Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Coagulation, Urinalysis & body fluids > Disorders of Hemostasis > Flashcards

Disorders of Hemostasis Flashcards

1
Q

Infusion of platelets

A

used to treat bleeding caused by thrombocytopenia or dysfunctional platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Fresh Frozen plasma

A

provides replacement coagulation factors & contains all coag factors
used for patients w/ multiple factor deficiencies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cryoprecipitate

A

concentrate of fibrinogen, vWF, factor VIII, factor XIII
used for the replacement of fibrinogen & factor XIII
historically used as treatment of von willebrand disease & FVIII deficiency
* blood borne viruses cannot be inactivated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Factor concentrates

A

from either human plasma or genetically engineered cell line

individual concentrates are not availalbe for all factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Prothrombin complex concentrates (PCC)

A

made from human plasma & includes factors: II, VII, IX, X (vit K def)
suitable for individual deficiencies of factor II, IX, X

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Desmopressin (DDAVP)

A

synthetic hormone used to promote the release of vWF in patients w/ von willebrand disease, mild hemophilia A (FVIII) & thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Petechiae

A

pinpoint bruising, small red to purple spots in the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ecchymoses

A

bruises larger than 3 mm red to purple when first formed & become yellowish green as they heal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hematoma

A

bruise that occurs when blood leaks from an opening in a vessel & collects beneath intact skin, blue or purple & slightly raised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acquired Disorders of the Vascular System

A

purpura due to decreased connective tissue: scurvy, excess glucocorticoids
purpura due to vasculitis: drugs/infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Quantitative platelet disorders

A

thrombocytopenia: primary & secondary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Functional Platelet disorders

A
  1. bernard-soulier disease

2. Glanzmann’s thrombasthenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Thrombocytopenia: Decreased platelet production

A 
bone marrow function is abnormal 
3 causes:
megakaryocyte hypoplasia (aquired)
ineffective thromopoiesis (inherited)
hereditary condition affects ability of bm to support megakaryocyte growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

May Hegglin anomaly

A

inherited cause of thrombocytopenia- lack of adequate bm megakaryocytes
large plts
dohle bodies present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Thrombocytopenia: accelerated or increased plt destruction

A

most common cause of thrombocytopenia

destruction can be immune (ITP, NAIT, HIT) mediated & nonimmune (TTP, DIC, HUS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ITP (immune thrombocytopenic purpura)

A

common disorder causing severe thrombocytopenia

an autoimmune disorder in which autoreactive antibodies bind to platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Acute ITP

A

disease of children!
usually follows viral infection
spontaneous remission
lab <20x10^9/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Chronic ITP

A 
disease of young adults
female > male
plt count: 30-80x109/L
mucosal bleeding 
duration of month or years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

NAIT

A

immune plt destruction by alloantibodies that are stimulated by foreign antigen during pregnancy
similar to HDN except antibodies are directed towards plt antigens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Heparin Therapy thrombocytopenia

A

decrease in plt count is either:

  1. heparin associated thrombocytopenia (HAT)
  2. heparin induced thrombocytopenia (HIT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Heparin associated thrombocytopenia (HAT)

A

non-immune, benign & limited thrombocytopenia

not associated w/ bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Heparin-induced thrombocytopenia (HIT)

A

immune mediated adverse effect of heparin that increases risk of thrombosis
develop an IgG antibody to heparin-plt 4 complexes
associated w/ bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Hemolytic-uremic syndrome (HUS)

A

more commonly found in young children
90% of cases caused by Shigella dysenteriae or E. coli
toxins from bacteria attach themselves to glomerulus cells, damages the cells, leads to formation of thrombi in renal vasculature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

HUS lab results

A

hemolytic anemia!
schistocytes
renal failure
thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Thrombotic thrombocytopenic purpura (TTP)

A

rare but often fatal; women > men; 30-40 yrs
50% have a history of a virus prior to onset
thrombotic lesions from arterioles & capillaries using up available plts
results in thrombus in organs (!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

TTP lab results

A

neurological manifestation
PT normal
APTT normal
fibrinogen, FDP, D-dimer normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Disseminated intravascular coagulation (DIC)

A

body’s blood clotting mechanism are activated throughout the body
fibrin formation w/in the blood vessels leads to plt activation & consumption!

28
Q

DIC lab results

A

Prolonged PT, APTT, TT
increased FDPs & D-dimer
decrease in fibrinogen

29
Q

Primary thrombocytosisor Essential Thrombocytosis

A

neoplastic stem cell disorder causing dyregulated production of large #s of abnormal plts

30
Q

Primary thrombocytosis or Essential Thrombocytosis lab values

A

increased plts
abnormal plt shapes
hemorrhages

31
Q

Secondary thrombocytosis

A

caused by another disease or condition
normal plt morphology
elevated thrombocytosis

32
Q

Bernard-Soulier Syndrome (BSS)

A

rare hereditary disorder of platelet adhesion
‘giant plt syndrome’
decrease in amount or abnormal function of the GPlb/IX complex
prevents adhesion!

33
Q

Bernard-Soulier disease lab results

A

normal or decreased plt count
platelet aggregation test is abnormal with RISTOCETIN! (normal w/ others)
giant plts

34
Q

Glanzmann’s thrombasthenia

A

rare hereditary disorder
aggregation does not occur!
def. of GPlb/IIIa complex - site of attachment of fibrinogen to plt surface
plt aggregation test is abnormal w/ ADP, collagen & epinephrine!!

