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Pathology - Hematology > Bleeding Disorders > Flashcards

Bleeding Disorders Flashcards

(45 cards)

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1
Q

activation of coagulation cascade takes place in association with…

A

phospholipids (platelet/cell surface)
Ca
Cofactors

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2
Q

Nearly all coagulation proteins are produced where_____

Exception?

A

in the liver

vW n the endothelial cells

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3
Q

Name the Vit K ones…

A

2, 7, 9, 10, C, S

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4
Q

Deficiencies of which factors are not associated with bleeding tendencies

A

12, prekalikrein, HMW kininogen

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5
Q

How is coagulation inhibited?

A
  1. Plasminogen-Plasmin system breaks down fibrin polymerization, cleavage to plasmin by activators
  2. ANTITHROMBINS
  3. PROTEIN C + S
  4. C1 ESTERASE INHIBITOR, ALPHA 2 MACROGLOBULIN
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6
Q

PROTEIN C AND S INHIBIT…

A

FACTOR 5 AND FACTOR 8

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7
Q

Antithrombins inhibit the activity of…

A

thrombin

9a, 10a, 11s, 12a

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8
Q

Platelet structural features tested as…

A

Platelet factor 3

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9
Q

Thrombin activated ______. So what?

A

FACTOR 13
This is a fibrin-stabilizing factor that allows for cross linking. This make a clot resistant to solubilization in 6M urea

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10
Q

Importance of plasminogen activators

A

They induce the formation of active plasmin, which degrades several proteins, but especially plasminogen on fibrin

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11
Q

What is EACA?

A

a competitive inhibitor of plasminogen activators

Decreases fibrinolysis

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12
Q

Name two common drugs used as plasminogen activators therapeutically

A

Urokinase

Streptokinase

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13
Q

How does Heparin work?

A

potentiates anti-thrombin III

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14
Q

How does Coumadin work?

A

Interferes with Vit K carboxylation

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15
Q

What is DDAVP?

A

desmopressin acetate –> increases factor 8 levels transiently

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16
Q

What do patients get in fresh frozen plasma

A

Coag factors, no platelets

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17
Q

Normal Bleeding time

A

2-7 mintues

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18
Q

Which clotting factor being low can cause a low bleeding time

A

fibrinogen

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19
Q

INR is equivalent to which test

20
Q

Solubility in 6M urea is a test for…

Study These Flashcards
A

Factor 8 stabilization

21
Q

Ristocetin test is used to test

Study These Flashcards
A

Specific aggregation of platelets due to vWF

22
Q

Causes of non-thrombocytopenic purpuras?

Study These Flashcards
A

Infections, Drug reactions, Scurvy, Ehlers Danlos

23
Q

Infections that cause non-thrombocytopenic purpuras

Study These Flashcards
A

Septicemia
Meningococcemia
Severe Measles
Rickettsia

24
Q

Thrombocytopenia is a platelet count of…

Study These Flashcards
A

under 100,000

25
Six causes of thrombocytopenia
1. Bone Marrow Disease 2. Ineffective megakeryopoesis (folate/B12) 3. Immune Destruction 4. Mechanical 5. Hypersplenism (sequestration) 6. Dilutional (from massive transfusion)
26
Cause of neonatal thrombocytopenia
PLA1 antigens can lead to destruction of fetal platelets by antibodies made in mother (like erythro. fetalis)
27
What is ITP? Secondary causes?
Platelets are destroyed by anti-platelet antibodies | SLE, AIDS, post-viral, drug therapy complication
28
Target antigens in ITP
IIb/IIIa and Ib/IX
29
Major form of immune damage in ITP?
mostly via IgG | Phagocytosis follows
30
Why do a splenectomy for ITP
Decrease antibody formation and sequestration
31
Clinical features of ITP
Women of CB age Bruising, excessive bleeding, epistaxis Treat w/ steroids
32
Pentad of symptoms of TTP
Fever, Thrombocytopenia, MAHA, Neurological deficits, renal failure
33
TTP leads to widespread formation of....
Hyaline thrombi in microcirculation Dense platelet aggregates + fibrin Large multimers of vWF/complex leading to microvascular thrombosis
34
How to distinguish HUS from TTP
Absence of neurological symptoms | Mostly a renal problem
35
Inheritance for hemophillia A
X linked
36
Inheritance for vW disease
autosomal dominant
37
What is Leiden Factor V
Arg-->Glu in Factor 5 makes resistant to protein C | Causes Deep vein thromboses
38
Other than Leiden Factor V, other important hereditary hypercoagu. disorders
Prothrombin Deficiency Hyperhomocysteinurea Protein C or S Deficiency
39
What is Heparin induced thrombocytopenia syndrome
Unfrax. heparin induces formation of antibodies to complexes of heparin and PF4
40
What is anti-phospholipid syndrome
Make anti-phospholipid antibodies in SLE Cardiac valvular vegitations, repeated miscarriages False positive for Syphilis
41
medication classically associated with hypercoagubility
oral contraceptives
42
What is ticlopidine
ADP antagonist
43
What is abciximab
monoclonal Ab to GpIIb-IIIa
44
How does TTP present differently than DIC
In DIC you use up all the coagulation factors
45
You need Factor ___ or the clot will stabilize in 6M urea
13

Pathology - Hematology (9 decks)

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