

40
Q

vWD

A

positive for epistaxis, bruising, petechiae, GI bleeding, menorrhagia, hematoma (type 1), hemarthrosis (type 1), postpartum bleeding, post procedure bleeding

41
Q

adhesion defects

A

vWD bernard-soulier disease

42
Q

adhesion labs

A

ristocetin

43
Q

aggregation defects

A

glanzmann thrombasthenia

44
Q

aggregation labs

A

ADP/collage/epi/arachidonic acid

45
Q

gray platelet syndrome

A

empty platelet alpha granules mild bleeding autosomal dominant or recessive

46
Q

morphology of gray platelet syndrome

A

hypogranular platelets giant platelets thrombocytopenia myelofibrosis

47
Q

diagnosis of gray platelet syndrome

A

variably abnormal platelet aggregation abnormal platelet appearance on blood smear electron microscopy shoeing absent alpha granules

48
Q

uremia

A

defects in adhesion, granule secretion, and aggregation

49
Q

acquired platelet storage defects

A

SLE cardiopulmonary bypass platelet activation

50
Q

acute immune idiopathic thrombocytopenic purpura

A

ITP childhood disease w/acute onset (2 weeks post viral) self-limited (resolves w/in 6 months) autoAbs against platelet Ags

51
Q

chronic immune (refractory) thrombocytoenic purpura of adults

A

20-49 years 3F:1M spontaneous remissions rare primary or secondary to SLE, HIV, Leukemias/lymphomas autoAbs against platelet Ags

52
Q

Primary TTP

A

deficency of ADAMTS13

treated w/plasmaphoresis

53
Q

waterhouse-friderichsen syndrome

A

massive adrenal hemorrhages

54
Q

blue top

A

plasma

add anticoagulant

55
Q

red top

A

serum

no anticoagulant, fluid that does not clot

56
Q

vit K deficieny or warfarin

A

pronlonged PT

prolonged aPTT

platelet funx and platelet count unaffected

57
Q

DIC

A

prlonged PT

prolonged aPTT

unaffected platelet function

decreased platelet count

58
Q

vWD

A

unaffected PT and platelet count

prolonged aPTT

decreased platelet fnx

59
Q

Haemophilia

A

unaffected PT, platelet count, platelet fnx

prolonged aPTT

60
Q

Aspirin

A

unaffected PT, aPTT, platelet count

decreased platelet function

61
Q

thrombocytopenia

A

unaffected PT and aPTT

decreased platelet count

62
Q

early liver stage

A

prolonged PT

unaffected aPTT and platelet count

decteased platelet function

63
Q

end-stage liver disease

A

prolonged PT and aPTT

decreased platelet count and function

64
Q

ureima

A

decreased platelet fnx

65
Q

congenital afibrogenemia

A

prolonged PT, aPTT

66
Q

factor V deficicency

A

prolonged PT and aPTT

67
Q

glanzmann’s thrombocytopenia

A

decreasd platelet fnx

68
Q

bernard-soulier syndrome

A

decreased platelet function and count