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Coagulation Flashcards

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1
Q

Stability of a PTT test

A

4 hours

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2
Q

Stability of a heparin sample

A

separate within 1 hour and test within 2 hours

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3
Q

Stability of PT test

A

if cap 24 hours

if uncapped 4 hours

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4
Q

Factors measured using PT

A

1,2,5,7,X

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5
Q

Clinical use of PT

A

monitor oral coagulation therapy such as warfarin and Coumadin

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6
Q

What pathway is measured by PT test

A

extrinsic

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7
Q

Reagents used for PT

A

thromboplastin (neoplastic) and CaCl

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8
Q

what’s the purpose of warfarin therapy

A

to inhibit vitamin K factors

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9
Q

What are the vitamin K factors

A

2,7,9,X

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10
Q

When do we see vitamin K deficiency

A

in obstructive jaundice or sterile gut

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11
Q

Whats the half life of factor 7

A

3.5 - 5

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12
Q

What is PT sensitive to?

A

liver diseases, hyperfibrinogenemia and vitamin K deficiency

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13
Q

Whats the reference range of PT

A

11.4 - 14.4

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14
Q

What have a heparin neutralizer

A

Neoplastic for PT test

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15
Q

What does INR stands for

A

International Normalized Ratio

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16
Q

What does INR do?

A

correct PT’s reagents sensitivity due to warfarin

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17
Q

What does ISI stands for

A

International Sensitivity Index

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18
Q

How to measure INR

A

Patient PT/Mean of Lab reference ^ ISI

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19
Q

Whats the reference range of INR

A

2 - 3

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20
Q

What factors are measure in PTT

A

1,2,5,8-12

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21
Q

What factors are part of the common pathway

A

1,2,5,X

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22
Q

Whats the purpose of heparin

A

to increase antithrombin 3 which inhibits 12a,11a,9,a and 2a

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23
Q

What does lupus anticoagulant do to coagulation studies

A

prolong PTT

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24
Q

When is PTT prolonged

A

during liver diseases, hypofribrinogemia and warfarin therapy

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25
Whats the reference range of PTT
23-34
26
Whats the purpose of mixing studies
to determine whether there's a factor deficiency or an inhibitor
27
Whats the reagent used in mixing studies
pooled normal plasma
28
What does no/partial correction in a mixing studies indicates
the presence of an inhibitor
29
what does correction in a mixing studies indicates
the presence of an deficiency
30
Fibrinogen is ___ to the time for clot formation
inversely proportional
31
Clinical use of fibrinogen
determine dic, trauma cases and asparginase therapy
32
reference range of fibrinogen
185-465
33
Whats the purpose of thrombin time
measures the time it takes for a clot to form after an excess of thrombin has been added.
34
Clinical use of thrombin time
heparin contamination dysfibrinogemia hypofibri
35
what are the thrombin inhibitors
lepuridin and argatroban
36
What test do we perform if Thrombin is abnormal
reptilase time
37
Whats repitlase time
a bothrops venom that cleave fibrinopeptides A from fibrinogen
38
Whats the purpose of reptilase time
detect fibrinogen polymerization disorders in the presence of heparin
39
Whats the cause of normal reptilase time
heparin
40
Whats the cause of equally prolonged reptilase time/thrombin
hypofibrino
41
Whats the cause of strongly prolonged reptilase time
dysfribrino
42
Whats the cause of slightly prolonged reptilase time
elevated fdp
43
What test is used to determine fibrinolysis or fibrinogenolysis
FDP
44
What happen during DIC
Elevated FDP and D dimers
45
Secondary fibrinolysis
clot formation followed by fibrin dissolution
46
Fibrinogenolysis
systemic activation of plasminogen
47
Primary fibrinolysis
increased FDP but no D Dimers due to no degradation of cross linked fibrin, but degradation of fibrinogen
48
reference range of FDP
<5
49
Plasminogen activators , what converts plasminogen into plasmin
TPA urokinase streptokinase
50
What neutralizes plasmin
alpha 2 antiplasmin
51
what degrades fibrin clots into different products
plasmin
52
what's the by product of fibrin
d dimers
53
Clinical used of D dimers
determine DIC
54
what causes false elevation of D dimers
Rheumatoid factor >50
55
what causes false decreased of D dimers
lipemia
56
reference range of D dimers
<0.5
57
Hemostasis
a balance that maintains the blood liquid and inside the vessels
58
PLT
small, anuclear and disk form
59
what's the unstimulated state of plt
discoid
60
What system does hemostasis depend on
Vascular plasma coagulation factors plt fibrinolytic system
61
What are the 4 functions of PLT
response to vascular injury contributes to coagulation cascade maintain vascular integrity response to inflammation
62
Sequence of vascular injury
Attraction to site due to collagen adhesion morphologic changes aggregation due to phospholipid layer
63
Where the coagulation factors generated from
liver
64
what coagulation does not generates in the liver
Factor 8, the vW part
65
where is vW produced
in the endothelial cells or megaK
66
What activates the intrinsic pathway
surface contact
67
what activates the extrinsic pathway
vascular injury
68
What does primary hemostasis depend on
plt response and constriction (vessel wall)
69
What does primary hemostasis depend on
cascade systems
70
what factors aren't proteins
calcium factor 4 | thromboplastin factor 3, tissue factor
71
What are the categories of coagulation factors
fibrinogen prothrombin contact famil
72
Fibrinogen family
fibrinogen, factors 5,8,13
73
Prothrombin family
2,7,9,X and protein C/s
74
contact family
Pk, HMWK, Factor 12 and 11
75
What factors are not measured in PT
3,4
76
what are the advantage of a thromboplastin reagent which has a lower ISI value
the lower the ISI, the more responsive the reagent
77
What factors aren't measure by PTT
7,13
78
Activators used in PTT
kaolin,silica and elegiac acid
79
What causes prolonged PTT
heparin
80
Whats heparin plasma cofactor
antithrombin 3
81
Natural inhibitors
antithrombin 3 and protein c/s
82
whats the most important inhibitor
antithrombin 3
83
primary function of antithrombin 3
inactivate thrombin
84
Where do we see low and high levels of anti3
low levels: hepatic disorders such as cirrhosis or acute hepatitis high inflammation
85
what factors does protein C/S inhibits
5a and 8a and PAI-1
86
How is fibrinolysis accomplished
intrinsic, extrinsic or exogenous
87
Exogenous therapeutic activation
streptokinase, urokinase and tpa
88
main inhibitor of plasmin
pai -1
89
main inhibitor of plasminogen
alpha 2 antiplasmin
90
when is d dimers present
after degradation of fibrin clot

Coagulation (1 decks)

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