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S.N Pathophys final > Pathophys II- Hemostasis > Flashcards

Pathophys II- Hemostasis Flashcards

1
Q

Which test measures Extrinsic pathway?

A

PT

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2
Q

Which test measures Intrinsic pathway?

A

aPTT

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3
Q

aPTT means

A

activated Partial Thromboplastin Time

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4
Q

Bleeding time measures=

A

PLT ability of adhesion to vessel walls

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5
Q

Normal BT value

A

3-8 min

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6
Q

BT↑ when PLT__

A

Decrease

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7
Q

If BT↑ and PLT are normal=

A

Problem with PLT function

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8
Q

What is needed for aPTT?

A

Phospholipid
Surface
Calcium

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9
Q

Normal aPTT time=

A

30-40 sec

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10
Q

When checking for aPTT, are there any PLT?

A

No

Only plasma

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11
Q

How de we detect Inhibitors?

A

We mix patient plasma with normal plasma 1:1

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12
Q

If PT and aPTT prolonged

A

Inhibitor of common pathway or strong lupus inhibitor

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13
Q

Initiation of extrinsic pathway

A

TF
Lipid
Calcium

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14
Q

Normal PT time

A

10-14 sec

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15
Q

Normal INR

A

1

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16
Q

Prolonged PT may mean-

A 
Deficiency of:
I
II
V
VII
X
Oral anticoagulant
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17
Q

TT determines

A

Rate of thrombin induced fibrinogen cleavage

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18
Q

Normal value TT

A

<20 sec

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19
Q

Prolonged TT means

A

Many things-

<100 mg/dL Fibrinogen

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20
Q

Normal value Fibrinogen

A

200-400 mg/dL

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21
Q

Decreased FIbrinogen seen in

A

Liver disease

DIC

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22
Q

Which clotting factors need vitamin K?

A 
II
VII
IX
X
Protein S
Protein C
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23
Q

Warfarin mechanism

A

Blocks enzyme that activates vit.K

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24
Q

D-dimer may be elevated in

A 
DIC
Venous thromboembolism
Infection
Cancer
Pregnancy
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25
Q

Heparin mecahnism

A

Binds Antithrombin III and activates it

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26
Q

Laboratory alteration in DIC

A

PLT↓
FIbrinogen↓
D-dimer in serum and urine

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27
Q

When do Purpura happens?

A

When small blood vessels burst

28
Q

High MPV may mean

A

We produce too many PLT

29
Q

Patient with thrombocyopenia and known history of SLE=

A

Idiopathic Thrombocytopenic purpura

30
Q

What shoould we check in order to determine Idiopathic Thrombocytopenic purpura

A

Auto ab

31
Q

Immune complex deposition is type __ HSN

A

III

32
Q

Patient with thrombocyopenia and known history of SLE.

How can we explain the renal failure?

A

Lupus nephritis- Immune complex deposition

33
Q

What can explain the anemia in this patient with SLE?

A

Renal failure means low EPO

34
Q

WHy low PLT in the patient with SLE

A

Spleen recognize the Ab coated PLT and destroys them

35
Q

BUN=

A

Blood Urea Nitrogen

36
Q

Recurrent epileptic seizures
Fever
Purpura
Low PLT

A

Thrombotic Thrombocytopenic purpura

37
Q

Thrombotic Thrombocytopenic purpura mecahnism

A
  • Antibodies inhibiting ADAMTS13

- ADAMTS13 disfunction

38
Q

ADAMTS13 job

A

Breaks down multimers of vWF

39
Q

What happens when multimers of vWF are not broken down?

A

More prone to coagulation

Coagulation happens ,ore frequently in the microcirculation

40
Q

Why LDH is high in Thrombotic Thrombocytopenic purpura

A

RBC passing microscopic clots are subject to shear stress→Membrane damage→Rupture of RBC

41
Q

Why anemia and schistocyte in Thrombotic Thrombocytopenic purpura?

A

RBC passing microscopic clots are subject to shear stress→Membrane damage→Rupture of RBC

42
Q

Why renal failure in Thrombotic Thrombocytopenic purpura?

A

Microthrombi in renal vessels

43
Q

Why Haptaglobin is low in Thrombotic Thrombocytopenic purpura?

A

Intravascular hemolysis

44
Q

What od we expect to see on blood smear in case of Thrombotic Thrombocytopenic purpura?

A

Schistocytes

45
Q

Normal ESR values

A

0-20 mm/h

46
Q

Is CK 160 U/l normal?

A

Yes

47
Q

Which cardiac marker should be elevated in MI?

A

CK-MB

48
Q

CK-MB means

A

Creatine Kinase Myocardial Band

49
Q

Right swollen thigh
Dilated superficial veins
Dyspnea
Chest pain

A

DVT with PE

50
Q

How to confirm DVT with PE

A

Ultrasound
Chest CT angiogram
ECG

51
Q

What pattern on ECG can we see in PE

A

S1Q3T3

52
Q

Patient with:
PLT↓↓↓
BT↑
Normal coagulation parameters

A

Severe Thrombocytopenia

53
Q

What can cause Severe Thrombocytopenia?

A

Acute Leukemia
Autoimmune Thrombocytopenia
Drug induced

54
Q

TT normal value

Thrombin Time

A

<20 sec

55
Q

Why we see aPTT↑ in vWF disease?

A

Bcs it is bound to fVIII usually and without it fVIII has shorter life time and it effects the Intrinsic pathway

56
Q

How can we make sure it is vWF disease except genetics?

A

Ristocetin aggregation test

57
Q

Describe Ristocetin

A

Ristocetin enhance vWF ans PLT GPbI addhesion

58
Q

GPbI deficieny is called

A

BSS

Bernard Soulier Syndrome

59
Q

Normal ESR

A

<20 mm/h

60
Q

TT value

A

<20 sec

61
Q

Pain in the leg+elevaated D-Dimer can be due to

A

DVT

62
Q

What can trigger formation of Anti-phospholipid Ab?

A

HLA-DR7 mutation

63
Q

HLA-DR7 makes what protein

A

MHC-II on B cells

64
Q

Young women eith SLE and aPTT↑

A

Antiphospholipid syndrome

65
Q

We can diagnose TTP while checking for

A

ADAMTS-13

S.N Pathophys final (11 decks)

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