Coagulation Disorders

Question 1

what is the life span of a platelet?

Answer 1

8-10 days

Question 2

how does levonox work?

Answer 2

anti 10a clotting factor medicine

Question 3

what is the most common inherited clotting disorder?

Answer 3

disorder with clotting factor V (factor V leiden)

Question 4

which pathway is tested with the PT study?

Answer 4

extrinsic

Question 5

which pathway is tested with the PTT study?

Answer 5

intrinsic

Question 6

what abnormalities present with problems with clotting cascade?

Answer 6

epistaxis
gum bleeding
hematochexia
melena
petechiae or easy bruising
hemarthrosis**(sometimes the first sign)
menorrhagia
intramuscular hemorrhage

Question 7

what sign points to hemophilia?

Answer 7

spontaneous hemathrosis

Question 8

what is the pneumonic for DDx of bleeding disorders?

Answer 8

CALF DIPS

Question 9

what drug affects the PT time?

Answer 9

coumadin

Question 10

what drug affects the PTT time?

Answer 10

heparin

Question 11

what is the most common inherited disorder of hemostasis?

Answer 11

von willebrand’s dz

Question 12

what is the carrier protein for factor VIII?

Answer 12

von willebrand’s factor

Question 13

what is the process of primary hemostasis?

Answer 13

platelet plug

Question 14

what is the process of secondary hemostasis?

Answer 14

coagulation cascade

Question 15

how do you use desmopressin in vWD?

Answer 15

give it immediately prior to sx procedure

releases endogenous stored factor VIII from tissues into circulation

Question 16

what is humate used for?

Answer 16

factor VIII replacement that a pt would need post trauma

Question 17

why would you use IVIG in acquired vWD?

Answer 17

may quite down the immune response that is causing the problem with vWD

Question 18

how do vWD factors changed during pregnancy for someone with the dz?

Answer 18

rises in the 2nd and 3rd trimesters and falls quickly postpartum

Question 19

what hemophilia has factor VIII deficiency?

Answer 19

A

Question 20

what hemophilia has factor IX deficiency?

Answer 20

B (christmas dz)

Question 21

what type of genetics is hemophilia?

Answer 21

x-linked

Question 22

when are many hemophilia pts diagnosed?

Answer 22

w/in first 2 years

Question 23

what is a bad complication of hemophilia?

Answer 23

ICH- can cause seizure and long term side effects

Question 24

what joints are most affected in hemophilic joints?

Answer 24

weight bearing joints (hips, knees, ankles)

Question 25

what is common in hemophilia?

Answer 25

``` massive delayed bleeding and hemorrhage joint destruction (deposition of iron in joint, pain and decreased ROM) ```

Question 26

what is considered severe hemophilia dz?

Answer 26

spontaneous bleeding

Question 27

what is considered moderate hemophilia dz?

Answer 27

bleeding with mild injury

Question 28

what is considered mild hemophilia dz?

Answer 28

bleeding with surgery or trauma

Question 29

which type of hemophilia is more common?

Answer 29

hemophilia A

Question 30

what is hemophilia C?

Answer 30

autosomal recessive factor XI reduced mild bleeding disorder manifested mostly by post operative bleeding

Question 31

what is FFP?

Answer 31

fresh frozen plasma | what you give to hemophilia C pts b/c recombinant factor XI is not available

Question 32

what is the diagnostic feature of anti-phospholipid antibody syndrome?

Answer 32

abnormal antibodies documented 6 months apart with one pregnancy loss

Question 33

how does a blood clot present?

Answer 33

``` leg or neck edema calf or lower leg pain acute chest pain SOB incidental findings ```

Question 34

what is a VQ scan?

Answer 34

scan that can be used for ppl who can not get a contrast CTA for possible PE

Question 35

what is acute txment of DVT pt?

Answer 35

1. hospitalize and immobilize leg 2. heparin (lovenox) 3. transition to Coumadin a few days later

Question 36

how do you treat elevated homocysteine levels?

Answer 36

B6, B12 and folate

Question 37

how do you calculate risk of DVT?

Answer 37

``` D D-dimer A age (>50) S sex (male) H hormones (estrogen therapy) ```

Question 38

what is a normal PT time?

Answer 38

11-16 seconds

Question 39

what is a normal aPTT time?

Answer 39

25-38 seconds