Coagulation Flashcards by Shaquan Moore

Q

General term for any process that stops bleeding?

homeostasis or Hemostasis

A

Hemostasis

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Q

Which is reinforcement of platelet plug with fibrin

ANTIPLATELETS , COAGULATION, ANTICOAGULANTS

A

COAGULATION

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Q

Which comes first in Hemostasis stages

Coagulation , Formation of a platelet plug

A

Formation of a platelet plug

Coagulation

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Q

STAGE ONE- Formation of platelet plug fill in blank!

Damaged blood vessel
Platelets come into contact with collagen on exposed surface of damaged vessel.
Platelets ? to damage site (von Willebrand Factor via GP 1b)
? initiates platelet ?
? leads to platelet ?

adhesion, adhere, activation, aggregation

A

adhere
adhesion
activation
activation
aggregation

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Q

STAGE ONE- Formation of platelet plug fill in blank! CON

activation leads to platelet ?
Aggregation- ?
results in formation of ? between ? on adjacent platelets
? create a plug that stops bleeding ?Stable or Unstable? plug

complex process, glycoprotein IIb/IIIa receptor, aggregation, fibrinogen bridges, aggregated platelets

A

aggregation
complex process
fibrinogen bridges
glycoprotein IIb/IIIa receptor
aggregated platelets
Unstable

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Q

STAGE ONE- Formation of platelet plug fill in blank! CON
What complex process is formed during Aggregation?

complex process, glycoprotein IIb/IIIa receptor, aggregation, fibrinogen bridges, aggregated platelets

A

fibrinogen bridges

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Q

STAGE TWO- Coagulation

Defined as production of ?

Done by two pathways
? (contact/surface activation pathway)
? (tissue factor pathway)
Both ultimately converge at ?

Intrinsic, fibrin (I), Factor Xa, Extrinsic

A

fibrin (I)
Intrinsic
Extrinsic
Factor Xa

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Q

STAGE TWO- Coagulation

What is the production of Coagulation define as ?

Intrinsic, fibrin (I), Factor Xa, Extrinsic

A

fibrin (I)

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Q

STAGE TWO- Coagulation

Which contact/surface activation pathway?

Intrinsic, fibrin (I), Factor Xa, Extrinsic

A

Intrinsic

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Q

STAGE TWO- Coagulation

Which is tissue factor pathway

Intrinsic, fibrin (I), Factor Xa, Extrinsic

A

Extrinsic

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Q

STAGE TWO- Coagulation

Where do Intrinsic and Extrinsic converge at

Intrinsic, fibrin (I), Factor Xa, Extrinsic

A

Factor Xa—-10a

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Q

STAGE TWO- Coagulation
What is the final result of both Intrinsic and Extrinsic pathways

fibrin (I), Factor Xa, fibrin

A

fibrin

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Q

Hemostasis/Coagulation
Which is an enzyme that causes a blood clotting factor?

plasminogen, von Willebrand Factor, thromboplastin, prostacyclin, proteins C & S

A

thromboplastin

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Q

Hemostasis/Coagulation
Which is an enzyme that causes dissolution of fibrin blood clots.

plasminogen, von Willebrand Factor, thromboplastin, prostacyclin, proteins C & S

A

plasminogen

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Q

Hemostasis/Coagulation
Which is a lipid molecules that inhibits platelet activation and is also an effective vasodilator.

plasminogen, von Willebrand Factor, thromboplastin, prostacyclin, proteins C & S

A

prostacyclin

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Q

Hemostasis/Coagulation
Which is a blood glycoprotein involved in hemostasis.

plasminogen, von Willebrand Factor, thromboplastin, prostacyclin, proteins C & S

A

von Willebrand Factor

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Q

Hemostasis/Coagulation
Which regulates blood clotting?

plasminogen, von Willebrand Factor, thromboplastin, prostacyclin, proteins C & S

A

Proteins C & S

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Q

Hemostasis/Coagulation
Which of the following promotes the above?

a. Platelets
b. Prostacyclin
c. von Willebrand Factor
d. anti-thrombin III,
e. activated clotting factors
f. Proteins C & S,
g. plasmin(plasminogen)
h. thromboplastin
i. TXA2
j. ADP

A

a. Platelets
c. von Willebrand Factor
e. activated clotting factors
h. thromboplastin
i. TXA2
j. ADP

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Q

Hemostasis/Coagulation
Which of the following inhibits the above?

a. Platelets
b. Prostacyclin
c. von Willebrand Factor
d. anti-thrombin III
e. activated clotting factors
f. Proteins C & S,
g. plasmin(plasminogen)
h. thromboplastin
i. TXA2
j. ADP

A

b. Prostacyclin
d. anti-thrombin III
f. Proteins C & S
g. plasmin(plasminogen)

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Q

Which is an irregular and often rapid heart rate that occurs when the two upper chambers of your heart experience chaotic electrical signals.

