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Flashcards in BL Practice Deck (24):
1

Is the first MTP involved in gout or CPDD?

Gout

remember gout is cool extremities and 1st MTP

2

Hemophilia A
- what is it?
- PT vs PTT?
- Genetic disorder?

(VIII Deficiency)

most common

PT is normal, but PTT is prolonged.

X linked

3

Hemophilia B
- what is it?
- PT vs PTT?
- Genetic disorder?

(Christmas/IX def)

PT is normal, but PTT is prolonged. (just like hem A)

4

Hemophilia C
- what is it?
- PT vs PTT?
- Genetic disorder?

Factor XI Deficiency

AR

PT is prolonged, but PTT is normal.
(Opp of Hem A and B)

5

The most commonly used treatment options in ITP include:

Corticosteroids
Intravenous immunoglobulin (IVIG)
Splenectomy
Rituximab
TPO (=thrombopoetin):

6

Desmopressin (DDAVP)

DDAVP stimulates release of von Willebrand factor and factor VIII from endothelial stores.It will temporarily increase levels of those factors 3 to 5 times.

7

Argatroban

direct thrombin inhibitor
- used to treat Heparin-induced thrombocytopenia syndrome (HIT) (platelets <50%)

can also use Lepirudin

8

anti jo Ab are associated with?

DM/PM

9

causes of a prolonged PT and PTT

Liver disease
Vit K def
Warfarin

10

Causes of a prolonged PTT more than protime

DIC

11

Serine Proteases

1. Protein C
2. Plasminogen
3. t-PA (tissue plasminogen activator)
4. u-PA (urokinase)

Plasmin

12

Inhibitors of fibrinolysis

PAI-1
alpha 2- antiplasmin
TAFI (an exopeptidase)

13

things factor XIII can do

aid TAFI and alpha 2- antiplasmin in fibrinolysis

- link D-D in DEDs together

14

TFBI

plays a role in anticoagulation and in protection from atherosclerosis.

(part of the quaternary complex with Xa, VIIa, TF)

15

What to avoid if you have VWD?

aspirin, NSAID’s, other platelet inhibiting drugs

16

Platelet type excessive bleeding

nosebleed,
GI bleeding,
menorraghia

*top down

17

Clotting factor

hemophilia,
joint bleed,
bleed into muscle or retroperitoneum

18

lupus anticoagulant

• Common acquired abnormality → Results in hypercoaguable state.

• Causes Antiphospholipid Antibody Syndrome (APS) → in vivo thrombotic disorders)

*remember: This is due to lupus anticoagulant: an IgG antibody that reacts against the phospholipid in the platelet membrane and endothelial cells.
○ PTT will NOT correct when mixed with normal plasma.

19

Arterial thrombi:

○ Occur in high shear stress
○ Primarily platelets, few RBCs (white thrombi)
○ If large enough, cause downstream ischemia
○ Thick, high pressure, muscular
○ High oxygen

20

Venous thrombi

○ Slow blood flow
○ Large amounts of fibrin with lots of RBCs (red thrombi)
○ More common with increased age
○ Thin, low muscle
○ Oxygen poor

21

Antithrombin deficiency:

• Regulatory protein
• 60% of people w/ deficiency have recurrent venous thrombosis

22

acquired disorders that are associated with recurrent venous or arterial thromboembolism.

1. Antiphospholipid Antibody Syndrome (One of the more severe)
2. Malignancy (Myeloproliferative disorders)
3. Trauma
4. Oral contraceptives
5. Pregnancy

23

antiphospholipid antibody syndrome

○ Can see both venous and arterial thrombosis

Clinical Criteria:
• Vascular thrombosis:
○ 1+ clinical episodes of thrombosis
• Complications of pregnancy:
○ 1+ unexplained death of fetus > 0 wks
○ 1+ premature births of neonates <10 wks

24

LMWH

Subcutaneous, longer half life, better bioavailability