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Haematology > Haemostasis and Thrombosis > Flashcards

Haemostasis and Thrombosis Flashcards

(50 cards)

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1
Q

is blood clotted in plasma

A

no (it is clotted in serum)

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2
Q

what is haemostasis

A

process by which blood loss is prevented

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3
Q

what is required for primary haemostasis

A

vWF, platelets

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4
Q

what is required for secondary haemostasis

A

fibrin

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5
Q

what should you administer if low VWF

A

cryoprecipitate- high in VWF

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6
Q

what blood product to give if platelets low

A

platelets

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7
Q

what blood product to give if missing clotting factors

A

FFP

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8
Q

what type of sample for haemostasis test

A

plasma sample

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9
Q

what does the APTT measure

A

intrinsic pathway (activated partial thromboplastin time)

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10
Q

what does the PT measure

A

extrinsic pathway (prothrombin time)

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11
Q

what if the APTT is abnormal and PT normal

A

problem in the intrinsic pathway

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12
Q

what if the PT is abnormal and the APTT is normal

A

problem in the extrinsic pathway

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13
Q

what if APTT and PT are abnormal

A

problem in the common pathway

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14
Q

what factors are involved in intrinsic pathway

A

XII, XI, IX, X

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15
Q

what factors involved in extrinsic pathway

A

VII, X

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16
Q

what is the fibrinogen assay for (clauss assay)

A

fibrinogen- fibrin (IIa- thrombin). see how long it takes fibrin to form

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17
Q

why do you need to test LFTs

A

as this is where coag factors are produced

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18
Q

what is the normal INR

A

2-3

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19
Q

what is INR based on

A

PT: PT patient/PT normal

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20
Q

what factors are affected by warfarin

A

2,7,9,10

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21
Q

how does warfarin work

Study These Flashcards
A

blocks vitamin K cycle, which is needed for carboxylation of factors 2,7,9,10

22
Q

what is the intrinsic pathway responsible for

Study These Flashcards
A

fibrin production

23
Q

which pathway is the initiation phase

Study These Flashcards
A

extrinsic pathway- makes just enough thrombin to trigger- initiation, but not enough to make the fibrin

24
Q

normal lifespan platelet

25
when is there reduced lifespan platelets
incr consumption- infection, thrombosis, splenic enlargement
26
normal conc platelets
140-400 x 10^9/l
27
what stimulates platelet production
TPO- thrombopoietin
28
what are coagulation inhibitory factors for
inhibit coag cascade and ensure action of thrombin is limited to site of injury
29
what are the coagulation inhibitory factors
antithrombin, proteins C and S , tissue factor pathway inhibitor
30
inherited disorders of vessel wall
hereditary haemorrhagic telangiectasia, Ehlers Danl;os, Marfan
31
acquired disorders vessel wall
vit C def (scurvy), steroids, normal ageing, amyloid, immune complex deposition
32
what is Henoch schlonein purpura
allergic vasculitis, after an infection- arthropathy, haematuria, GI
33
what is thrombocytopenia
decr platelets- below 140
34
congenital causes thrombocytopenia
fanconi (aplastic anaemia), rare selective congenital defects of platelet production
35
acquired causes thrombocytopenia
increased destruction- autoimmune, DIC, TTP, drugs, hypersplenism. failure production- bone marrow failure (leukaemia, myeloma, AA, HIV), infiltration (lymphoma, carcinoma)
36
treatment autoimmune thrombocytopenia
prednisolone, IV Ig, immunosuppressive therapy, splenectomy
37
what happens in TTP
thrombosis in small vessels, red cell fragmentation, haemolytic anaemia, thrombocytopenia
38
what happens to PT and APTT in TTP
normal
39
what is there a deficiency of in TTP
ADAMTS13- normally cleaves VWF
40
what is haemolytic uraemic syndrome
occurs in childhood. thrombosis in small vessels. follows infection- E coli..
41
treatment TTP
plasma exchange- FFP. antiplatelets, corticosteroids
42
target INR pulmonary embolism and DVT
2-3, 3.5 if recurrent
43
target INR AF
2-3
44
target INR prosthetic metallic heart valves for stroke prevention
3-4
45
anticoag in DVT/PE
at least 6 weeks for below knee DVT, at least 3 months for above the knee DVT or PE. at least 6 months if no cause found
46
what to do if INR is 4.5-6
reduce warfarin dose or omit.restart when INR
47
what to do if INR is 6-8
stop warfarin. restart when INR
48
what to do if INR is >8
if no bleeding stop warfarin. 0.5-2.5mg vitamin K if risk factors for bleeding
49
what to do with warfarin if any major bleed
stop warfarin. give prothrombin complex concentrate. FFP. vitamin K
50
problem with vitamin K
may take some hours to work and can cause prolonged resistance when restarting warfarirn so avoid if possible if need long term coag

Haematology (12 decks)

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