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CPS Exam #2 > Case #5 -- Car Wreck > Flashcards

Case #5 -- Car Wreck Flashcards

(72 cards)

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1
Q

What are petechiae?

A

1-3 mm red spots caused by bleeding into the skin

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2
Q

What are fibroids?

A

Benign tumors of muscular or fibrous tissues

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3
Q

What do the temperatures 37C and 40C correlate with in Farenheight?

A 
37C = 104 F
37C = 98.6 F
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4
Q

What does the phrase “well-developed”

A

Common in Pediatrics

Comparison of development to average for age group

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5
Q

PT times is a measure of? PTT is a measure of?

A

PT – Extrinsic Pathway

aPTT – Intrinsic Pathway

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6
Q

Loss of von willebrand factor corelated with loss of what other factor?

A

8

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7
Q

What does a Ristocetin cofactor assay assess?

A

Ristocetin needs vW to aggregate

If added and no aggregation, no vW

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8
Q

What does the platelet aggregation to ADP assay indicate?

A

GB2P – It activated the receptor

Decreased levels – Bernard Sollier

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9
Q

DDAVP is also known as…

A

Desmopressin

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10
Q

Common symptoms of vW?

A

Bleeding during operations/trauma
Abnormal Periods
Bruising, Nosebleed, Rash

In type III – Hemearthrosis

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11
Q

What does vW factor do?

A

It helps platelets clump together and stick to the blood vessel

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12
Q

Difference between type I, II, and III

A

I – Reduced vW factor
II – Production of vW that doesn’t work
III – Basically No vW factor

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13
Q

What drugs is it important not to give to vW patients?

A

NSAIDS

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14
Q

What vitamin deficiency should you watch for in bleeding disorders?

A

K

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15
Q

Hemarthresis is characteristic of what type of bleeding disorders?

A

Hemophillia

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16
Q

Components of plugging the blood flow.

A

Activation of platelets that form platelet plug

Stabilization by cross-linked fibrin

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17
Q

Three components of hemostasis? The role of vW?

A

Platelets, Vascular Wall, Coagulation Factor

vW links vascular wall to platelets.

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18
Q

How might hemostasis fail?

A

Too Few Platelets
Dysfunctional Platelets (Heredity, Acquired)
Improper Adhesion (vW, abnormal collagen)
Decreased Coagulation Factors (Heredity, Acquired)

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19
Q

Platelets bind to eachother via…

A

Fibrinogen (GpIIb-IIIa)

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20
Q

Platelets bind to denuded collagen via…

A

vWF (GpIb)

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21
Q

Hereditary causes or improper adhesion of platelets to eachother?

A

Bernard-Soulier

Glanzmann Thrombasthenia

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22
Q

Blood vessel abnormalities that may influence clotting?

A

Ehlers-Danlos Syndrome

Vasculitis

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23
Q

What causes platelet activation (3)?

A

Exposure to collagen
Exposure to Tissue Factor
Exposure to Thrombin

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24
Q

When would you expect platelets to be exposed to collagen?

