Coagulation

Question 1

3 steps of hemostasis

Answer 1

vasospasm
platelet plug fomation
coagulation

Question 2

hemostasis

Answer 2

the ability to minimize blood loss

Question 3

vasospasm

Answer 3

vasoconstriction

Question 4

4 steps of platelet plug formation

Answer 4

1. adhesion
2. platelet activation
3. platelet aggregation
4. platelet plut

Question 5

vonWillebrand factor (vWH)

Answer 5

holds platelets up to the exposed collagen

Question 6

platelet activation

Answer 6

platelets release chemical messages to get more platelets to come (ADP, seratonin, thromboxane, A2)

Question 7

platelet aggregation

Answer 7

a bunch of platelets come together to plug up the exposed area

Question 8

prostacyclin

Answer 8

secreted by neighboring, healthy cells so that platelets only aggregate in the correct area

Question 9

factor XII

Answer 9

activated when surface contact-turns into activated 12a

Question 10

what is thrombin’s key function?

Answer 10

turn fibrinogen into fibrin (active form)

Question 11

fibrinolysis

Answer 11

breakdown of a clot and resorbtion of the clot

Question 12

plasmin

Answer 12

enzyme responsible for the breakdown of fibrin

Question 13

normal platelet count

Answer 13

150,000-450,000/ uL

-not a measure of function

Question 14

why is the patient bleeding?

Answer 14

platelet?

coagulation?

Question 15

platelet bleeding problems may be seen with

Answer 15

petechiae, ecchymosis or purpura

Question 16

thrombocytopenia

Answer 16

low platelet count

Question 17

reasons why platelets may not be working

Answer 17

aspirin
uremia
genetic disorders (rare)
vWF (can’t bind without it)

Question 18

bleeding test

Answer 18

BT (higher it is, the longer you bleed)

-not used anymore

Question 19

normal range PT (prothrombin time)

Answer 19

13-17 seconds

Question 20

what does the PT measure?

Answer 20

extrinsic and common pathways
(5, 7, 10, 2 and 1)
-INR (intl normalized ratio)
-used to monitor coumadin

Question 21

increased PT time values may indicate

Answer 21

vitamin K deficiency and liver disease

Question 22

vitamin K deficiency can be caused by

Answer 22

bile duct obstruction

malabsorption

Question 23

liver disease affects coagulation in that

Answer 23

vitamin K is used by the liver to make the clotting factors and bile salts are also used and formed in the liver

Question 24

normal values for the aPPT

Answer 24

25-36 seconds

Question 25

what does the aPPT measure?

Answer 25

intrinsic and common pathway (12, 11, 9, 8, 10, 5, 2, 1) -used to monitor heparin therapy

Question 26

what conditions would cause a prolonged aPPT?

Answer 26

``` hemophilia A (missing factor 8) hemophilia B (missing factor 9) biliary obstruction (no vitamin K absorbed) hepatocellular diseases ```

Question 27

normal ranges for fibrinogen

Answer 27

150-350 mg/dl

Question 28

what is fibrinogen used for?

Answer 28

diagnose fibrinogen disorders or inhibitors of thrombin | -also to diagnose problems with fibrinolysis

Question 29

when might fibrinogen be increased?

Answer 29

tissue inflammation

Question 30

normal ranges of TT (thrombin time)

Answer 30

15-18 seconds | -measures common pathway

Question 31

tissue factor pathway inhibitor

Answer 31

acts on the common pathway to control the clot

Question 32

bleeding differential diagnosis

Answer 32

``` CALFDIPS cirrhosis and coumadin aspirin leukemia factor definciency (hemophilia) disseminated intravascular coagulopathy idopathic thrombocytopenic purpura (ITP) platelet deficiency or dysfunction scurvy-vitamin C deficiency ```

Question 33

vonWillebrands disease

Answer 33

most common inherited congenital bleeding disorder | -clinical presentation is bleeding (nasal, sinus, vaginal, GI, deep tissue bleeding)

Question 34

what other factor is related to the vWF?

Answer 34

factor VIII

Question 35

how is DDAVP used?

Answer 35

treat VWD (stimulates release vWF)

Question 36

hemathrosis

Answer 36

main symptom of hemophilia | -hematoma of the joints

Question 37

expected lab results for hemophilia

Answer 37

aPPT will be high | PT will be low

Question 38

FDP

Answer 38

fibrinogen degradation products

Question 39

how does aspirin prevent clotting?

Answer 39

kills platelet function for the life of the platelet

Question 40

how do NSAIDS prevent clotting?

Answer 40

deactivate platelet, but function returns w/in 24 hours

Question 41

what is the main symptom of hemophilia a or b?

Answer 41

hemarthrosis

Question 42

what are the causes of hypercoagulability?

Answer 42

too many platelets vascular injury clotting factors not working properly (anticlotting factors) stasis and surgery