Flashcards in Hemostasis Deck (104)
How many hours before surgery should the following drugs be discontinued?
Clopidogrel (Plavix)--> 7-10 days (life of PLT)
Ticlopidine (Ticlid)---> 14 days
How does the drug Dipyridamole (Persantine) work? What is it commonly used for?
increases cAMP in pt's---> increased cAMP prevents aggregation of PLTs
commonly used in combination with warfarin to treat prosthetic heart valves
What is the MOST common ACQUIRED blood clotting defect?
inhibition of cyclooxygenase production by aspirin or NSAIDs
There is no factor ______.
Where do platelets come from?
bone marrow--> thrombocytes
Secondary Hemostasis is all about the production of _____.
If it requires vitamin K it MUST be made in the ______.
What are the vitamin K dependent factors?
II, VII, IX, X (procoagulants) and protein C & S (anticoagulants)
All procoagulant factors except _____, _______, and ______ are made in the liver.
vWF (VIII) made in endothelial cells, tissue factor (III) made in the tissues, and calcium (IV) from diet
______ is woven into platelets and crosslinked.
How strong is a fibrin clot?
insoluble in water; stable
also called a red clot or red thrombus
Cross-linking of fibrin strands requires coagulation factor _______. The final steps in fibrin production involve the ________ pathway.
XIIIa (fibrin stabilizing factor)
extrinsic, intrinsic, and final common pathways
________ gets converted into fibrin and creates a _____ bond after being stabilized by XIIIa.
*cryo contains I, VIII, XIII--> helps stabilize fibrin
What is the Leroy Brown story of the extrinsic, intrinsic, and final common pathways?
Look man, I picked up 0.37 cents outside (EXTRINSIC) and I really want those potato wedges... I can't pay 12.00 but I can give you 11.98 (INTRINSIC)..... "No man".... Look fool, It's common on Friday the 13th to kill 1, 2, 5, 10 of you fools (COMMON)
What is the textbook answer for appropriate heparinization for cardiac surgery?
Warfarin (coumadin) interferes with the ______ pathway.
Prothrombin time (PT) and the International Normalized Ratio (INR) assess the _________ pathway.
Heparin interferes with the ________ pathway.
Partial thromboplastin time (PTT) and activated coagulation time (ACT) assess the ______ pathway.
What is the second MOST common INHERITED coagulation disorder?
So both are factor VIII
2) VIII:C hemophilia factor
What is the difference in hemophilia A and hemophilia B?
hemophilia A is from factor VIII:C, hemophilia B is from christmas factor IX deficiency
What is the most important clue to clinically significant bleeding disorders in an otherwise healthy patient?
What is the most common reason for coagulopathy in patients receiving massive blood transfusions?
Lack of platelets
*PLT's in stored blood are non functional after 1-2 days.... there is also dilution of factors V and VIII
What is the only acceptable clinical indication for transfusion of packed red blood cells?
to increase oxygen carrying capacity of blood
ALL procoagulants except ______ are present in fresh frozen plasma.
Cryoprecipitate contains factor _______, factor ______, and factor ______.
factor I (fibrinogen), factor VIII (both vWF and C), and factor XIII (fibrin stabilizing factor)
How is cryoprecipitate harvested?
from FFP as it is thawing
One unit of platelets will increase count by _______.
One unit of RBCs will increase Hct by ______% or ____g/dl.
3-4% or 1g/dl