A

Damaged Vessels

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25
When would you expect platelets to be exposed to tissue factor?
Damaged endothelial cells to other tissue
26
When would you expect platelets to be exposed to thrombin?
Activation of coagulation cascade
27
Common sign of platelet problems? | How to you test for it?
Petechiae, easy bruising | Bleeding Time
28
What do you do in a bleeding time test?
Make a small cut and at different time intervals, assess the clot formation. Abnormally long bleeding time/oozing = platelet problem
29
Why do hemophiliacs have normal bleeding time?
Defects of coagulation factors alone do not prohibit platelet plugging of small fascular holes. CFs stabilise the plugs and large vascular tears
30
Name the four receptors platelets respond to?
Gp Ia-IIa Gp Ib/V/IX (vW) Gp VI Gp IIb-IIIa
31
What is Bernard Soulier?
Gp Ib Deficiency
32
Deficiency of GpIb... GpIIa-IIIa...
Bernard Soulier | Glanzmann thrombasthenia
33
Causes of too few platelets?
``` Increased Destruction (ITP, hypersplenism) Decreased Synthesis (Leukemia) ```
34
Aspirin and NSAIDs inhibit...
Thromboxane | Causes contraction and increased clotting
35
Enzyme important in clotting cascase?
Serine proteases
36
Alternate names for factor I and II
I -- Fibrinogen | II -- Thrombin
37
Two roles of thrombin?
Activated plasmin from plasminogen | Forms fibrin from fibrinogen
38
Plasminogen activators are used in what medical scenario?
Dissolving clots in MI or stroke
39
Extrinsic pathway is mediated by.... Starts with Factor.... Tested with....
Thromboplastin Factor VII PT
40
Intrinsic pathway is triggered by... Starts with Factor.... Tested with...
High MW kininogen and exposure of collagen Factor XII aPTT
41
Two factors associated with hemophilia?
VIII and IX
42
Mneumonic for PT?
You do PT outside at 7AM.
43
Factors in Common Pathway?
X, V, and II
44
Bleeding Time, Ristocetin, PT, and aPTT. What's off in platelet disorders?
Bleeding Time
45
Bleeding Time, Ristocetin, PT, and aPTT. What's off in Hemophillia?
aPTT
46
Bleeding Time, Ristocetin, PT, and aPTT. What's off in Vitamin K deficiency?
PT and aPTT
47
Bleeding Time, Ristocetin, PT, and aPTT. What's off in Liver Failure?
PT and aPTT
48
Bleeding Time, Ristocetin, PT, and aPTT. What's off in vW?
Bleeding Time, aPTT, Ristocetin
49
Why does Vitamin K influence PT and aPTT?
Vitamin K carboxylates elements of both passages
50
Why does vW disease cause a prolonged aPTT?
vW stabilizes and localizes Factor VIII
51
Why can't a aPTT test distinguish btw hemophilia A and B?
Hemophilia A -- Factor XIII deficiency Hemophilia B -- Factor IX deficiency Both deficiencies present in the intrinsic pathway
52
How do you distinguish between Hemophilia A and B?
Add the blood to a solution with blood with the respective factors to assess clotting. If neither works, an inhibitor is present.
53
Inheritance pattern of vW I, II, and III
vW I -- Autosomal Dominant II -- Autosomal with variable penetrance III -- Autosomal Recessive
54
Why might desmopressin be ineffective against Type II vW?
Type II vW is a qualitative defect
55
Common causes of acquired vW? (5)
``` Cancer Hypothyroidism Systemic Lupus erythematosus Heart Problems Meds ```
56
Four sources of Vascular Abnormalities?
Ehlers-Danlos Syndrome (Collagen Abnormalities) Scurvy (Abnormality of cross-linking of collagen) Vascular Infections (Riskettsia) Henoch-Schonlein Purpura
57
Genetic inheritance of hemophilia?
X-linked inheritance
58
Unexplained pain in hemphilia should be assumed to be...
bleeding
59
Hemophilia treatment?
Factor Replacement Pain Control Rest Immobilize Joints
60
If low response to factor replacement, probably means...
Test for Inhibitor
61
Difference between Concentrates and Cryoprecipitates.
Concentrates are Screened and Irradiated. | Cryoprecipitates are screened, but not irradiated
62
What is desmopressin?
A synthetic version of vasopressin
63
What does desmopressin do?
Increase in vW release from endothelial cell Weibel-Palade bodies
64
Name for intranasal desmopressin?
Stimate
65
Side effects of desmopressin?
Water conservation with hyponatremia (dilution of Na) | Can cause seizures
66
Why cans highly purified FVIII concentrates be used to treat VWD?
They lack VWF
67
When would a cryoprecipitate be an appropriate recommendation?
If a concentrate is not available and DDVAp is unavailable or ineffective.
68
What is Epsilon aminocaproic acid?
Treatmet used to prevent dissolution of the hemostatic plug, esp. in mucous membrances
69
What topical agents are used to treat bleeding?
``` GelFoam, Surgicel (Have topical thrombin) Micronizen Collagen (Avitene) ```
70
Influence of estrogen on vWD?
Increased vWD synthesis
71
What pain treatment might you use for VW patients?
Acetaminophen
72
What does multifactorial inheritance mean?
Disease is caused by interplay between genetic and environmental factors

CPS Exam #2 (2 decks)

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