Pulmonary embolism, DVT, Thrombus, Atrial Fibrillation, Embolism, Prophylaxis

A

Atrial Fibrillation

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Q

is a sudden blockage of blood clot that break loose and travels through the bloodstream to the lungs in a lung artery.

Pulmonary embolism, DVT, Thrombus, Atrial Fibrillation, Embolism, Prophylaxis

A

Pulmonary embolism

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Q

Which is an obstruction of an artery by blood clots/

Pulmonary embolism, DVT, Thrombus, Atrial Fibrillation, Embolism, Prophylaxis

A

Embolism

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Q

Which is a blood clot formed in within the vascular system (Veins and Arteries)

Pulmonary embolism, DVT, Thrombus, Atrial Fibrillation, Embolism, Prophylaxis

A

Thrombus

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Q

Which of is when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs.

Pulmonary embolism, DVT, Thrombus, Atrial Fibrillation, Embolism, Prophylaxis

A

DVT

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Which of the following means action taken to prevent diseases? Pulmonary embolism, DVT, Thrombus, Atrial Fibrillation, Embolism, Prophylaxis

Prophylaxis

Hemostasis/Coagulation What disease states are we concerned about? ?-state why. a. DVT Prophylaxis b. Travelling c. Pregnancy d. Cancer e. Atrial Fibrillation- f. Mechanical heart Valve g. All Hypercoagulable, Hospitalized/immobile, Stroke

All a. Hospitalized/immobile b. c. Hypercoagulable e. Stroke

Hemostasis/Coagulation What complications from these disease states can arise? a. Blood clot b. Thrombus c. Ulcers d. Embolism e. Toxics f. Pulmonary embolism g. DVT

a. Blood clot b. Thrombus d. Embolism f. Pulmonary embolism g. DVT

Coagulation Modifier Drugs Which is an Antithrombotic drugs? Antiplatelet drugs- ,Anticoagulants, Thrombolytic drugs

Anticoagulants

Coagulation Modifier Drugs Which is DVT/PE prevention/treatment ? Antiplatelet drugs- , Anticoagulants/Antithrombotic drugs, Thrombolytic drugs

Anticoagulants/Antithrombotic drugs

Coagulation Modifier Drugs Which inhibit platelet aggregation Antiplatelet drugs- , Anticoagulants/Antithrombotic drugs, Thrombolytic drugs

