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Board Review CRNA (Sweat Book) > Hemostasis > Flashcards

Flashcards in Hemostasis Deck (104)
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91

What is the definitive test for DIC?

none

92

Name some conditions that contribute to or cause DIC?

sepsis, hemolysis, transfusion reaction, ischemia, hypotension, obstetrical emergencies (abruptio placenta, amniotic fluid embolism), acute DIC in surgical patients

93

What are some causes of acute DIC in surgical patients?

infection, shock, and ischemia are MOST common precipitating factors of acute DIC in surgical patients

94

What lab abnormalities reflect consumption of clotting factors and enhanced fibrinolysis that can be seen with DIC?

decreased--> PLTs, fibrinogen, prothrombin, levels of factors V-VIII-XIII
increased--> fibrin degradation products

95

What is the most common cause of isolated high "PT"?

liver disease

96

What is the treatment for coagulation abnormalities associated with liver disease?

replace clotting factors with FFP, cryoprecipitate, and vit K as needed

97

Coagulation abnormalities can be associated with massive blood transfusion. What is deficient in transfused blood?

platelets, and factors V and VIII

Treatment: platelet transfusion, FFP (supplies all coagulation factors), cryoprecipitate is a primary source of factor I (fibrinogen), VIII, and XIII

98

What clotting factor is considered the physiologic initiator of the coagulation cascade?

III (tissue factor or thromboplastin)

99

Antithrombin III inhibits what 5 clotting factors?

II, IX, X, XI, XII
II and X MOST profoundly inhibited

100

How does protamine work to reverse heparin? What kind of reaction is this?

combines electrostatically; neutralization

101

Name 3 substances that convert plasminogen to plasmin.

1) tpa
2) upa
3) streptokinase

102

When is aprotinin generally used in anesthesia? How does it work?

for repeat sternotomies and works by inhibiting plasmin

103

What is the BEST test for primary hemostasis, or platelet function?

standardized skin bleeding time

104

What are the typical manifestations of DIC?

bleeding, with oozing from tubes, wounds, and vascular access sites