Term
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Definition
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Term
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Definition
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Term
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Definition
Tissue Factor
or
Thromboplastin |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| Plasma Thromboplastin Antecedent |
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Term
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Definition
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Term
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Definition
| Fibrin-Stabilizing Factor |
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Term
| What two proteins resolve clots? |
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Definition
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Term
| What coagulation factors are Vit K dependent? |
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Definition
Factors II, VII, IX, X
Protein C and Protein S are also Vit K dependent |
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Term
| Where is vWF produced and stored? |
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Definition
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Term
| What is the first line treatment for vonWillibrands disease? |
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Definition
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Term
| What can you give for von Willibrands disease if DDAVP is ineffective? |
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Definition
| Cryo or Factor VIII concentrate |
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Term
| What factors are present in Cryo? |
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Definition
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Term
| Average lifespan of platelets? |
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Definition
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Term
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Definition
| 150,000 to 400,000 cells per ml |
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Term
| What is the most common INHERITED coagulation defect? |
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Definition
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Term
| When should vonWillibrand Disease be suspected? |
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Definition
| When there is increased bleeding time in the presence of a normal platelet count. |
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Term
| What activates the platelet? |
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Definition
| Thrombin adheres to the platelet and causes a surface change. |
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Term
| What is released from the platelet after it is activated? |
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Definition
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Term
| What do thromboxane A2 and ADP when they are released from the platelet? |
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Definition
| Promote Platelet aggregation by uncovering fibrinogen receptors allowing platlets to link to one another. |
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Term
| What factor solidifies the fibrin clot? |
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Definition
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Term
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Definition
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Term
| What is a normal PT value? |
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Definition
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Term
| What is a normal PTT value? |
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Definition
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Term
| What two tests access the intrinsic pathway? |
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Definition
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Term
| What two tests access the extrinsic pathway? |
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Definition
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Term
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Definition
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Term
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Definition
| Christmas Disease or Factor IX deficiancy |
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Term
| What is a common cause for coagulation issues found in individuals after massive transfussion? |
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Definition
Lack of functioning platelets.
Platelets stored in blood are non functional after 1-2 days. |
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Term
| What procoagulant is not present in FFP? |
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Definition
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Term
| How much will one unit of RBC's increase HCT? |
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Definition
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Term
| How much will one unit of RBC's raise Hgb? |
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Definition
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Term
| How much will one unit of platelets raise the platelet count? |
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Definition
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Term
| What is the definition of a massive blood transfusion? |
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Definition
| Transfusion of one complete blood volume within 24 hours. |
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Term
| How does antithrombin III work? |
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Definition
Binds to factor II and factor X, and to a lesser degree Factors IX, XI, XII.
Inactivating these factors anti-coagulates the blood. |
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Term
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Definition
| It enhances the effects of Anti-thrombin III by 1,000 times |
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Term
| What can you give if your heparin dose does not produce an appropriate ACT? |
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Definition
| Administration of FFp may be necessary, becasue FFP contains all coagulation and anticoagulation factors produced in the liver |
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Term
| What pathways does Heparin block? |
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Definition
| Intrinsic and final common pathways. |
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Term
| Explain how protamine reverses heparin? |
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Definition
| Protamine a positively charged acid combines electrostatically with heparin a negatively charged base creating a neutralization reaction. |
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Term
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Definition
| Binds to the vitamin K receptor in the liver ans inhibits vitamin K. This depresses the production of vitamin K clotting factors II, VII, IX, X. |
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Term
| Name three thrombin inhibitors? |
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Definition
| Hirudin, Ximelagatran, Argatroban |
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Term
| Heparinization is adequate at a value of? |
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Definition
| Greater than 400-450 seconds |
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Term
| What two thrombin inhibitors could be used in a patient with heparin resistance? |
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Definition
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Term
| Bleeding time normal value? |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| What breaks down clots after the clot is stabilized? |
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Definition
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Term
| How is Plasminogen activated to Plasmin |
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Definition
| Plasminogen is synthesized in the liver and circulates in the blood. It is incorporated into the clot when it is formed. tPA and uPA convert plasminogen to plasmin, and plasmin breaks down fibrin. |
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Term
| What two agents convert plasminogen to plasmin? |
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Definition
Tissue Type Plasminogen Activator (tPA)
Urokinase Plasminogen actovator (uPA) |
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Term
| How do Amicar and Aprotonin decrease bleeding? |
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Definition
| Inhibits plasmin, therefore the fibrin that is formed breaks down slowly and bleeding is decreased. |
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Term
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Definition
Increases risk of intra-op MI
May cause renal dysfunction
Allergic Reaction after first dose
Possible Anaphylaxas after Second dose
Vascular occlussion |
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Term
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Definition
| Sepsis, Hemolysis, Ischemia, Brain Trauma, Abruptio PLacentae, Amniotic Fluid Embolism, Aneurysm, Hemangiomas, Allograft Rejection |
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Term
| Coagulation abnormalities associated with liver disease |
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Definition
Defective formation of platelet plug from thrombocytopenia due to hyper splenism and platelet dysfunction from elevated fibrin degredation products.
