Term
|
Definition
Antithrombin III
(thrombin converts fibrinogen to fibrin, and also activates platelets) |
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Term
|
Definition
| Converts plasminogen to plasmin-->degrades fibrin plug |
|
|
Term
| Factors lost in stored blood (and not lost in FFP)? |
|
Definition
FV and FVIII
(FVIII not synthesized in liver) |
|
|
Term
Vitamin K takes effect in _____ hours?
Effect of FFP last _____ hours? |
|
Definition
|
|
Term
VWF deficiency--Type I and III...
Qualitative or Quantitative deficiency? |
|
Definition
| Quantitative defect (Type I dominant, type III recessive) |
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|
Term
Type II VWF:
Quantitative of Qualitative Deficiency? |
|
Definition
|
|
Term
|
Definition
|
|
Term
Lab abnormalities in HIT?
(Up or Down:)
Platelets?
PT?
PTT?
Fibrinogen?
D Dimer?
|
|
Definition
Plts DOWN
PT UP
PTT UP
Fibrinogen DOWN
D dimer UP |
|
|
Term
Stop ASA how long before surgery?
Stop Coumadin how long before surgery? |
|
Definition
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|
Term
| Condition in which heparin does not work? |
|
Definition
ATIII deficiency
(can give FFP first, then heparin) |
|
|
Term
How long is treatment warranted for:
1. 1st DVT?
2. 2nd DVT?
3. 3rd or significant PE? |
|
Definition
1. 6 months
2. 1 year
3. lifelong |
|
|
Term
Reversal agent for:
1. heparin
2. coumadin |
|
Definition
1. protamine
(can get rxn with hypotension, bradycardia, decreased heart function)
2. FFP (works immediately, lasts 6 hours)
& Vit K (takes 6 hours to work) |
|
|
Term
| Mechanism of action of argatroban |
|
Definition
direct
thrombin
inhibitor |
|
|
Term
| mechanism of action of Amicar? |
|
Definition
| Inhibits fibrinolysis by inhibiting plasmin (antifibrinolytic)--often used post bypass patients with persistent bleeding or in DIC |
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|
Term
| 4 areas evaluated by FAST |
|
Definition
| perihepatic fossa, perisplenic fossa, pelvis, pericardium |
|
|
Term
Abdominal compartment syndrome:
Signs? |
|
Definition
Bladder pressure >25-30
Low UOP
High peak airway pressures
|
|
|
Term
ED Thoracotomy:
When to perform?
How? |
|
Definition
When: Blunt trauma-->BP/pulse lost in ED
Penetrating-->BP/pulse lost en route OR in ED
How: 4th or 5th intercostal space, anterolateral incision from sternum totally lateral; incise pericardium anterior to phrenic nerve; cross clamp aorta |
|
|
Term
Epidural hematoma-
caused by damaged what? |
|
Definition
Middle meningeal artery
Lens shaped on CT (biconvex)
initial loss of consciousness-->lucid period-->deterioration |
|
|
Term
|
Definition
bridging vein tear
crescent shaped on CT
can be chronic in elderly after minor fall |
|
|
Term
| Clotting factor with the shortest half-life? |
|
Definition
|
|
Term
| Mechanism of action of DDAVP? |
|
Definition
Release VWF and VIII from endothelium
(useful in patients with renal failure too) |
|
|
Term
Two most common uses for Cryoprecipitate?
(other than in the CT SICU) |
|
Definition
Von Willibrand's disease
and
Hemophilia A (F VIII deficiency)
*Cryo contains highest concentration of VWF and VIII* |
|
|
Term
Prostacyclin (PGIis produced by what?
What is its function? |
|
Definition
Produced by ENDOTHELIUM
DECREASES platelet aggregation and promotes vasoDILATION |
|
|
Term
Where is THROMBOXANE (TXA2) produced?
What is its function? |
|
Definition
Produced by PLATELETS
INCREASES platelet aggegation by exposing GIIb/IIIa receptor
&
vasoCONSTRICTION (Ca release via PIP signaling) |
|
|
Term
| Best test for synthetic liver function? |
|
Definition
|
|
Term
| Treatment of Von Willebrand's (type I and III)? |
|
Definition
|
|
Term
| Treatment of VonWillebrand's Type II? |
|
Definition
|
|
Term
| Abnormal coag profile in Hemophilia A and B? |
|
Definition
|
|
Term
| Abnormal bleeding profile in Factor VII deficiency? |
|
Definition
|
|
Term
| Coag abnormalities in Von Willebrand's Disease: |
|
Definition
Prolonged PTT
Long bleeding time
+ Ristocetin test
(3 types, 3 abnormalities) |
|
|
Term
| Pathophysiology of Glanzman's Thrombocytopenia and treatment: |
|
Definition
GIIb/IIIa deficiency, so platelets can't bind to one another.
