287b acquired coag Flashcards Preview

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Flashcards in 287b acquired coag Deck (11):
1

qualitative platelet defect causes?

immune mediated
toxins - uremia from renal disease
medications -ASA, penicillins
myelodysplastic syndrome (MDS)

2

what does vit k dep N-terminal glutamic acid carboxylation allow?

binding Ca to bring to phospholipids

3

Causes of Vit Deficiencies?

severe malnutritions

antibiotics

malabsorption (requires bile b/c fat soluble) - biliary cirrhosis, cholestasis, celiac sprue

4

liver cirrhosis - portal htn effect on spleen?

splenomegaly --> platelet sequestration

5

what coag factor has the shortest t 1/2 and goes down first with liver disease? what test reflects this?

F VII

PT

6

when should you treat coagulopathy in liver disease?

only when symptomatic (i.e. bleeding)

7

pathologic inhibitors of coagulation?

antibodies against factors from...

idiopathic

acquired IgG to F VIII --> mucosal bleeding + easy bruising; elevated PTT; mixing doesn't fix PTT; Bethesda assay quantifies

cancer

8

what does thrombin act on to activate coagulation?

Va
XIII
VIII
XI

9

acquired F VIII treatment?

bleeding - DDAVP (low titer) or Prothrombin complex concentration (high tighter)

eradication of antibody - steroids, rituximab (binds CD 20 on B cells)

10

Antiphospholipid syndrome (APLS)

AB --> anionic PL --> thrombosis, livedo reticularis (lacy rash), pregnancy complications

LAC (lupus anticoagulant), anticardiolipin, Beta 2

causing thrombosis (veins and arteries) despite high PTT

10

Antiphospholipid syndrome (APLS)

AB --> anionic PL --> thrombosis, livedo reticularis (lacy rash)

LAC (lupus anticoagulant), anticardiolipin, Beta 2

causing thrombosis (veins and arteries) despite high PTT