Fibrinolysis - increased lytic activity due to poor clearance of tPA. |
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Term
| How do you treat coagulation abnormalities associated with Liver disease? |
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Definition
| Replace clotting factors with, FFP, Cryo and Vit K as needed. |
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Term
| Uremia Related Coagulation Problems |
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Definition
Platelet adherance impaires
Platelet synthesis of Thromboxane A2 impaired
Platelets have lower concentration of ADP
Platelet transfusion is ineffective
Fibrinogen and other clotting factors are decreased
Fibrinolytic system impaired |
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Term
| Uremia related coagulation problem treatment? |
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Definition
Dialysis and elevation of HCT
Cryo or DDAVP may correct bleeding problem |
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Term
| Coagulation abnormalities associated with massive blood transfussions? |
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Definition
Transfused blood is defficient in platelets, and Factor V and VIII.
Diffuse bleeding caused by thrombocytopenia |
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Term
| Treatment of coagulation abnormalities associated with massive transfussion? |
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Definition
Platelet transfusion
FFP Transfusion
Cryo for Factors I, VIII, XIII |
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Term
| What substance anchors platelets to endothelial collagen? |
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Definition
von-Willibrand Factor
Factor VIII |
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Term
| What clotting factor activates the platelet at the site of vascular injury? |
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Definition
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Term
| What two substances released from the platelet stimulate platelet aggregation? |
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Definition
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Term
| What substance links platelets together? |
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Definition
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Term
| What agents inhibit platelet aggregation by impairing COX? |
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Definition
ASA and NSAID
ASA for life of plaetlet, NSAID for 24 -96 hours |
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Term
| What clotting factors are found in the extrinsic pathway? |
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Definition
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Term
| What clotting factors are found in the intrinsic pathway? |
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Definition
| Factors XII, XI, IX, VIII |
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Term
| What factors are found in the common pathway? |
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Definition
| Factors X, V, II, I, XIII |
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Term
| What clotting factor is considered the physiologic initiator of the coagulation cascade? |
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Definition
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Term
| What clotting factor promotes fibrin cross-linking? |
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Definition
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Term
| Antithrombin III inhibits what 5 clotting factors? What 2 are most profoundly inhibited? |
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Definition
Factors II, IX, X, XI, XII
Factors II and X |
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Term
| What clotting factors are VIt K dependent? |
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Definition
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Term
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Definition
| Enhances the activity of Antithrombin III |
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Term
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Definition
| Competitively inhibits the Vit K dependent clotting factors. |
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Term
| What two coagulation tests assess the extrinsic pathway? |
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Definition
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Term
| What two coagulation tests assess the intrinsic pathway? |
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Definition
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Term
| What enzyme is responsible for breaking down fibrin? |
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Definition
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Term
| What two pharmacological agents inhibit plasmin? |
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Definition
Amicar (Aminocoproic Acid)
Aprotonin (Trasylol) |
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Term
| Name three substances that convert plasminogen to plasmin? |
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Definition
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Term
| When is aprotonin normally used in anesthesia? |
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Definition
| Used for repeat sternotomies |
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Term
| What is the best test of primary hemostasis, or platelet function? |
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Definition
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Term
| What is the most common cause for coagulapathy after massive transfussion? |
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Definition
| Lack of functioning platlets |
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Term
| What clotting factors are found in FFP? |
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Definition
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Term
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Definition
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Term
| Transfused blood is deficient in what 2 coag factors? |
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Definition
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Term
| What are typical manifestations of DIC? |
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Definition
| Bleeding, oozing from tubes, wounds and vascular access sites. |
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