Term
| What platelet level is indicative of thrombocytopenia? |
|
Definition
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Term
| Which clotting pathway is fast and slow? What is the final results of both pathways? |
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Definition
| Fast is the extrinsic, slow is the intrinsic. Final result of both is activation of prothrombin to thrombin which converts fibrinogen to fibrin threads.. |
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|
Term
| What is the most common cause of abnormal bleeding? |
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Definition
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|
Term
| Common causes of thrombocytopenia? |
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Definition
| RT/chemo, chemicals, vital hepatitis, drugs, malignancy or idiopathic |
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Term
| Which lab test measures the extrinsic and common pathway only for coagulation? |
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Definition
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Term
| Which lab test is used to monitor heparin? Coumadin? |
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Definition
Heparin = PTT
Coumadin = PT |
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Term
| Which lab test evaluates the intrinsic and common pathway? |
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Definition
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|
Term
| Which lab test evaluates platelet function? |
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Definition
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Term
| What blood disorder is an autoimmune IgG disorder and is often preceded by a viral URI? |
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Definition
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Term
| How will ITP affect platelets, PT and PTT? |
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Definition
| Platelets will be decreased, PT and PTT will be increased. |
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Term
| Which blood disorder is seen with pregnancy, marrow transplant complication or drugs and has neurologic systems? |
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Definition
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Term
| How will TTP look on CBC. smear and coagulation tests? |
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Definition
| It will appear as a hemolytic anemia and thrombocytopenia with schistocytes on smear. It will have normal coagulation tests. |
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Term
| Which blood disorder presents similarly to TTP but does not have any neurologicl symptoms? |
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Definition
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Term
| Which blood disorder primarily affects kids and is associated with E. coli infection leading to bloody diarrhea, acute renal failure, thrombocytopenia and anemia? |
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Definition
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Term
| Which two blood disorders involve non-immunologic destruction of platelets? |
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Definition
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Term
| What are the two main distinguishable differences between TTP and HUS? |
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Definition
| HUS is will have renal failure but no neurologic symptoms. TTP will not have renal failure but will have neurologic symptoms. |
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Term
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Definition
| Widespread intravascular damage leads to widespread intravascular fibrin formation which occludes small vessels and depletes platelets and coagulation factors leading to bleeding. The microvascular thromosis leads to organ failure and the depletion of coag factors leads to bleeding. |
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|
Term
| What are some common causes of DIC? |
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Definition
| septicemia, crush injury, viral infection, chemo, pregnancy, blood transfusion rxn, snake venom, burns and liver disease. |
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Term
| How will DIC present on PT, PTT, fibrinogen, bleeding time and platelet count? |
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Definition
| Increased PT and PTT. Decreased fibrinogen. Increased bleeding time and decreased platelet count. |
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Term
|
Definition
| Treat the underlying cause and replace factors and platelets. |
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Term
| What is the most common congenital coagulopathy? |
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Definition
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|
Term
| What is the pathology of vW disease? |
|
Definition
| inadequate platelet aggregation and a defective factor 8. |
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|
Term
|
Definition
| mucosal bleeding, easy bruising and menorrhagia. |
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|
Term
| Do you have platelets with vW disease? What is the problem? |
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Definition
| You have platlets but they cannot make a good plug due to factor absence |
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|
Term
| How will vW disease present on PTT and bleeding time? |
|
Definition
| They will both be increased. |
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|
Term
| Describe the deficiency seen with Hemophilia A and B. |
|
Definition
| A is a factor 8 deficiency. B is a factor 9 deficiency. |
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|
Term
| Which pathway is affected in Hemophilia A? |
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Definition
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|
Term
| Which hemophilia is more mild? |
|
Definition
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|
Term
|
Definition
| spontaneous bleeding, hemarthroses, intracranial bleeding, bleeding into soft tissues and gingiva. |
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|
Term
| How will Hemophilia A affect PTT, PT, bleeding time and platelet levels? |
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Definition
| PTT will be increased(Factor 8 is intrinsic), PT, bleeding time and platelet count are normal. |
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|
Term
| How do you treat Hemophilia A? B? |
|
Definition
A = IV heat treated factor 8 concentrate.
