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Board Review CRNA (Sweat Book) > Hemostasis > Flashcards

Flashcards in Hemostasis Deck (104)
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31

How many hours before surgery should the following drugs be discontinued?
Clopidogrel (Plavix)
Ticlopidine (Ticlid)

Clopidogrel (Plavix)--> 7-10 days (life of PLT)
Ticlopidine (Ticlid)---> 14 days

32

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

33

What is the MOST common ACQUIRED blood clotting defect?

inhibition of cyclooxygenase production by aspirin or NSAIDs

34

There is no factor ______.

VI

35

Where do platelets come from?

bone marrow--> thrombocytes

36

Secondary Hemostasis is all about the production of _____.

Fibrin

37

If it requires vitamin K it MUST be made in the ______.

liver

38

What are the vitamin K dependent factors?

II, VII, IX, X (procoagulants) and protein C & S (anticoagulants)

39

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

40

______ is woven into platelets and crosslinked.

fibrin

41

How strong is a fibrin clot?

insoluble in water; stable

also called a red clot or red thrombus

42

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

43

________ gets converted into fibrin and creates a _____ bond after being stabilized by XIIIa.

fibrinogen
covalent

*cryo contains I, VIII, XIII--> helps stabilize fibrin

44

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)

45

What is the textbook answer for appropriate heparinization for cardiac surgery?

400-450

46

Warfarin (coumadin) interferes with the ______ pathway.

extrinsic

47

Prothrombin time (PT) and the International Normalized Ratio (INR) assess the _________ pathway.

extrinsic

48

Heparin interferes with the ________ pathway.

intrinsic

49

Partial thromboplastin time (PTT) and activated coagulation time (ACT) assess the ______ pathway.

intrinsic

50

What is the second MOST common INHERITED coagulation disorder?

hemophilia A

So both are factor VIII
1) vWF
2) VIII:C hemophilia factor

51

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

52

What is the most important clue to clinically significant bleeding disorders in an otherwise healthy patient?

THE HISTORY

53

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

54

What is the only acceptable clinical indication for transfusion of packed red blood cells?

to increase oxygen carrying capacity of blood

55

ALL procoagulants except ______ are present in fresh frozen plasma.

platelets

56

Cryoprecipitate contains factor _______, factor ______, and factor ______.

factor I (fibrinogen), factor VIII (both vWF and C), and factor XIII (fibrin stabilizing factor)

57

How is cryoprecipitate harvested?

from FFP as it is thawing

58

One unit of platelets will increase count by _______.

5,000-10,000/mm3

59

One unit of RBCs will increase Hct by ______% or ____g/dl.

3-4% or 1g/dl

60

1 cc/kg of RBCs will increase Hct by _____%.

1%