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Anesthesia 101 > ITE Heme > Flashcards

ITE Heme Flashcards

1
Q

Hypothermia (increases/decreases) risk of bacterial infection compared to normothermic pts

A

increases

- hypothermia decreases regional blood flow, oxygen tension, and chemotaxis

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2
Q

Trauma triad of death

A
  1. Hypothermia
  2. Coagulopathy
  3. Acidosis
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3
Q

(Hyper/Hypo)ventilation increases the risk of citrate toxicity

A

Hyperventilation

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4
Q

_____ is more likely to cause citrate toxicity compared with other blood products bc more citrate is used

A

FFP

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5
Q

________ contains all clotting factors, fibrinogen, albumin, electrolytes, physiologic anticoagulants (prot C and S), and citrate

A

FFP

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6
Q

Recipients serum is mixed with commercially supplied RBCs containing selected antigens commonly implicated in hemolytic transfusion reactions

A

Antibody screen

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7
Q

Recipients serum is mixed with donor RBCs

A

Crossmatching

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8
Q

Recipients RBCs are mixed with commercially supplied anti-A and anti-B sera

A

ABO typing

  • most important
  • ABO incompatibility will cause hemolytic rxns
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9
Q

4 Ts of HIT

A
  1. Thrombocytopenia
  2. Timing of reduced plt count
  3. Presence of thrombosis
  4. Exclusion of oTher thrombocytopenia
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10
Q

Having a platelet count of > _____ is a risk factor for heparin resistance

A

300,000/mm^3

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11
Q

Heparin resistance is defined as an ACT of _____ after 500 U/kg of IV heparin has been administered

A

< 480

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12
Q

Antithrombin levels ____ of normal is a risk factor for development of heparin resistance

A

< 60% of normal

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13
Q

Treatment of heparin resistance

A
  1. supplemental heparin
  2. AT3
  3. FFP
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14
Q

_____ are separated from RRBCs mainly by centrifugation, and from leukocytes by leukocyte reduction filters

A

Platelets

*but small amounts of RBCs and leukocytes are still present in platelet concentrates and cause RH sensitization

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15
Q

______ is the most common blood product associated with TRALI

A

Plasma

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16
Q

Platelets lose their activity if ______ and should be stored at ____ deg C

A

refridgerated

20 deg C

17
Q

If a pt develops contrast-induced nephropathy and continues to take metformin it can ________

A

accumulate to toxic levels resulting in lactic acidosis

18
Q

Can metformin be continued through the perioperative period?

A

Yes

19
Q

Anemia causes a (Right/Left) shift of oxygen hgb dissociation curve? This allows for (Higher/lower) hgb affinity to oxygen, which results in greater oxygen release into tissue.

A

Right shift
lower

*anemia is a disease state of low hgb. The oxygen extraction ratio is increased

20
Q

The body compensates for anemia by (3)

A
  1. increasing CO
  2. redistributing flow to favor heart and brain
  3. oxygen extraction ratio is increased (R shift)
21
Q

_______ is given to pts with Type 1 von willebrand disease (partial decrease in VWF) prior to surgery

A

desmopressin (DDAVP)

- increases release of von Willebrand factor from endothelial cells

22
Q

________ is a common genetically inherited quantitative or qualitative dysfunction of von willebrand factor

A

Von willebrand disease

23
Q

vWD is divided into 3 major categories:

A
  1. Partial quantitative deficiency (type I)
  2. Qualitative deficiency (type II)
  3. Total deficiency (type III)
24
Q

_______ is given to pts with Type III von willebrand disease (total depletion) prior to surgery

A

vWF concentrate

- DDAVP has no effect

25
Q

DDAVP trials are contraindicated in pts with type IIB von Willebrand Disease bc of _____ and ____

A

thrombocytopenia and thrombotic complications

by decreasing plt count

26
Q

The anticoagulant response to enoxaparin (LMWH) can be monitored by measuring _____ activity

A

factor Xa activity

27
Q

(LMWH/UFH) is suitable for outpt use

A

LMWH

  • one or twice daily dosing
  • more predictable level of ac
  • does not need routine monitoring
28
Q

Unfractionated heparin exerts its anticoagulation effects by _____

A

binding to and enhancing effects of AT3 by several thousand folds

*AT3 inactivates multiple coagulant factors, esp factor II (thrombin)

29
Q

Most preferred way to reverse INR?

A

Prothrombin complex concentrate
- contains all Vit K dependent coag factors II, VII, IX, X (2790)

*more consistent and rapid than FFP

30
Q

Warfarin MOA

A

interferes with hepatic synthesis of Vit K dependent coagulation factors II, VII, IX, X (2790), Protein C and S

31
Q

Half life of warfarin

A

2-4 days

32
Q

________ is the most common inherited bleeding disorder

A

Von Willebrand disease

33
Q

Von willebrand factor is a protein that _____

A

assists platelets to adhere to sites of vascular injury

and stabilizes clotting factor VIII

34
Q

What are all of the blood products that can be given to pts with von willebrand disease?

A
  1. VWF concentrates
  2. desmopressin (DDAVP)
  3. Cryoprecipitate
35
Q

Cryoprecipitate contains what?

A
  1. Factor VIII
  2. VWF
  3. Factor XIII
  4. Fibrinogen
36
Q

PTT measures the speed of clotting of the ______ pathway, which involves factors ______

A

intrinsic

I, II, V,
VIII, IX, X, XI, XII (89 11 13)

37
Q

PT measures the speed of clotting of the ______ pathway, which involves factors ______

A

Extrinsic

I, II, V,
VII, X (710)

Anesthesia 101 (38 decks)

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