Antiplatelet drugs

``` Coagulation Modifier Drugs Which Lyse (break down) existing clots ``` Antiplatelet drugs- , Anticoagulants/Antithrombotic drugs, Thrombolytic drugs

Thrombolytic drugs

Coagulation Modifier Drugs Which Inhibit the action or formation of clotting factors Antiplatelet drugs- , Anticoagulants/Antithrombotic drugs, Thrombolytic drugs

Anticoagulants/Antithrombotic drugs

Coagulation Modifier Drugs Which Prevents platelet plugs Antiplatelet drugs- , Anticoagulants/Antithrombotic drugs, Thrombolytic drugs

Antiplatelet drugs

Coagulation Modifier Drugs Which Prevents clot formation Antiplatelet drugs- , Anticoagulants/Antithrombotic drugs, Thrombolytic drugs

Anticoagulants/Antithrombotic drugs

Coagulation Modifier Drugs Which drug deals with coronary arteries- ARTERIES Antiplatelet drugs- , Anticoagulants/Antithrombotic drugs, Thrombolytic drugs

Antiplatelet drugs

Coagulation Modifier Drugs Which drug deals with the veins Antiplatelet drugs- , Anticoagulants/Antithrombotic drugs, Thrombolytic drugs

Anticoagulants/Antithrombotic drugs

NOAC/DOACs what does this mean a. Novas oral anticoagulants b. Novel oral anticoagulants c. Dispensed oral anticoagulants d. Direct oral anticoagulants

b. Novel oral anticoagulants | d. Direct oral anticoagulants

Anticoagulants Drugs Which are ORAL? Heparin Type Products, Vitamin K Antagonists, Non-Heparin Products, NOAC/DOACs

Vitamin K Antagonists | NOAC/DOACs

Anticoagulants Drugs Which are PARENTERAL? Heparin Type Products, Vitamin K Antagonists, Non-Heparin Products, NOAC/DOACs

Heparin Type Products | Non-Heparin Products

Anticoagulants Drugs Which are Heparin Type Products a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

b. Heparin | e. Enoxaparin

Anticoagulants Drugs Which are non Heparin Type Products a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

g. Argatroban

Anticoagulants Drugs Which are Vitamin K Antagonists a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

f. Warfarin

Anticoagulants Drugs Which are NOAC/DOACs a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

a. Apixaban c. Rivaroxaban h. Dabigatran

Which of the following are signs and symptoms of DVT? a. Calf Pain/Tenderness/Swelling b. Jaundice c. Shortness of Breath d. Headaches e. Confusion

a. Calf Pain/Tenderness/Swelling | c. Shortness of Breath

Which has this suffix "parin" a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

Heparin type drugs b. Heparin e. Enoxaparin

Heparin treats a. PE prophylaxis (SQ) b. DVT prophylaxis (SQ) c. DVT prophylaxis (IM) d. PE prophylaxis (IM)

b. DVT prophylaxis (SQ)

Heparin treats a. PE treatment(therapeutic) IV Drip b. DVT/PE treatment(therapeutic) - CON IV Drip c. DVT/PE treatment(therapeutic) IV Drip d. PE treatment(therapeutic) CON IV Drip

b. DVT/PE treatment(therapeutic) - CON IV Drip

Heparin Which has a slow administration a. PE prophylaxis (SQ) b. DVT prophylaxis (SQ) c. DVT prophylaxis (IM) d. DVT/PE treatment(therapeutic) - HIT CON IV Drip e. PE treatment(therapeutic) IV Drip f. DVT/PE treatment(therapeutic) - CON IV Drip g. . DVT/PE treatment(therapeutic)(SQ) Non- IV Drip h. PE treatment(therapeutic) CON IV Drip

f. DVT/PE treatment(therapeutic) - CON IV Drip | But Enoxaparin is g.. DVT/PE treatment(therapeutic)(SQ) Non- IV Drip

Heparin Which had a high dose administration depending on the patients situation/ a. PE prophylaxis (SQ) b. DVT prophylaxis (SQ) c. DVT prophylaxis (IM) d. DVT/PE treatment(therapeutic) - HIT CON IV Drip e. PE treatment(therapeutic) IV Drip f. DVT/PE treatment(therapeutic) - CON IV Drip g. . DVT/PE treatment(therapeutic)(SQ) Non- IV Drip h. PE treatment(therapeutic) CON IV Drip

b. DVT prophylaxis (SQ)

Which of the following patients can recieve a high dose of Heparin DVT prophylaxis (SQ) a. Cancer b. Covid-19 c. Malaria d. Pregnant

b. Covid-19 | d. Pregnant

Which Heparin treatment a pregnant patient can recieve a. DVT prophylaxis (SQ) b. DVT/PE treatment(therapeutic) - CON IV Drip c. both a & b

c. both a & b

Which is is a condition in which your heart doesn't get enough blood flow and oxygen. It may lead to a heart attack Stable angina or Unstable angina

Unstable angina

Which of the following is heparin used for? a. MI b. Open heart surgery c. Chemo therapy d. Stroke e. Cancer f. Dialysis g. Flush IV's with coagulant agents

a. MI b. Open heart surgery d. Stroke f. Dialysis g. Flush IV's with coagulant agents

What is heparin correct dosage for general adult?

5,000 units

How often is heparin given?

SC every 8 or 12 hours

Which anticoagulant stops the clotting cascade and prevents fibrin formation? a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

b. Heparin | e. Enoxaparin

Heparin DVT PROPHYLAXIS: Heparin ? units subcutaneously ? times daily (or ? daily)

5000 three twice

Heparin SUBCUTANEOUS ADMINISTRATION: For subcutaneous injections, use a (? ‑ to ?) ‑gauge needle to withdraw medication from the vial. Then, change the needle to a smaller needle (? ‑ or ?) ‑gauge, ½ to ⅝ inches long. •Administer deep subcutaneous injections in the abdomen, ensuring a distance of at least (?)inches from the umbilicus •Do or do not aspirate? •Apply gentle pressure for (? to ?) min after the injection. • (?) and record injection sites

``` 20 -22 25 - 26 2 Do not 1 - 2 Rotate ```

Heparin DVT TREATMENT: ◦Heparin IV drips are ? based ◦Some patients may receive a (small or large) bolus dose followed by a continuous IV drip (to reach steady state!) ◦We need to check baseline levels, followed by levels every ?-? hours until two levels return within range ◦Does Heparin break down a blood clot or is it a clot buster?

