Flashcards in Nikcevich- Clincal Cases in Coagulation Deck (43)
What is a normal platelet count?
What happens if the platelet count is 25,000
What happens if the platelet count is <10,000
Increased risk of mucocuntaneous bleeding and CNS hemorrhage
What is more important in regards to platelets than the actual number of platelets?
Platelet surface area
What is the most common reason for impaired platelet function?
INR is used to usually monitor what drug?
What is the target INR?
What does PTT measure?
NOT LMW heparin
What is the single worse clinical test available?
was designed to measure platelet function
What is the most common cause of increased bleeding time?
What does Aspirin do?
Irreversibly acetylates platelets
How long does aspirin's effects last for?
Up to 10 days
How do you reverse aspirin?
Wait 10 days and see if you can give platelets
What do ibuprofen, naproxen, etorolac, sulindac and indomethacin do?
Reversibly effect platelet function
**effects can be reversed w/in 6-8 hrs
What is the most common anti-coagulant?
Interferes w/ vit K dep secondary glycosylation of factors 2,7,9,10
How is warfarin dosed?
Accodring to INR
What is the biggest disadvantage of Warfarin?
It has a lot of drug interactions
How do you reverse warfarin?
Fresh frozen plasma
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
When is clopidogrel used?
After cardiac stents/ stroke
What does tPA do? When is it used?
Responsible for direct fibrinolysis.
MI, stroke, PE
What does vit K do?
Reverses effects of warfarin
often helpful w/ coagulopathy of liver disease
What does DDAVP do?
Increases vWF prodcution
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
What does cryprecipitate do?
Provides fibrinogen, VWF, facotr 8 and 13, fibronectin
What is commonly sen w/ platelet defects?
petechiae and easy bruising
skin and mucous membranes
What is seen w/ coagulation defects?
What do you think when you see an elevated PTT?
Lupus-anticoagulant or antiphospholipid Ab?
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