Thrombopilia/Hypercoag States

Question 0

most important part of virchow’s traid for arteries

Answer 0

vessel injury

Question 1

Virchow’s Triad

Answer 1

blood vessel wall damage
altered blood flow( stasis)
altered blood composition (hypercoag)

Question 2

most important part of virchow’s tria for veins

Answer 2

stasis, hypercoag

Question 3

treatment of hyperhomocysteinemia

Answer 3

vitamins will bring down homocysteine levels but not decrease the risk of thrombosus

Question 4

4 types of antiphospholipid antibody diseases

Answer 4

lupus anticoagulant
anti bII/Gp1
anti-prothrombin
anti-cardiolipin

Question 5

how does lupus anticoagulant work

Answer 5

prevents binding of prothrombinase complex to phospholipid surface

Question 6

lab studies

Answer 6

prolongs PTT and sometimes (but not commonly) PT

Question 7

effects of lupus anticoagulant

Answer 7

in vitro- prolongs clotting time

in vivo- triggers thrombosis (by unknown mech in both arterial and venous)

Question 8

activated protein C resistance

Answer 8

due to g–>a in factor 5 which renders factor 5a resistant to inactivation by activated protein C

Question 9

ways to acquire APCR

Answer 9

pregnancy
cancer
thalidomide uses in multiple myeloma
oral contraceptives
lupus anticoagulants

Question 10

Factor V Leiden

Answer 10

heterozygotes 5-8% caucasians, asymptomatic in majority, mild risk factor for venous thrombosus, homozygotes have a much higher risk

Question 11

where does factor V affect?

Answer 11

venous circulation, little to no risk for arterial circulation

Question 12

prothrombin G20210A

Answer 12

G–>A point mutation in 3’ untranslated region of prothrombin gene
same manifestation as factor V leiden

Question 13

hereditary protein c deficiency genetics

Answer 13

autosomal dominant
homos lethal in utero
venous not arterial thrombosis

Question 14

job of protein C

Answer 14

with cofactor protein S, inactivates factors V and VIII

Question 15

lab tests for protein C deficiency

Answer 15

screen activity level–>if low screen for antigen–>if low, type 1, if normal, type 2

Question 16

how is protein S different from protein C?

Answer 16

longer half life

Question 17

protein S deficiency genetics

Answer 17

normally lethal as homozygous- autosomal dominant

Question 18

Type 1 Protein S deficiency

Answer 18

functional activity low
free antigen low
total antigen low

Question 19

type II protein S deficiency

Answer 19

functional activity low
free antigen normal
total antigen normal

Question 20

type III protein S deficiency

Answer 20

functional activity low
free antigen low
total antigen normal

Question 21

hereditary antithrombin def genetics

Answer 21

autosomal dom

homos die

Question 22

when does antithrombin deficiency present

Answer 22

usually before agre 50, typically <35

Question 23

why is antithrombin deficiency different?

Answer 23

more severe than thrombophilia

Question 24

why does factor V leiden persist in population

Answer 24

higher sperm count in males, less bleeding in childbirth–>gene persists