Term
| What is the plasma protein which inactivates Factors V & VIII |
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Definition
protein C
The TM-T complex activates this. |
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Term
| an endothelial cell receptor that binds thrombin |
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Definition
Thrombo-modulin
This binding is called (TM-T complex - thrombomodulin thrombin complex); slows process by removing thrombin. |
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Term
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Definition
| is layer of carbohydrates ; to repel clotting factors & platelets |
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Term
| Endothelial surface factors that prevent blood clotting |
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Definition
Smoothness -- to prevent contact activation
Glycocalyx --to repel clotting factors & platelets
Thrombo-modulin --remove thrombin |
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Term
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Definition
| Protein C is a 62-kD, vitamin K-dependent glycoprotein synthesized in the liver. |
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Term
| What circulates in the blood as an inactive zymogen? At what concentration? |
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Definition
| Protein C circulates in the blood as an inactive zymogen at a concentration of 4 μg/mL. |
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Term
| What is associated primarily with venous thrombosis. |
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Definition
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Term
| What engenders a pro-thrombotic environment |
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Definition
activated protein C deficiency
A deficiency of activated protein C (aPC) disturbs the delicate balance between pro-coagulant and anti-coagulant proteins and
En-genders a pro-thrombotic environment
(especially important in the slow-flowing venous circulation). |
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Term
Which patients have a high incidence of coagulation time prolongation.
What percentage has inc coags in ICU pts? |
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Definition
Trauma patients, in particular, have a high incidence of coagulation time prolongation.
A prolonged global coagulation time (such as the prothrombin time (PT) or the activated partial thromboplastin time (aPTT)) occurs in 14% to 28% of intensive care patients. |
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Term
| Which patients has the highest percentage of elevated fibrin split products- |
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Definition
99% of patients with sepsis.
elevated fibrin split products- are detectable in 42% of intensive care patients, 80% of trauma patients, |
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Term
| Which patients has the Lowest levels of coagulation inhibitors |
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Definition
90% of sepsis patients.
Low levels of coagulation inhibitors, such as antithrombin and protein C, are found in 40% to 60% of trauma patients |
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Term
| What percentage of critical ill pts have thrombocytopenia |
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Definition
| (35-44% of patients; clinical relevance of thrombocytopenia is an increased risk of bleeding) |
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Term
In DIC, what may cause
failure of the microvasculature and thereby contribute to organ dysfunction.
Ongoing and inadequately compensated consumption of platelets and coagulation factors
pose a risk for serious bleeding, especially in perioperative patients. |
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Definition
| Formation of microvascular thrombi, and inflammatory activation |
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Term
| In DIC, what pose a risk for serious bleeding, especially in perioperative patients. |
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Definition
Ongoing and inadequately compensated consumption of platelets and coagulation factors
TX: plasma transfusion with coag factors or
give purified coag factors instead of whole plasma |
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Term
| In DIC, what causes release of TF |
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Definition
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Term
| What causes weak or fragile blood vessel walls due to a lack of stable collagen |
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Definition
Vitamin C deficiency- (elderly, alcoholics)
bleeding gums,
nosebleeds,
bruises easily |
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Term
| What may cause vit K deficiency |
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Definition
| Fat malabsorption may cause vit K deficiency since it is a fat-soluble vitamin. |
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Term
| Why does Vit K deficiency cause bleeding disorders |
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Definition
required for ;
prothrombin,
factors VII, IX, and X, as well as
Protein S,
Protein C and
Protein Z. |
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Term
| hemophilia A, which factor is defective? |
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Definition
Factor VIII
(hemophilia A, 1 / 5,000-10,000 male births)
recessive X-linked chromosomal syndromes
hemophilia have prolonged bleeding time, have joint problems and pain from bleeding into joints |
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Term
| hemophilia B - which factor is defective? |
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Definition
Factor IX
(hemophilia B, 1 / 100,000)
recessive X-linked chromosomal syndromes
hemophilia have prolonged bleeding time, have joint problems and pain from bleeding into joints |
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Term
| Hemophilia C, which factor is defective? |
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Definition
Hemophilia C, autosomal (not sex-linked) inheritance involving Factor XI.
hemophilia have prolonged bleeding time, have joint problems and pain from bleeding into joints |
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Term
| Which disease causes Immune attack of platelets |
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Definition
Idiopathic thrombocytopenic purpura (ITP)-- Body's immune system mistakenly identifies platelets as foreign and forms antibodies against them.
Immune attack of platelets also occurs in lupus and rheumatoid arthritis. |
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Term
| Define thrombocytopenia. Give an example. |
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Definition
Thrombocytopenia -platelet count below 50,000 per microliter
Hemolytic uremic syndrome |
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Term
| What activates antithrombin III |
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Definition
IV Heparin –
activates antithrombin III, which blocks thrombin |
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Term
| IV Heparin injection increases the clotting time by how much? How long does it lasts? |
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Definition
Inc from 6 to 30+ minutes;
lasts 1.5 - 4 hrs |
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Term
|
Definition
| antithrombin III, which activated by Heparin |
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Term
| Why is a Low molecular weight heparin is more predictable & fewer side effects |
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Definition
more purifed set of molecules
fraction of heparin is a more homogenous prepartion |
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Term
| Name Direct thrombin inhibitors (DTIs) – |
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Definition
| hirudin (Refludan), argatroban (Acova) |
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Term
| How does coumadin act as an anticoagulant |
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Definition
Coumadins – (eg is warfarin) depresses liver formation of prothrombin and Factors VII, IX & X by
competing for Vit K binding sites |
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Term
| What is Used to assess heparinization |
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Definition
Activated clotting time–usually 4-10 minutes;
minimum safe ACT is about 300 seconds for patients on ECMO or cardio-pulmonary bypass. |
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Term
| What measures the extrinsic pathway. |
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Definition
Prothrombin Time/INR– measures the extrinsic pathway.
PT is normally 10-13 seconds;
normal range for the INR is 0.8–1.2.
Therapeutic anticoagulation may aim for an INR from 2-3. |
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Term
| What measures both intrinsic & common pathways |
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Definition
| Partial thromboplastin time (PTT)-25-39 seconds; |
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Term
| What assesses platelet function; |
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Definition
| Bleeding Time – assess platelet function; normally 1-6 minutes, lack of platelets prolongs |
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Term
|
Definition
| mucopolysaccharide adsorbed to the surfaces of endothelial cells |
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Term
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Definition
| Name 2 coagulation inhibiters found in the body |
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Term
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Definition
| This often results from the presence of large amounts of traumatized or dying tissues in the body that release large amounts of TF |
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