B = Fresh frozen plasma. |
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Term
| What kind of acquired coagulopathy is seen with post-op patients that arent eating well and may be on broad spectrum antibiotics? |
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Definition
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|
Term
| What disorder has been seen in a higher prevalence in Greek and northern European decent and leads to an increased risk of thromboembolic disease? |
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Definition
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|
Term
| How is Heparin delivered? What reverses the effects of heparin? |
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Definition
| It is only administered IV and is reversed by protamine sulfate. |
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|
Term
| What is the drug of choice for those at risk of thromboembolic disease during pregnancy? |
|
Definition
| Low Molecular Weight Heparin (LMWH) |
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|
Term
| Which anticoagulant is started simultaneously with Heparin but takes 3-4 days for its effect to take place so they can go home with this drug? |
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Definition
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|
Term
| How is Warfarin (Coumadin) OD reversed? |
|
Definition
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|
Term
| : excessive iron loading of the tissues as a result of genetic defect, liver disease or certain anemias. |
|
Definition
|
|
Term
|
Definition
| asymptomatic, fatigue, loss of libido, bronzing of the skin, diabetes, arthralgia, cardiac problems, cirrhosis and abdominal pain. |
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|
Term
| How much iron in the body do you need to see symptoms with hemochromatosis? |
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Definition
|
|
Term
| What is the gold standard test for hemochromatosis? |
|
Definition
| genetic testing for HFE1 gene |
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|
Term
|
Definition
| Phlebotomy, chelation (removes heavy metals from the body) and avoidance of iron in diet. |
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|
Term
| Complication of hemochromatosis? |
|
Definition
| Diabetes, cirrhosis, liver cancer, pancreatic damage and cardiac complications. |
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|
Term
| What levels are indicative of lead poisoning for children and adults? |
|
Definition
Children = above 50 ug/dL.
Adults = above 80-100 uf/dL. |
|
|
Term
| Explain the pathophys of lead poisoning on the blood. |
|
Definition
| It inhibits 3 enzymes (PBG synthase, heme synthase and coproporphyrinogen oxidase) which injures the RBC membrane and inhibits the synthesis of the alpha and beta globin chains, making them defective. |
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|
Term
| What is pathopneumonic of lead poisoning on peripheral smear? |
|
Definition
| ringed sideroblasts (RBCs that are ringed and have ferritin deposits in them) and RBC stippling (small dots at the periphery) |
|
|
Term
| What are some S&S of lead poisoning in children and adults? |
|
Definition
Children = speech and learning deficits.
Adults = blue-black line on gingiva, GI distress, motor neuropathies, CNS damage and fatigue. |
|
|
Term
| :caused by inherited defects in the heme biosynthetic pathway resulting in the excess production of porphyrin precursors. |
|
Definition
|
|
Term
| What are the common symptoms of all porphyria? |
|
Definition
| photosensitivity reactions and nervous system dysfunction |
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|
Term
| What are the S&S of the two main types of Porphyria, PCT (porphyria cutanea tarda) and EPP (erythropoietic porphyria)? |
|
Definition
PCT = bullous eruptions, plaquelike scar formation, hyperpigmentation and excess hair to face.
