Coagulation Book - Cardiac Anesthesia ch 19 Flashcards Preview

Perf Tech II (exam 1) > Coagulation Book - Cardiac Anesthesia ch 19 > Flashcards

Flashcards in Coagulation Book - Cardiac Anesthesia ch 19 Deck (23):
1

Major ligand for platelet activation

Fibrinogen

2

important ligand for platelet adhesion at low shear stress

vWF

3

important ligand for platelet aggregation at higher shear stress

vWF

4

Provides post feedback by activating Cofactors V and VIII

Thrombin

5

Accelerates cross linking of fibrinogen by activating FXIII

Thrombin

6

Activates Protein C, which provides neg feedback by inactivating FVa and FVIIIa

Thrombin

7

Inactivates FVa and FVIIIa

Proteins C and S

8

Inhibits initiation of extrinsic pathway

TF inhibitor

9

Heparin's pH status?

strong biologic acid
negatively charged at physiologic pH

10

Heparin distribution is mainly in the ? (2)

intravascular space and endothelial cells

11

Heparin eliminated by what?

kidneys of metabolism in reticuloendothelial system

12

Heparin boluses can decrease what?

SVR

13

The CPB priming solution should contain Heparin at what concentration?

approx the same conct as patients blood stream at onset of CPB

ex priming vol of 1500ml should contain 5000units heparin

14

whole blood heparin concentrations sufficient for CPB

3-4 U/mL

15

Thrombocytopenia is defined as?

platelet count of <100,000/uL

16

Hirudin

thrombin inhibitor isolated from leech salivary glands
inhibits clot bound thrombin
inhibits activation of protein C

alternative to UFH

17

Bivalirudin

synthetic
directly inhibits thrombin by binding to its active catalytic site and its substrate recognition site
no reversal agent

alternative to UFH (for HIT pts maybe)

18

Argatroban

direct thrombin inhibitor
alternative to UFH (for HIT pts maybe)

19

After Protamine admin on bypass the ACT should be where?

no more than 10% above value before heparin admin

20

Rapid Protamine admin (3mg/kg in 3 min or less) can cause what?

Hypotension -- decreases systemic and pulmonary pressures as well as venous return

21

Hypotension from rapid protamine admin treated how?

rapid fluid admin, large doeses of epiniphrine and possibly bronchodilators (inhaled)

22

Daily aspirin is known as what kind of therapy?

Antiplatelet therapy

to prevent thrombosis, can cause an increase in bleeding post op when taking this up to the day

23

Aprotinin

proteinase inhibitor
inhibits plasmin, kallikrein(reduce inflammatory response) and other serine proteases
decreases activation of hematologic system during CPB and subsequent fibrinolysis resulting in 30-40% decrease in chest tube drainage