Tx = PLATELETS! |
|
|
Term
| Pathophysiology of Bernard-Soulier disease and treatment? |
|
Definition
GpIb receptor deficiency (plts can't bind to collagen--VWF normally links the two)
Tx = PLATELETS! |
|
|
Term
| Mechanism of action of plavix (clopidogrel)? |
|
Definition
ADP receptor antagonist
(decreases ADP-dependent platelet aggregation) |
|
|
Term
| Mechanism of action of Asprin? |
|
Definition
| COX inhibitor, therefore, DECREASES TXA2 |
|
|
Term
| Condition responsible for 30% of spontaneous thrombosis? |
|
Definition
|
|
Term
| Pathophysiology of Factor V Leiden? |
|
Definition
| Resistance to activated protein C (defect on Factor V) |
|
|
Term
| Coag abnormality in Antiphospholipid Antibody syndrome? |
|
Definition
Prolonged PTT (but are hypercoagulable) + Russell Viper Venom time (False POS RPR for syphilis)
*(PTTdoes NOT correct with FFP) |
|
|
Term
| One of the reasons that heparin is needed during cardiopulmonary bypass? |
|
Definition
| Hageman factor (FXII) activated which results in hypercoagulable state) |
|
|
Term
| Pathophysiology of warfarin-induced skin necrosis: |
|
Definition
| Protein C & S have short half life and are first to decrease with coumadin, resulting in a tipping of the balance toward hypercoagulable |
|
|
Term
| Indications for IVC FIlter: |
|
Definition
Contraindication to anticoagulation:
Documented PE while on anticoagulation:
Free-floating DVT in iliofemoral, IVC or femoral vein |
|
|
Term
| Most common starting location for a PE?: |
|
Definition
|
|
Term
| Mechanism of action of sequential compression devices: |
|
Definition
| Releases tPa with compression to stimulate fibrinolysis; Improves venous return |
|
|
Term
Can it be used in pregnancy?
1. Heparin
2. Coumadin |
|
Definition
1. Yes-hep doesnt cross placental barrier.
2. NOPE |
|
|
Term
| What are the Vitamin K dependent coagulation factors? |
|
Definition
|
|
Term
| Giving blood products causes which shift (left or right) in the O2 dissociation curve? |
|
Definition
LEFT shift
(low in 2,3 DPG which ↑ Hgb affinity for Oxygen) |
|
|
Term
| Does albumin contain same risk for HIV and hepatitis as other blood products? |
|
Definition
|
|
Term
| Back pain, chills, tachycardia, fever, hemoglobinuria are signs of what? |
|
Definition
| Acute hemolytic transfusion reaction |
|
|
Term
| Treatment of an acute hemolytic transfusion reaction? |
|
Definition
Fluids, Benadryl,
pressors if needed, can give diuretic |
|
|
Term
Pathophysiology of acute hemolytic reaction?
|
|
Definition
|
|
Term
| Pathophysiology of delayed hemolytic transfusion reaction? |
|
Definition
| Antibody-mediated, against MINOR antigens |
|
|
Term
| What is the most common transfusion reaction? |
|
Definition
|
|
Term
| Pathophysiology of febrile nonhemolytic transfusion reaction? |
|
Definition
| Antibody rxn against WBC in donor blood |
|
|
Term
| Pathophysiology of anaphylaxis during blood transfusion? |
|
Definition
IgG attack of IgA in donor blood
(because recipient in that case is usually IgA deficient) |
|
|
Term
| Pathophysiology of urticaria during a blood transfusion? |
|
Definition
Rxn against plasma proteins or IgA
(treat with benadryl and supportive care) |
|
|
Term
| LIkely pathophysiology of TRALI? |
|
Definition
| Donor Antibody reaction to recipent WBC, causes clot in pulmonary capillaries |
|
|
Term
Transfusion Reaction Summary Card:
Febrile, Non-hemolytic Rxn: vs WBC (in donor)
TRALI: vs WBC (in recipent)
Anaphylaxis and Urticaria: vs IgA |
|
Definition
|
|
Term
| Electrolyte abnormality most common after massive transfusion? |
|
Definition
HYPOcalcemia
(important cuz Ca needed for coag cascade) |
|
|
Term
Most common bacterial contaminant in stored blood?
Most common stored blood component to be contaminated? |
|
Definition
GNRs
(E.Coli)
Platelets (stored at room temp) |
|
|
Term
| Risk of transfer of HIV from blood transfusion? |
|
Definition
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