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