Flashcards in 287b acquired coag Deck (11):
qualitative platelet defect causes?
toxins - uremia from renal disease
medications -ASA, penicillins
myelodysplastic syndrome (MDS)
what does vit k dep N-terminal glutamic acid carboxylation allow?
binding Ca to bring to phospholipids
Causes of Vit Deficiencies?
malabsorption (requires bile b/c fat soluble) - biliary cirrhosis, cholestasis, celiac sprue
liver cirrhosis - portal htn effect on spleen?
splenomegaly --> platelet sequestration
what coag factor has the shortest t 1/2 and goes down first with liver disease? what test reflects this?
when should you treat coagulopathy in liver disease?
only when symptomatic (i.e. bleeding)
pathologic inhibitors of coagulation?
antibodies against factors from...
acquired IgG to F VIII --> mucosal bleeding + easy bruising; elevated PTT; mixing doesn't fix PTT; Bethesda assay quantifies
what does thrombin act on to activate coagulation?
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)
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