Hemostasis Defects Flashcards Preview

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Flashcards in Hemostasis Defects Deck (66)
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31

When is Factor XI deficiency most commonly diagnosed?

Post-operative hemorrhage

32

What test time is usually prolonged in Factor VII deficiency?

JUST PROTIME

33

What is the inheritance pattern of Factor VII deficiency?

Autosomal disease: Homozygous severe but heterozygous still affected.

34

What are the two functions of von Willebrand protein?

1. Adhere platelets to exposed collagen at the wound site.

2. Carrier of Factor VIII

35

What two tests are prolonged in von Willebrand's Disease?

PTT
Bleeding time

36

What is type I von Willebrand's disease?

Deficiency of normal von Willebrand protein

37

What is type II von WIllebrand's disease?

Presence of an abnormal protein

38

DDAVP (arginine vasoprressin is very effective in treating which type of von Willebrand's disease?

Type I

39

What is the inheritance pattern of von Willebrand's disease?

Autosomal dominant

40

What are some symptoms of von Willebrand's disease?

Bleeding from mucosal mebranes, and nose bleeds, GI bleeds and menorrhagia

They also bleed after surgery

41

Acquired Factor VIII inhibitor is an extremely rare acquired factor inhibitors seen in postpartum or advanced age patients.
How does this acquired disease present?
What test is prolonged?

-Soft tissue and muscle bleeding, and usually marked hematomas of their skin or mucosal bleeding

-Abnormal PTT only. Which will not correct after two hours of incubation.

42

What is the prognosis for Aquired Factor VIII inhibitor?

Although the disease has a 25% mortality due to bleeding it has an EXCELLENT long-term prognosis since most patients respond to immune suppression.

43

Name some very rare acquired inhibitors that can be seen.

Inhibitors to von Willebrand protein
Factor II inhibitors
Factor V inhibitors

44

Where are most coagulation factors synthesized?

Liver

45

What are the factors that are especially lowered due to liver disease?

Factor V
Factor II
Factor VII
Factor IX
Factor X
Fibrinogen

46

What tests are prolonged in liver disease?

PT
Relatively less prolonged PT
Thrombin time may also be prolonged

47

In liver disease you should always make sure that there is not a component of ____________ deficiency

Vitamin K

48

Vitamin K is obtained from the diet. What two circumstance cause vitamin deficiency?

No oral intake and broad spectrum antibiotics

49

A 16 year old patient is brought into the emergency room by his parents. He is unconscious and his parents report that he suffers from depression and that they found a box of d-Con by his bed. They show you the box that has an upside-down rat on it. Based on your knowledge of rat poison you know that this patient will need what type of therapy? Besides charcoal and gastric lavage blah blah blah

Vitamin K therapy for many months

50

What two tests are decreased in disseminated intravascular coagulation?

Fibrinogen level is decreased

Platelet count is low

51

Fibrin cleavage products, fibrin degradation products and D-dimer can be measured in DIC. These products can inhibit two tests. Which two tests?

PTT >>>it being prolonged

TT>>>>.it being prolonged.

52

What two factors are consumed in DIC?

Factor VIII and Factor V

53

How is DIC distinguished from liver disease just based on the labs?

Liver disease PT is prolonged a lot more than PTT

DIC: PTT is increased relatively much more than the protime

54

Define thrombosis

Formation and propagation of clot within the vasculature

55

Thrombosis occurs due to some combination of what three factors?

Stasis
Inflammation
Vessel wall injury

56

What factors create a hypercoagulable state?

Chronic damage to vessel walls
Excess of procoagulant factors
Deficiency of anticoagulant facotrs
Fibrinolytic activity

57

Name four risk factors for thrombosis

1. A thrombotic episode in the absence of a defined precipitating condition

2. Recurrent episodes of throbosis, or throbosis at an early age and is otherwise health

3. A severe, life threatening thrombosis, or thrombosis at an unusual site

4. Family history of thrombosis

58

Is it appropriate to search for an underlying hemostatic defect that can contribute to a "hypercoagulable state"?

Yeah

59

Lupus anticoagulant is
rare or common?
congenital or acquired?

Common acquired abnormality

60

What is the pathogenicity of Lupus anticoagulant?

IgG antibody which reacts against phospholipid in the platelet membrane or endothelial cell