Flashcards in Hematology #1 Deck (24):
Normal lab values: WBC, Plt
Plt (thrombocytes): 150k-400k
Normal lab values: Na, K, Cl
Normal lab values: CO2, BUN, creatine
Fluid part of blood,
-91% is H2O
-7% are proteins, primarily albumin
Primary factors for oncotic pressure
#2: proteins (albumin)
Consequences of low albumin level
1. Decreased oncotic pressures - 3rd spacing
2. Decreased drug binding = increased bioavailability drug per dose
Decreased kidney function
-high levels of products normally excreted.
What is the best colloidal solution during a traumatic resuscitation?
What is the target MAP during a trauma resuscitation?
Deliberate hypotension technique
Intentional hypotension to limit bleeding and keep clear surgical fields during surgery.
-requires intensive hemodynamics monitoring
-not performed prehospital
BP maintained normal to slightly low to limit bleeding
Blood should only be administered with NS, why not LR?
LR has calcium component
-blood contains calcium kelating to prevent clotting in bag, can be overwhelmed by calcium in LR resulting in clotting in the line.
Von Willembrand's Factor
Free flowing in blood. Adhere to exposed collagen, then to platelets.
Individual platelets adhere to one another by which 2 factors?
-thromboxane A2 (TXA2)
Thromboxane A2 development
Tertiary development from prostaglandins
ASA / NSAIDs interfere with prostaglandin conversion to TXA2
Extrinsic Clotting cascade
Damaged tissue, exposed collagen and thromboplastin.
Where are the highest concentrations of thromboplastin?
Brain and placenta
-thus high incidence of DIC in head and pregnancy related trauma
Intrinsic clotting cascade
Damage to inside of the vessel wall (endothelium)
Which cation is most important during the clotting cascade.
-low Ca levels result in malfunction of clotting cascade
Extrinsic pathway to final common pathway
Tissue damage => release of thromboplastin from tissues => activates factor X => final common pathway
Intrinsic pathway to final common pathway
Blood vessel damage => cascade of clotting factors in the blood => activates factor X => final common pathway.
Final common pathway
Factor X converts prothrombin to thrombin => converts fibrinogen to fibrin => blood clot
Fibrin clot break down
Plasminogen within clot converts to plasmin => clot breaks down to fibrin degradation products.