Term
| What must coagulation testing always be PRECEDED by? |
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Definition
- detailed clinical history as well as physical exam should ALWAYS precede ordering coagulation tests
If you just order "shotgun" tests, you will get results that will not make sense |
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Term
| Use of coagulation testing |
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Definition
- classification of disorder
- anticoagulant therapy
- thrombolytic therapy
- transfusion therapy
- disease therapy
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Term
| laboratory utilization of dx of bleeding disorder |
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Definition
- screening analysis (major insight into compartment effected)
- bleeding time
- platelet count
- PT
- PTT
- fibrinogen
- TT
- D-Dimer
- CBC
- UA
- selective analysis (more specific, and get to different subsets of compartments)
- factors
- aggregometry (platelet function)
- anticoagulant proteins (for coagulative disorder)
- fibrinolytic proteins
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Term
| Prolonged bleeding time indicative of what |
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Definition
- thrombocytopenia (usually not desireable for this disorder)
- von Willebrand disease (most indicative test)
- platelet dysfunction (most indicative test)
- vascular dysfunction
Very good for platelet dysfunction |
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Term
| Disorders of prolonged PT (time to form clot) |
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Definition
- I, II, V, VII, X deficiencies
- hypo or dysfibrinogenemia
- inhibitors (usually Ab, so in autoimmune disorders)
- anticoagulation therapy
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Term
| prolonged PTT (partial thromboplastin time) indicative of what |
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Definition
- I, II, V, VIII-XII deficiencies
- contact factors
- hypo or dysfibrinogenemia (like PT)
- inhibitors (like PT)
- monitor anticoagulation therapy, traditionally UFH (like PT)
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Term
| prolonged TT (thrombin time) indicative of what? |
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Definition
- hypo or dysfibrinogenemia
- FSP or D dimer
- D dimer- tells us that you are forming thrombi somewhere that are being broken down (ex: DIC)
- inhibitors to thrombin
- anticoagulation therapy
Note it has no indicative values of factor deficiencies. |
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Term
| fibrinogen assays (2 methods) |
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Definition
- functional (clot based)- best way to find out; how much fibrinogen you have
- immunologic
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Term
| circulating inhibitor types |
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Definition
- lupus like (autoimmune disorder that takes out all the factors simultaneously by Ab directed against carrier protein stabilizing factors)
- factor specific Ab's
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Term
| disorders of hemostatic system |
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Definition
- hemorrhagic diathesis
- thrombotic diathesis
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Term
| Causes of hypercoagulability |
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Definition
- altered anticoagulant proteins
- altered fibrinolytic proteins
- altered endothelial cell function
- altered platelet function
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Term
| Various hypercoagulable disorders |
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Definition
- factor V leiden (APC resistent)
- increase risk of venous thrombi
- protein C
- protein S
- antithrombin III
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Term
| Mechanism of protein C action |
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Definition
- thrombin binds to thrombomodulin
- protein C (vitamin K dependent) binds to thrombin-thrombomodulin complex
- activated protein C complex bind with protein S to inactivate factor V
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Term
| Variables of coagulation tests |
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Definition
- preanalytical
- collection
- patient status
- analytical: problem w/
- post analytical
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