what is the life span of a platelet?
8-10 days
how does levonox work?
anti 10a clotting factor medicine
what is the most common inherited clotting disorder?
disorder with clotting factor V (factor V leiden)
which pathway is tested with the PT study?
extrinsic
which pathway is tested with the PTT study?
intrinsic
what abnormalities present with problems with clotting cascade?
epistaxis gum bleeding hematochexia melena petechiae or easy bruising hemarthrosis**(sometimes the first sign) menorrhagia intramuscular hemorrhage
what sign points to hemophilia?
spontaneous hemathrosis
what is the pneumonic for DDx of bleeding disorders?
CALF DIPS
what drug affects the PT time?
coumadin
what drug affects the PTT time?
heparin
what is the most common inherited disorder of hemostasis?
von willebrand’s dz
what is the carrier protein for factor VIII?
von willebrand’s factor
what is the process of primary hemostasis?
platelet plug
what is the process of secondary hemostasis?
coagulation cascade
how do you use desmopressin in vWD?
give it immediately prior to sx procedure
releases endogenous stored factor VIII from tissues into circulation
what is humate used for?
factor VIII replacement that a pt would need post trauma
why would you use IVIG in acquired vWD?
may quite down the immune response that is causing the problem with vWD
how do vWD factors changed during pregnancy for someone with the dz?
rises in the 2nd and 3rd trimesters and falls quickly postpartum
what hemophilia has factor VIII deficiency?
A
what hemophilia has factor IX deficiency?
B (christmas dz)
what type of genetics is hemophilia?
x-linked
when are many hemophilia pts diagnosed?
w/in first 2 years
what is a bad complication of hemophilia?
ICH- can cause seizure and long term side effects
what joints are most affected in hemophilic joints?
weight bearing joints (hips, knees, ankles)
what is common in hemophilia?
massive delayed bleeding and hemorrhage joint destruction (deposition of iron in joint, pain and decreased ROM)
what is considered severe hemophilia dz?
spontaneous bleeding
what is considered moderate hemophilia dz?
bleeding with mild injury
what is considered mild hemophilia dz?
bleeding with surgery or trauma
which type of hemophilia is more common?
hemophilia A
what is hemophilia C?
autosomal recessive
factor XI reduced
mild bleeding disorder manifested mostly by post operative bleeding
what is FFP?
fresh frozen plasma
what you give to hemophilia C pts b/c recombinant factor XI is not available
what is the diagnostic feature of anti-phospholipid antibody syndrome?
abnormal antibodies documented 6 months apart with one pregnancy loss
how does a blood clot present?
leg or neck edema calf or lower leg pain acute chest pain SOB incidental findings
what is a VQ scan?
scan that can be used for ppl who can not get a contrast CTA for possible PE
what is acute txment of DVT pt?
- hospitalize and immobilize leg
- heparin (lovenox)
- transition to Coumadin a few days later
how do you treat elevated homocysteine levels?
B6, B12 and folate
how do you calculate risk of DVT?
D D-dimer A age (>50) S sex (male) H hormones (estrogen therapy)
what is a normal PT time?
11-16 seconds
what is a normal aPTT time?
25-38 seconds
