Hemostsis

Question 1

Von Willebrands factor promotes what

Answer 1

platelet Adhesion

Question 2

Von Willebrands factor is manufactured by and released from where

Answer 2

endothelial cells

Question 3

Thrombin is also know as what factor

Answer 3

activated Factor II or IIa

Question 4

what factor activates platelets

Answer 4

Thrombin IIa

Question 5

Once activated via thrombin the platelet synthesizes and releases what?

Answer 5

Tromboxane A2

ADP

Question 6

Both Thromboxane A2 and ADP promote platelet aggregation how?

Answer 6

by binding to receptors and activating signal transduction

uncover the fibrinogen I receptors BPIIb and IIIa

Question 7

Fibrinogen ( Factor I) does what

Answer 7

aggregates platelets ( makes them stick together)

Question 8

The most common acquired blood clotting defect is d/t what?

Answer 8

Inhibition of cyclooxygenase (COX) production by ASPIRIN or NSAIDs

Question 9

What is factor I

Answer 9

Fibrinogen

Question 10

What is factor II

Answer 10

Prothrombin

Question 11

What is factor III

Answer 11

Tissue Factor (or Thromboplastin)

Question 12

What is factor IV

Answer 12

Calcium

Question 13

What is factor VIII

Answer 13

2 factors for VIII
VIII: vWF - is von Willebrands fctor
VIII: C - is anti hemophiliac factor
KNow vWF

Question 14

What is factor XIII

Answer 14

Fibrin Stabilizing factor

Question 15

All but 3 clotting factors are made from where?

Answer 15

liver

Question 16

What are the 3 clotting factors not made from the liver? and where are they made from

Answer 16

Calcium (IV) - Diet
Tissue Factor (III) - vascular wall
vWF VIII - endothelial cells

Question 17

What is factors are Vitamin K dependent factors

Answer 17

II- Prothrombin
VII- Proconvertin
IX- Christmas Factor
X- Stuart Power factor
C- Protein C
S- Protein S

Question 18

What is factor XI

Answer 18

there is none

Never ever ever pick factor XI for anything

Question 19

Coumadin (warfarin) interferes with what Pathway

Answer 19

Extrinsic (III, VII)

Question 20

Prothrombin time (PT) and INR assess what pathway

Answer 20

Extrinsic (III, VII)

Question 21

Heparin interferes with what pathway

Answer 21

Intrinsic (XII, XI, IX, VII)

Question 22

PTT and ACT assess what pathway?

Answer 22

Intrinsic Pathway

Question 23

The most important clue to clinically significant bleeding d/o in an otherwise healthy patient is what?

Answer 23

history

Question 24

one of the most important questions to ask preoperatively deals with what?

Answer 24

hemostatic responses to prior operations

Question 25

The most common reason for coagulopathy in pt's receiving massive blood transfusions is what?

Answer 25

the lack of functioning platelets

Question 26

Platelets in Stored blood are inactive after how long

Answer 26

1-2 days

Question 27

The only acceptable clinical indication for transfusion of PRBCs is what

Answer 27

to increase the O2 carrying capacity of blood

Question 28

ALL procoagulants except ______ are present in FFP

Answer 28

Platelets

Question 29

Cryoprecipitate contains what factors?

Answer 29

VIII (both C and vWF) I (fibrinogen) XIII ( fibrin stabilizing factor)

Question 30

One unit of PRBCs will increase Hct what %? and what g/dL?

Answer 30

3-4% | 1 g/dL

Question 31

One unit of Platelets will increase platelet count how much

Answer 31

5,000- 10,000/mm3

Question 32

Massive transfusion is defined as what?

Answer 32

1 complete blood volume in 24 hours

Question 33

A pt is scheduled for a CABG surgery is heparinized. The ACT is reported to be 210 seconds. After administration of more heparin, the ACT is 240 seconds. Question: is the pt adequately heparinized? what should you do?

Answer 33

- Not adequately heparinized; adequate is greater then 400 seconds - Give FFP. FFP contains all the coagulation and anticoagulation factors made by the liver, including antithrombin. then proceed with the case

Question 34

what is the normal Value? | Bleeding time

Answer 34

3-10 min

Question 35

what is the normal Value? | Platelet count

Answer 35

150,000-400,000 cells/mL

Question 36

``` what is the normal Value? prothrombin time (PT) ```

Answer 36

12-14 seconds

Question 37

what does the PT assess

Answer 37

Extrinsic and final pathways

Question 38

what is the normal Value? | PTT

Answer 38

25-35 sec

Question 39

What does the PTT assess

Answer 39

Intrinsic and Final pathways

Question 40

what is the normal Value? | Thrombin time?

Answer 40

< 30 sec

Question 41

what does the Thrombin time assess?

Answer 41

final common pathway

Question 42

what is the normal Value? | ACT

Answer 42

80-150 sec

Question 43

what does ACT assess?

Answer 43

adequacy of heparinization

Question 44

what is the normal Value? | Fibrinogen?

Answer 44

> 150 mg/dL

Question 45

Heparinization is adequate if ACT is what?

Answer 45

> 400-450 sec ( one book says 480)

Question 46

Aprotinin and Amicar work by how?

Answer 46

inhibiting plasmin

Question 47

Aprotinin and Amicar work by inhibiting plasmin, when Plasmin is inhibited what happens?

Answer 47

Fibrin that is formed breaks down slowly, so bleeding is decreased