Hypercoagulable States Flashcards
(39 cards)
Protein C/S deficiency causes increased risk of thrombotic skin necrosis with hemorrhage after _________administration
Warfarin
Factor V Leiden is a mutated form of factor V that is resistant to degradation by:
Protein C
What is the most likely underlying etiology of DVT in a young, White patient with no obvious risk factors that presents with leg swelling, positive D-dimer, and shortness of breath?
Factor V Leiden
What is the most common inherited cause of hypercoagulable state in White populations?
Factor V Leiden
Painful purpura, hemorrhagic bullae, and areas of necrosis that appear within the first days of treatment with warfarin are highly suggestive of
Warfarin-induced skin necrosis
- _______ and _____reverse warfarin overdose
- ______reverses heparin overdose
- Prothrombin complex concentrates (PCC)/FFP + Vitamin K (phytonadione)
- Protamine
What is the likely diagnosis in a young woman with a history of two miscarriages and the laboratory values below?
- VDRL: positive
- FTA-ABS: negative
- PT: 12s (normal)
- PTT: 46s (high)
Antiphospholipid syndrome
Antiphospholipid syndrome effects:
CLOTS
- Coagulation defect
- Livedo reticularis
- Obstetric (miscarriages)
- Thrombocytopenia
- SLE
What is the likely diagnosis in a young adult female with stroke-like symptoms and a positive RPR test despite no clinical evidence of syphilis?
Antiphospholipid syndrome
What are the main APS antibodies?
Lupus anticoagulant, anticardiolipin, anti-beta-2-glycoprotein
What analgesics are associated with decreased metabolism of warfarin (i.e. increased bleeding risk)?
Acetaminophen and NSAIDs
What is the recommended treatment for a pregnant patient with antiphospholipid syndrome?
Aspirin and LMW heparin
PTT and PT evaluate:
Platelet levels evaluate:
- Clotting factors
- Bleeding time (ability to aggregate, i.e., form a clot)
Disseminated intravascular coagulation (DIC) presents with: - Platelet count
- PT
- PTT
- Fibrinogen
- D-dimer
- ↓
- ↑
- ↑
- ↓
- ↑
Treatment of disseminated intravascular coagulation (DIC) includes:
Transfusion of blood products and cryoprecipitate as needed
What peripheral blood smear finding is associated with disseminated intravascular coagulation (DIC)?
Schistocytes
The physician should suspect TTP if 3 out of 5 of the following symptoms are present:
LMNOP
- Low platelets
- Microangiopathic hemolytic anemia
- Neurologic changes
- Obsolete renal function
- Pyrexia
What is the potential complication of intrauterine fetal demise that is retained in utero for several weeks?
Coagulopathy (e.g. disseminated intravascular coagulation (DIC)) due to systemic absorption of thromboplastin produced by the placenta and dead fetus
The classic triad of hemolytic uremic syndrome (HUS) is:
- Acute kidney injury
- Thrombocytopenia
- Microangiopathic hemolytic anemia
Initial management of HUS include:
Supportive care (e.g., with fluid therapy)
First-line treatment for thrombotic thrombocytopenic purpura
Plasma exchange therapy (PEX)
What is the recommended treatment for patients that develop nonimmune heparin-associated thrombocytopenia?
None; continue heparin and monitor platelets
Patient who was diagnosed with deep vein thrombosis (DVT) and subsequently started on unfractionated heparin (UFH). Laboratory studies showing a < 30% decrease in platelet count in the first 5 days after initiation of treatment with UFH. This is highly suggestive of:
Nonimmune heparin-associated thrombocytopenia,
How to differentiate Heparin-induced thrombocytopenia (type 2 HIT) from nonimmune heparin-associated thrombocytopenia?
Type 2 HIT usually manifests with > 50% reduction in platelet count. In addition, the onset of type 2 HIT is typically 5–14 days after heparin therapy has begun.