35
Q

Signs/symptoms of coag pathway factor deficiency

A

excessive bleeding following trauma, uncontrolled menstrual bleeding, vomiting blood, nosebleeds, unexplained hematomas

36
Q

Clotting factor disorders grouped by (3)

A

autosomal recessive disorders
sex-linked disorders
autosomal dominant disorders

37
Q

Autosomal Recessive disorders

A 
Factor I (fibrinogen) deficiency
Factor II (prothrombin) deficiency
Factor V (proaccelerin) deficiency 
Factor VII (proconvertin) deficiency 
Factor X (Stuart) deficiency
Factor XI (plasma thromboplastin antecedent)
deficiency
Factor XII (hageman) deficiency
Factor XIII (fibrin stabilizing) deficiency
Prekallikrein (fletcher) deficiency 
HMWK (Fitzgerald) deficiency
38
Q

Factor I (fibrinogen) deficiency

A

autosomal recessive

2 forms: Afibrinogenemia & hypofibrinogenemia

39
Q

Afibrinogenemia

A

no functionally detectable fibrinogen found
more severe @ birth & can lead to death (bleeding from umbilical cord etc)
increased PT, PTT, & TT
decreased fibrinogen
would be corrected w/ mixing study

40
Q

Hypofibrinogenemia

A

few bleeding symptoms
normal PT, APTT
abnormal TT
normal fibrinogen

41
Q

Factor II (prothrombin) deficiency

A 
mild hemorrhaging
rarest bleeding disorder
increased PT, PTT
normal TT, BT
2 types: congenital & acquired is more common
42
Q

Factor V (proaccelerin) deficiency

A

mild to moderate bleeding w/ bruising
increased PT, PTT
normal TT
diagnosis made w/ factor V assay

43
Q

Factor VII (proconvertin) deficiency

A

mild to moderate bleeding
increased PT * only coag factor deficieny in which PT alone is prolonged!***
diagnosis made w/ factor VII assay

44
Q

Factor X (stuart) deficiency

A 
mild to severe bleeding
increased PT, PTT
normal TT
diagnosis made w/ factor X assay 
*** may want to exclude vit K deficiency before diagnosis
45
Q

Factor XI (plasma thromboplastin antecedent) deficiency

A 
Hemophilia C
mild bleeding after trauma
normal PT, TT
increased PTT!
diagnosis made w/ factor XI assay
2nd most common bleeding disorder affecting females!
46
Q

Factor XII (Hageman) deficiency

A

asymptomatic NO BLEEDING
normal PT, TT
increased PTT

47
Q

Factor XIII (Fibrin stabilizing) deficiency

A

umbilical cord bleeding & delayed healing
normal PT, PTT, TT
lab diagnosis relies on dissolution of the fibrin clot in 1% monochloroacetic acid or 5 M urea

48
Q

Prekallikrein (fletcher) deficiency

A

asymptomatic!
normal PT, TT
increased PTT

49
Q

HMWK (Fitzgerald) deficiency

A

asymptomatic!
normal PT, TT
Increased PTT

50
Q

Sex-Linked Disorders

A

Factor VIII deficiency (hemophilia A)

Factor IX deficiency (hemophilia B)

51
Q

Factor VIII deficiency

A 
sex-linked hemophilia A
effects males
normal PT
increased PTT
musculoskeletal lesions, neurological deficiencies
52
Q

Factor IX deficiency

A

sex linked hemophilia B

less common than hemophilia A but presents the same

53
Q

Autosomal Dominant Disorders

A

von Willebrand Disease

54
Q

Von Willebrand Disease

A

plts are intrinsically normal but exhibit abnormal adhesion bc of the absence or dysfunction of vWF & results in decreases in factor VIII & abnormal secondary hemostasis
very variable
3 types

55
Q

Type 1 vWF disease

A

autsomal dominant
70% of all cases
quantitative decrease in vWF
mild bleedign

56
Q

Type 2 vWF disease

A

variable inheritance

abnormality in structure of vWF

57
Q

type 3 vWF disease

A

rare autosomal recessive absent levels of vWF

severe bleeding - similar to hemophilia A

58
Q

vWF disease screening test

A
  1. bleeding time
  2. platelet function analyzer (replacing BT)
  3. APTT -typically increased
  4. plt count -normal
  5. PT- normal
59
Q

vWF specific tests

A
  1. measurements of plasma vWF antigen
  2. factor VIII activity
  3. assays of vWF plasma activity
    all are decreased!!
60
Q

vWF disease treatment

A

cryoprecipitate or DDAVP

61
Q

Acquired disorders of secondary hemostasis

A

DIC
acquired pathologic inhibitors
liver disease
vit K deficiency

62
Q

If every test (primary & secondary hemostasis) are abnormal what should you suspect first?

A

DIC

63
Q

Pathological inhibitors

A 
single coagulation factor inhibitor
lupus anticoagulant (LA)
64
Q

Inhibitors of single factors

A

usually seen in patients w/ inherited factor deficiencies
neutralizing antibody directed against specific coag factors leading to a loss of activity
common inhibitors are VIII & IX

65
Q

Diagnosis of inhibitors

A

APTT markedly prolonged
mixing study
assays for specific inhibitors

66
Q

Lupus Anticoagulant

A

nonspecific, usually does not cause bleeding problems
associated w/ autoimmune diseases, neoplasms etc
react w/ phospholipid surfaces of test reagents used in the APTT - prolongs test results

Coagulation, Urinalysis & body fluids (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions