Hereditary and Acquired Thrombotic Disorders Flashcards Preview

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Flashcards in Hereditary and Acquired Thrombotic Disorders Deck (28)
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1

In the arteries, ________ are more important for clotting, while in veins _______ are more important.

platelets; clotting factors

2

Again, Virchow's triad is _________.

the three states that lead to hypercoagulation: altered vessels, venous stasis, and altered coagulability

3

What are lifestyle risk factors for venous thrombosis?

Pregnancy, oral contraceptives, trauma, surgery, immobility, obesity, age (older = more likely), malignancy

4

What are inherited disorders of hypercoagulability?

Factor V Leiden; deficiencies of protein C, protein S, and antithrombin; prothrombin mutations

5

Some symptoms of deep vein thrombosis in the extremities include _________.

swelling, warmth, and duskiness of the leg; can be sudden or gradual; varices due to reliance on alternative pathways

6

Symptoms of pulmonary embolism are ________.

shortness of breath, weakness, fainting, cardiac arrest, tachycardia, cough

7

Embolisms are ___________.

pieces of the thrombus that break off

8

How would you diagnose a DVT or PE?

Look for risk factors in the patient history; check for elevated D-dimer levels (low D-dimers rule out thrombosis); ultrasound the suspected area; CT the lungs

9

How are DVTs and PEs treated?

Heparin treats the acute clot, and warfarin prevents future clots

10

The newer antithrombotic drugs are __________.

Rivaroxaban, apixaban, and endoxaban (all of which target Xa), and Dabigatran (which is an oral thrombin inhibitor)

11

Warfarin is an ___________.

antagonist of the glutamyl carboxylation of the serine protease clotting factors

12

How long should people be on anticoagulants after a thrombotic event?

At least three months (for the first provoked or unprovoked event) and indefinitely for those with cancer, thrombophilia, and second events

13

Factor V Leiden is inherited in a(n) ___________.

autosomal-dominant manner

14

Prothrombin gene mutations are __________.

relatively mild clotting disorders (risk is 2x-3x); they are associated with venous thrombosis

15

Type I antithrombin disorders are __________, while type II disorders are _________.

decreased levels of antithrombin; decreased antithrombin activity

16

Homozygous protein C deficiency is __________; heterozygous is ________.

fatal in infancy; survivable, but presents with thrombi in young adulthood

17

Antiphospholipid antibody syndrome is unique for its presentation of thrombi in ________.

arteries and veins

18

What are the laboratory criteria for antiphospholipid syndrome?

Anticardiolipin antibodies, lupus anticoagulant, and beta-2 glycoprotein-I antibodies

19

The HPI of APS is marked by ________.

vascular thromboses and pregnancy complications

20

Clinical features of APS are ___________.

thrombocytopenia, anemia, transient cerebral ischemia, transverse myelopathy/myelitis, livedo reticularis and migraines

21

Those with APS are treated with __________.

heparin and aspirin indefinitely

22

Aspirin doesn't work for ___________.

venous thrombi

23

Pulmonary embolism accounts for _______ of hospital deaths.

5%-10%

24

Mortality of pulmonary embolism is ______ without therapy and ______ with.

30%;

25

D-dimers have high ___________.

negative-predictive value (i.e., a low D-dimer indicates no clot is present)

26

What is a drug that blocks the GPIIb/IIIa receptor?

Abciximab

27

Those who are heterozygotes for protein C deficiency are at increased risk of __________ when given warfarin without heparin.

temporary hypercoagulability

28

What are the five known heritable hypercoagulation disorders?

Factor V Leiden, protein C deficiency, protein S deficiency, prothrombin mutations (resulting in increased circulatory prothrombin), and antithrombin deficiency

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