Nikcevich- Clincal Cases in Coagulation Flashcards Preview

IHO Week 6 > Nikcevich- Clincal Cases in Coagulation > Flashcards

Flashcards in Nikcevich- Clincal Cases in Coagulation Deck (43)
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1

What is a normal platelet count?

150-400,000

2

What happens if the platelet count is 25,000

Probably nothing

3

What happens if the platelet count is <10,000

Increased risk of mucocuntaneous bleeding and CNS hemorrhage

4

What is more important in regards to platelets than the actual number of platelets?

Platelet surface area

5

What is the most common reason for impaired platelet function?

Aspirin

6

INR is used to usually monitor what drug?

Warfarin efficacy

7

What is the target INR?

2-3.5

8

What does PTT measure?

heparin efficacy

NOT LMW heparin

9

What is the single worse clinical test available?

Bleeding time

was designed to measure platelet function

10

What is the most common cause of increased bleeding time?

Aspirin

11

What does Aspirin do?

Irreversibly acetylates platelets

12

How long does aspirin's effects last for?

Up to 10 days

13

How do you reverse aspirin?

Wait 10 days and see if you can give platelets

14

What do ibuprofen, naproxen, etorolac, sulindac and indomethacin do?

Reversibly effect platelet function

**effects can be reversed w/in 6-8 hrs

15

What is the most common anti-coagulant?

Warfarin

Interferes w/ vit K dep secondary glycosylation of factors 2,7,9,10

16

How is warfarin dosed?

Accodring to INR

17

What is the biggest disadvantage of Warfarin?

It has a lot of drug interactions

18

How do you reverse warfarin?

Time
vit K
Fresh frozen plasma

19

What type of heparin has the most reliable absorption?

LMWH- no need to monitor levels

Unfractionated has UNPREDICTABLE absorption--need to monitor daily w/ PTT

20

When is clopidogrel used?

After cardiac stents/ stroke

21

What does tPA do? When is it used?

Responsible for direct fibrinolysis.

MI, stroke, PE

22

What does vit K do?

Reverses effects of warfarin

often helpful w/ coagulopathy of liver disease

(phytadione)

23

What does DDAVP do?

Increases vWF prodcution

24

What does fresh frozen plasma do?

Gets all coagulant factors to normal levels

can reverse warfarin effects/replace factors missing d/t liver disease/DIC

25

What does cryprecipitate do?

Provides fibrinogen, VWF, facotr 8 and 13, fibronectin

26

What is commonly sen w/ platelet defects?

Prolonged bleeding
petechiae and easy bruising
skin and mucous membranes
non-recurrent bleeding

27

What is seen w/ coagulation defects?

pro-longed bleeding
deep hematomas
recurrent bleeding

28

What do you think when you see an elevated PTT?

Heparin?
Lupus-anticoagulant or antiphospholipid Ab?
Liver disease

29

How do you diagnose a problem from a prolonged PTT?

Do a mixing study

corrects- lab error, heparin contamination

don't correct- LAC or inhibitor

30

What are causes of prolonged INR?

Warfarin use- most common
anti-phospholipid ab
liver disease
malnutrition (vit K def)