Haematology Drugs and Tests

Question 1

What is Prothrombin Time Measuring/ PT?

Answer 1

Extrinsic Pathway

Factors:
VII, X, V, II and fibrogen

Question 2

What does APTT measure?

Answer 2

Intrinsic Pathway

XII, IX, XI, X, VIII, II and fibrinogen

Question 3

What does the clotting time measure?

Answer 3

how long it takes for fibrinogen to turn to fibrin.
the tests literally add thrombin. therefore it is not relying on any of the factors other than fibrinogen.

indication of:

• decreased fibrinogen
• inhibitor

Question 4

How does Warfarin work?

Answer 4

Blocks Vitamin K Oxide Reductase

No Reduced Vit K made.

No Carboxy-glutamic Acid Residues made on factors. therefore Ca2+ can’t bind and activate.

Question 5

What factors for Warfarin disabled?

Answer 5

II, VII, IX, X

Protein C

Protein S

Question 6

Name a factor IIa inhibitor:

Answer 6

Dabigatran

Question 7

Name three factor Xa inhibitors:

Answer 7

Rivaoxaban

Apixaban

Edoxaban

Question 8

Name a reversal drug of dabigatran:

Answer 8

Idarucizumab

Question 9

Name two kinase fibrinolysis:

Answer 9

Streptokinase

Urokinase

Question 10

Name three tissue plasminogen activators:

Answer 10

Atelplase

Tenecteplase

Reteplase

Question 11

Name two ADP inhibitors:

Answer 11

Clopidogrel

Ticlopidine

Question 12

By blocking ADP receptors on platelets, what is achieved?

Answer 12

decreased expression of:
Glycoproteins IIb/ IIIa
reduced fibrinogen binding

Question 13

Name two GP IIb/ IIIa antagonists:

Answer 13

Abciximab

Tirofiban

Question 14

Name phosphodiesterase III inhibitor and how does it work?

Answer 14

Dipyridamole

Blocks cAMP levels from being reduced. thus maintaining them.
which deactivates platelets.

Question 15

What are the common pathway factors, and what would the result be on the APPT and PT?

Answer 15

1,2,5, and 10

both would be increased as both involve them

Question 16

Can heparin be used in pregnancy?

Answer 16

Yes - they don’t cross the placenta

Question 17

When do you use heparin?

Answer 17

Acute short term situation

• pre opp
• DVT

usually low molecular heparin used

Question 18

What is the half life of Warfarin?

Answer 18

36 hours

Question 19

What’s the INR wanted in warfarin and what does it mean?

Answer 19

2-3 INR.

Means 2-3 x longer time to clot

Question 20

When is warfarin used?

Answer 20

AF

Acute DVT or Pulmonary Embolism (following heparin used)

Prosthetic heart valve.

Question 21

How quickly do the DOACs work?

Answer 21

Immediately

Question 22

What DOACs can’t be used in renal disease?

Answer 22

Dabigatran

Question 23

Whats a draw back of DOACs?

Answer 23

No reversible treatment - so if bleeding nothing that ca be done

Question 24

How does tPA differ from kinases?

Answer 24

They only activate plasminogen at the site of the clot

Question 25

Who gets tPA and when?

Answer 25

Must be given within 4.5hours Ischemic stroke M.I - when PCI is not indicated Massive pulmonary embolism that is immediate life threatening

Question 26

In DIC what blood results would you expect to see?

Answer 26

Pre-longed clotting times - used up coagulation. Increased D - Dimers - break down of the clots that inappropriately formed sliced RBCs

Question 27

Treatment of DIC

Answer 27

Coagulation factors Fresh Frozen plasma Treat underlying conditions

Question 28

What do you do if the INR of someone is on warfarin is too high?

Answer 28

Vitamin K - takes about 6 hours to take effect or Immediate action - can give coagulation factors - Beriplex

Question 29

List some causes of bleeding disorders in alcoholic:

Answer 29

Liver failure - lack of coagulation factor production Poor diet - Lack of Vitamin K intake Poor clearance of activated coagulation factors

Question 30

If someone has Haemophilia A or B, what test will identify it?

Answer 30

These are factors 8 and 9 that are affected. thus APPT will be affected.

Question 31

What is the new name for the intrinsic pathway?

Answer 31

Propagation

Question 32

What is the new name for the extrinsic pathway?

Answer 32

Initiation pathway