Fibrinolysis tests Flashcards
TESTS FOR FIBRINOLYSIS
Euglobulin Clot Lysis Time
1. Plasma Euglobulin Fraction contains _____,_____, & _____
2. plasma euglobulins are precipitated w/ ____
3. normal clot lysis time is within
4. <2hrs = _____
5. give 3 causes of increased fibrinolysis
- plasminogen, activators of plasminogen & fibrinogen
- 1% Acetic Acid
- 2-4hrs
- abnormal fibrinolytic activity
- adrenalin injections; sudden death; pulmonary surgery
TESTS FOR FIBRINOLYSIS
_____ & _____: designed to detect the presence of fibrin monomers in the plasma
- EGT method
- screening procedure utilized as an aid in diagnosis of
- _____ (and ___) will cause soluble fibrin monomer complexes to dissociate resulting in polymerization of monomers and subsequent gel
formation (______) - negative analysis
Ethanol Gelatin Test & Protamine Sulfate Test
- Breen & Tulis
- disseminated intravascular
coagulation - 50% ethanol (and protamine sulfate); paracoagulation
- NO GEL FORMATION
TESTS FOR FIBRINOLYSIS
arises from degradation of cross-linked fibrin; presence is specific
- ___ fibrinolysis
- uses _____ w/ _____
- principle
- increased results seen in (3)
- there should be ___ nanograms per ml
D-Dimer Test
- Secondary fibrinolysis
- latex bead w/ monoclonal Ab to D-Dimer
- Turbidimetry or Nephelometery
- DIC, thrombosis, phlebitis
- <200 nanograms per mL
TESTS FOR FIBRINOLYSIS
test for Fibrin Split Products (FSP)
- FDP =
- FSP =
- ____ is added to ____ to ensure complete clotting & _______ after incubation
- serum is diluted and mixed w/ _____ that have been coated w/ _______
- positive = presence of ____ (____)
Thrombo-Wellcotest
- Fibrin Degradation Product = inc D-dimer; fragments X,Y; D-D
- Fibrin Split Product = only inc fragments X,Y & D-D
- whole blood; thrombin; soy bean enzyme inhibitor
- latex particles; anti-fibrin split products
- presence of fragments (agglutination)
INHERITED DISORDERS OF COAGULATION
Hemophilia is defiency of ____
- most common
- deficiency of _____
- therapy (2) - second most common
- deficiency of _____
- therapy
antihemophilic factors
- A
- Factor VIII:C
- commercial factor VIII concentrate
- DDAVP (1-desamino-8-arginine-vasopressin) - B
- Factor IX
- factor IX concentrate
INHERITED DISORDERS OF COAGULATION
- silent type
- aka
- deficiency of
- increase among ____
- bleeding not common but ____ instead
- therapy - no associated bleeding tendencies
- vulnerable to _____
- C
- Rosenthal Syndrome
- Factor XI
- Ashkenazi Jews
- thrombosis
- fresh frozen plasma or whole blood - Prekallikrein; HMWK;
Factor XII deficiency
- THROMBOSIS
Acquired Coagulopathy: _____, ____, _____
II =
VII =
X =
Liver Disease, Vit.K deficiency, Oral anticoagulant therapy
II = prothrombin deficiency
VII = VII deficiency
X = X deficiency
Acquired Coagulopathy: _____, ____, _____
I =
V =
XIII =
Severe liver disease
DIC
Fibrinolysis
I = Afibrinogenemia, Dysfibrinogenemia
V = Owren’s Disease Labile Factor deficiency; Parahemophilia
XIII = XIII deficiency
ACQUIRED DISORDERS OF COAGULATION
- Inhibitors
- non specific
— directed against ___ & ___
— its presence will prolong ___
— dilute _____
- specific
— directed against ____
— examples - replacement of >1.5L blood volume in 24hrs resulting to DILUTION of coagulation factors
- increased introduction of _____
- increase anticoagulant in body by __%
- Inhibitors
- Lupus Anticoagulant
— platelet phospholipid & phospholipid-protein complexes
— Partial thromboplastin time
— Rusell Viper Venom test
- IgG AUTOANTIBODIES
— specific coagulation factors
— VIII:C, IX, XI - Massive Transfusion
- anticoagulants
- 10%
ACQUIRED DISORDERS OF COAGULATION
- results to functional decrease of factors 2,7,9,10: protein C, S, & Z
- 3 causes of this deficiency - leads to synthesis deficiencie
- most profound to be destroyed
- plasminogen activators increases FSP due to increased ______
- can decrease most coagulation factors except factor ___ & ___ - results from liberation of thromboplastin substance that activates coagulation
- coagulation and fibrinolysis
occur simultaneously and either may dominate, resulting to: (3)
- Vitamin K Deficiency
- decrease absorption, obstructive jaundice, decreased normal flora in GIT - Liver Disease
- 7
- fibrinolysis
- 3 & 4 - Disseminated Intravascular
Coagulation
- consumption of coagulation factors & platelets as thrombi ; RBC fragmentation; increased in FDP & D-dimer
DISORDERS OF FIBRINOLYSIS
1. Primary fibrinolysis
- ____ (insoluble) LYSIS
- treatment: _____ or ____
2. Secondary fibrinolysis
- ____ (soluble) LYSIS
- clot dissolution which results to increase ____that interfere w/ coagulation & platelet function
- Primary fibrinolysis
- FIBRINOGEN (insoluble) LYSIS
- anti-fibrinolytic drugs/ antiplasmin - Secondary fibrinolysis
- FIBRIN (soluble) LYSIS
- FSP/ FDP
THROMBOTIC DISORDERS
1. ACQUIRES conditions: related w/ (3)
2. INHERITED conditions: related w/ (2)
- age, smoking, and other diseases
- deficiency/ices in regulatory proteins (inhibitors) &
defective factors
Types of Pathologic Thrombosis
1. composed of platelets w/ small amounts of fibrin, red & white cells = white clot
- 3 causes
2. composed of large amounts of fibrin & red cells
- associated w/ (3)
- Arterial Thrombosis
- hypertension, hyperviscosity, atherosclerosis - Venous Thrombosis
- slow blood flow, activation of coagulation, deficiency of physiological inhibitors
CLINICAL MANIFESTATIONS OF COAGULATION FACTOR DEFICIENCIES
- Easy bruising & Hematomas
- Mucosal bleeding
- Hemarthrosis
- Intracranial bleeding
- 2, 8, 9
- 2,8,9,11
- 8,9,10
- 7,8,9,13
CLINICAL MANIFESTATIONS OF COAGULATION FACTOR DEFICIENCIES
- Delayed wound healing & Miscarriage
- Umbilical wound
healing - Asymptomatic
- Thrombosis
- 1, 13
- 10, 13
- 12, PK, HK
- abnormal fibrinogens, LA, inhibitor deficiencies