EPP = childhood onset, itching, burning, erythema, swelling of the exposed skin areas. |
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|
Term
| How is Porphyria diagnosed? |
|
Definition
| measure the levels of porphyria precursors in the urine and stool. |
|
|
Term
| :Hepatolenticular degeneration due to an autosomal recessive disorder leading to excess amounts of copper accumulating in the brain, liver, kidneys and cornea due to low levels of ceruloplasmin. |
|
Definition
|
|
Term
| What are the 3 ways that Wilson's disease will typically present? |
|
Definition
| Intravascular hemolytic anemia, hepatic dysfunction or neuropsychiatic illness. |
|
|
Term
| What are some S&S of Wilson's disease? |
|
Definition
| hepatomegaly, elevated LFTs, fatty liver, and decreased serum ceruloplasmin. |
|
|
Term
| What is pathopneumonic of Wilson's disease on physical exam? |
|
Definition
| Kayser-Fleischer rings on slit lamp (brown rings at corneal margins) |
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|
Term
| Treatment for Wilson's disease? |
|
Definition
| eliminate copper from diet and chelation therapy (removal of heavy metals from the body) |
|
|
Term
| At what level of blood volume loss is heart failure and death imminent without volume replacement? |
|
Definition
|
|
Term
| Describe the pathology of hypovolemic shock. |
|
Definition
| RBC and volume loss leads to a loss of tissue perfusion which leads to tissue hypoxia which leads to hypovolemic shock. |
|
|
Term
| Which way is the oxygen dissociation curve shifted with acidosis? |
|
Definition
| Acidosis shifts to the right (favors O2 unloading to the tissues) |
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|
Term
| Replacement of what is necessary to maintain blood homeostasis in a massive bleed? |
|
Definition
| platelets and coagulation factors |
|
|
Term
| What are the normal components of normal saline solution? |
|
Definition
|
|
Term
| Components of diarrheal Tx solution? |
|
Definition
| NaCl, K and lactate/acetate |
|
|
Term
| Components of Ringers solution? |
|
Definition
| NaCl, K, Ca, and lactate/acetate |
|
|
Term
| What kind of solution is preferred to manage large volume losses? Why? |
|
Definition
| Colloid solutions because they contain proteins. |
|
|
Term
| What are the advantages of giving FFP to someone with a massive bleed? |
|
Definition
| It contains coagulation factors |
|
|
Term
| What are the components of whole blood transfusions? |
|
Definition
| Whole blood cells and coagulation factors minus platelets. |
|
|
Term
| What kind of blood transfusion is commonly used to treat most anemias? |
|
Definition
| PRBCs (packed red blood cells) |
|
|
Term
| Do PRBCs contain WBCs or platelets? |
|
Definition
| Yes they do, but leukodepleted packed RBCs do not. |
|
|
Term
| What kind of blood transfusion is used commonly in those with transplants, malignancies and aplastic anemias? |
|
Definition
| Leukodepleted RBC transfusion |
|
|
Term
| What are Washed RBCs (Frozen) used for? |
|
Definition
| for long term storage of those with rare blood types |
|
|
Term
| What are Washed RBCs (Irradiated red cells) used for? |
|
Definition
| for immunocompromised patients |
|
|
Term
| What are Washed RBCs (CMV-negative cells) used for? |
|
Definition
| for CMV negative recipients having bone marrow transplants |
|
|
Term
| How much will each unit of PRBCs increase Hgb and Hct by? |
|
Definition
| Hgb by 1g/dL and Hct by 3%. |
|
|
Term
| What are the two examples of blood transfusions that are used to replace coagulation factors? |
|
Definition
|
|
Term
| What are the indications for FFP transfusion? |
|
Definition
| massive blood loss, emergency reversal of warfarin, DIC, liver disease and inherited coagulopathies |
|
|
Term
| What are the indications for cryoprecipitate transfusion? |
|
Definition
| factor 13 deficiency and fibrinogen replacement |
|
|
Term
| With repeated transfusions, what can develop that will shorten the lifespan of transfused platelets? |
|
Definition
|
|
Term
| What are some S&S of a transfusion reaction? |
|
Definition
| fever/chills, chest and low back pain, hypotension and a feeling of impending doom. |
|
|
Term
| What should you do if you suspect a blood transfusion reaction? |
|
Definition
| discontinue the transfusion stat and draw a venous blood sample stat. |
|
|
Term
| Describe the antigens and antibodies found with the ABO blood grouping system. |
|
Definition
Type A = person has A antigen and B antibodies.
Type B = person has B antigen and A antibodies.
Type AB = person has A and B antigens and no antibodies.
Type O = person has no antigens and A and B antibodies. |
|
|
Term
| Which blood type is the universal donor and recipient? |
|
Definition
Donor = Type O.
Recipient = Type AB. |
|
|
Term
| Describe the Rh system and how it can be fatal to newborns. |
|
Definition
| If an Rh negative mother has an Rh positive baby and she forms antibodies against the blood of her fetus during labor as the placenta detaches from the uterus. When she has another pregnancy, if that baby is Rh positive, the antibodies that she made from her first pregnancy will cross the placenta and cause hemolysis of the fetal blood and the baby will die. |
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|
Term
| What is given before and shortly after birth to prevent a Rh negative mother from forming Rh antibodies during delivery? |
|
Definition
|
|
Term
| What are the 3 most common etiologies of TTP? |
|
Definition
| pregnancy, bone marrow transplant and drugs. |
|
|
Term
| Is factor 8 part of the intrinsic or extrinsic pathway? |
|
Definition
|
|