Weight Large 4-6 Neither

Heparin IV heparin is in an appropriate range is called a. aPTT b. aPT c. PT

a. aPTT

Warfarin Warfarin is in an appropriate range is called a. aPTT b. aPT c. PT

c. PT

Heparin Heparin aPTT Ranges: Base: ATI:

30-40 sec | 60-80 sec

When you have a patient on a anticoagulate what do you check a. CDC b. CBC c. Glucose levels

CBC

What does cbc stand for?

Complete Blood Count

Which does the cbc (Complete Blood Count) include? a. Hemoglobin (Hgb) b. Activated Partial Thromboplastin Time (aPTT) c. Prothrombin Time (PT) d. Hematocrit (Hct) e. Platelets f. International Normalized Ratio (INR)

a. Hemoglobin (Hgb) d. Hematocrit (Hct) e. Platelets

Which do you only check Heparin IV for? a. Hemoglobin (Hgb) b. Activated Partial Thromboplastin Time (aPTT) c. Prothrombin Time (PT) d. Hematocrit (Hct) e. Platelets f. International Normalized Ratio (INR)

b. Activated Partial Thromboplastin Time (aPTT)

Which give a ratio between you patient (Pt Warfin) to the international Pt? a. Hemoglobin (Hgb) b. Activated Partial Thromboplastin Time (aPTT) c. Prothrombin Time (PT) d. Hematocrit (Hct) e. Platelets f. International Normalized Ratio (INR)

f. International Normalized Ratio (INR)

Does Heparin break down a blood clot or is it a clot buster? if not why?

Again Neither. Heparin helps to prevent the growth of blood clots while allowing our bodies to break the blood clots down at a faster rate!

``` Which cause: Local site injection reactions to occur? And how can you avoid this adverse side effect? a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran ```

b. Heparin e. Enoxaparin Rotate Sites?

Which is has fallen when a patient is taken heparin which results in bleeding? a. Hemoglobin (Hgb) b. Activated Partial Thromboplastin Time (aPTT) c. Prothrombin Time (PT) d. Hematocrit (Hct) e. Platelets f. International Normalized Ratio (INR)

a. Hemoglobin (Hgb) e. Platelets d. Hematocrit (Hct) CBC

Which of the following fall when HIT (Heparin Induced Thrombocytopenia ) while a patient is taking heparin? a. Hemoglobin (Hgb) b. Activated Partial Thromboplastin Time (aPTT) c. Prothrombin Time (PT) d. Hematocrit (Hct) e. Platelets f. International Normalized Ratio (INR)

e. Platelets | ONLY

Which cause the remaining platelets are actually hyperactive- clotting risk once platelets have declined? a. Subcutaneous use b. Heparin Induced Thrombocytopenia (HIT)

b. Heparin Induced Thrombocytopenia (HIT)

Which causes Some people make antibodies that attack heparin and platelets? a. Subcutaneous use b. Heparin Induced Thrombocytopenia (HIT)

b. Heparin Induced Thrombocytopenia (HIT)

Tiny round brown-purple spots due to bleeding under the skin, may be in a small area due to minor trauma or widespread due to blood-clotting disorder? a. petechiae a. petechiae b. bruising c. hematoma d. vomit of blood e. peptic ulcer disease

a.Petechiae

Which is coffee ground emesis? a. petechiae b. bruising c. hematoma d. vomit of blood e. peptic ulcer disease

d.vomit of blood

``` Which cause the following/ Nose bleeds, gum bleeding, tarry stools, extreme/sudden headache, abdominal pain, vomiting of blood (coffee ground emesis)◦Blood in urine (reddish/pink urine)◦Petechiae, bruising, hematoma a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran ```

All anticoagulates

``` Which cause the following Drop in blood pressure, Increased heart rate, increased breathing? a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran ```

All anticoagulates

Which has a Hematoma risk? a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

All anticoagulates

``` CONTRA-INDICATION Which of the following you should AVOID in epidurals + neurosurgery? a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran ```

b. Heparin e. Enoxaparin g. Argatroban

Which causes Osteoporosis – LONG TERM a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

b. Heparin | e. Enoxaparin

Which comes from from intestinal mucosa from pigs a. dairy b. chicken c. pork

Pork

``` CONTRA-INDICATION Which of the following should not be given with a patient with Pork allergies? a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran ```

b. Heparin | e. Enoxaparin

This occurs when stomach acid damages the lining of the digestive tract? a. petechiae b. bruising c. hematoma d. vomit of blood e. peptic ulcer disease

e. peptic ulcer disease

Which shouldnot be given with bleeding involved any where within or on the body. a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

All anticoagulates

Protamine Sulfate is the antidote for which of the following? a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

b. Heparin | e. Enoxaparin

Protamine Sulfate=?

parin

Which of the following increases a patient risk of bleeding? a. Electric shave b. NSAIDS+ASA c. Herbals- G’s,F’s and S’s d. Soft bristle toothbrush e. Garlic f. Ginger g. Fish Oil

b. NSAIDS+ASA c. Herbals- G’s,F’s and S’s e. Garlic f. Ginger g. Fish Oil

Low /Sub-therapeutic would require ? heparin dose? a. DECREASED b. INCREASED

b.INCREASED

High/ Supra- therapeutic would require ? heparin dose? a. DECREASED b. INCREASED

a.DECREASED

A nurse do not needs to check with the provider if a patients is still taking heparin before surgery. T/F

False

Enoxaparin is a ( ? Molecular Weight Heparin- ?MWH) a. High-HMWH b. Low-LMWH

Low-L

Enoxaparin is which a. PE prophylaxis (SQ) b. DVT prophylaxis (SQ) c. DVT prophylaxis (IM) d. PE prophylaxis (IM)

b. DVT prophylaxis (SQ) | Just like heparin

Enoxaparin is which a. PE prophylaxis (SQ) b. DVT prophylaxis (SQ) c. DVT prophylaxis (IM) d. DVT/PE treatment(therapeutic) - HIT CON IV Drip e. PE treatment(therapeutic) IV Drip f. DVT/PE treatment(therapeutic) - CON IV Drip g. . DVT/PE treatment(therapeutic)(SQ) Non- IV Drip h. PE treatment(therapeutic) CON IV Drip

g.. DVT/PE treatment(therapeutic)(SQ) Non- IV Drip | Heparin is f. DVT/PE treatment(therapeutic) - CON IV Drip

Enoxaparin 1. Enoxaparin ? mg SC once daily 2. Enoxaparin ? mg SC every 12 hours -80 kg patient

1. 40 | 2. a. 80

Enoxaparin Enoxaparin ? dose is given once daily a. high b. low

b. low

Enoxaparin ? dose is given every 12 hr and weight based? a. high b. low

a. high

Which causes History of HIT (heparin induced thrombocytopenia)? a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

b. Heparin | e. Enoxaparin

Which causes Peptic Ulcer Disease/GI Bleeding? a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

b. Heparin e. Enoxaparin g. Argatroban

Which can proved small pressure to injection site a. Heparin b. Enoxaparin

a. Heparin

Which you Do not rub the site for 1 to 2 min after the injection. Apply GENTLE Pressure a. Heparin b. Enoxaparin

b. Enoxaparin

Which should you Rotate and record injection sites. a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

b. Heparin | e. Enoxaparin

Which has Prefilled syringes are available in various dosages for subcutaneous injection? a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

e. Enoxaparin

Which is NO LMWH? a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

e. Enoxaparin | No Enoxaparin

Which mean NO unfractionated heparin? a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

b. Heparin | no Heparin

Which is Direct Thrombin Inhibitor? a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

g. Argatroban

``` What if you developed HIT? What do you use? a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran ```

g. Argatroban

Which is Argatroban a. PE prophylaxis (SQ) b. DVT prophylaxis (SQ) c. DVT prophylaxis (IM) d. DVT/PE treatment(therapeutic) - HIT CON IV Drip e. PE treatment(therapeutic) IV Drip f. DVT/PE treatment(therapeutic) - CON IV Drip g. . DVT/PE treatment(therapeutic)(SQ) Non- IV Drip h. PE treatment(therapeutic) CON IV Drip

d. DVT/PE treatment(therapeutic) - HIT CON IV Drip

What do you give if a patient has or a heparin allergy? a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

g. Argatroban

For which drug should you check CBC levels a. Apixaban b. Heparin c. Rivaroxaban e. Enoxaparin f. Warfarin g. Argatroban h. Dabigatran

b. Heparin e. Enoxaparin g. Argatroban