Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Lecture 31
Clinical Aspect of Coagulation and Hemostasis II
| Question | Answer |
|---|---|
| Approximately what percentage of proximal DVTs are associated with pulmonary embolism? | Approximately 50% |
| What is the appearance of an extremitiy with an arterial thrombosis? | Extremities are blue, cold, and pulseless. |
| What type of clot is platelet rich and white in appearance? | Aterial thromi |
| (T or F) Methylene tetrahydrofolate reductase results in primary elevated homocysteine levels. | True. |
| What are the antiphospholipid antibodies? | 1)Lupus anticoagulant 2)Prothrombin antibodies 3)Anti-cardiolipin antibodies 4)B2 Glycoprotein 1 antibodies |
| What are the clinical criteria for Antiphospholipid syndrome? | 1)Vascular thrombosis (artieral or venous) 2)Pregnancy complicatons |
| What are the laboratory criteria for Antiphospholipid syndrome? | 1)Anti-cardiolipin Antibody (IgG or IgM) 2) Positive Lupus anticoagulant assay |
| What is the suggested evaluation for venous thromboembolism in a patient with no previous family or personal history? | 1)Lupus anticoagulant and anticardiolipin Ab 2)Homocysteine level 3)Consider Factor V Leiden, Factor II mutation, Factor VIII level, Fibrinogen studies 3)Rule out estrogen and vasculitic risk factors |
| What is the suggested evaluation for arterial thrombosis? | 1)Lupus anticoagulant and anticardiolipin Ab 2)Homocysteine level 3)Lipid levels 4)Rule out estrogen and vasculitic risk factors |
| What are the accepted indications for thromboytic therapy? | 1)Acute myocardial infarctions 2)Acute peripheral arterial occlusive disease 3)Massive pulmonary embolism associated with hemodynamic instability |
| What are the contraindications to thrombolytic therapy? | 1)Major internal bleeding in the last 6 mo 2)Intracranial or intraspinal disease 3)Operation or biopsy in the preceding 10 days 4)HTN (sys >200, dia>110) 5)Active endocarditis 6)Pericarditis 7)Aneurysm 8)Presence of bleeding disorder |
| What is the mechanism of Argatroban? | Reversible Direct Thrombin (FIIa) Inhibitor |
| What is the mechanism of Bivalirudin? | Reversible Direct Thrombin(IIa) Inhibitors |
| What is the mechanism of Lepirudin? | Irreversible Direct Thrombin (IIa) Inhibitors |
| What pharmacologic agents are indirect Factor Xa Inhibitors? | 1)Heparin 2)Low Molecular Weight Heparin 3)Fondaparinux |
| Why does aPTT need to be standarized before comparing from different clinical laboratories? | 1)aPTT reagents differ in phospholipid content and contact activators 2)aPTT and heparin levels may be discordant due to effects of plasma proteins |
| Factor Xa to Factor IIa activity of unfractionated heparin vs. low molecular weight heparin | UFH= 1:1 vs. LMWH 4:1 - 2:1 (LMWH have less than 19 saccharide units therefore they lack thrombin inhibition) |
| What are the advantages of LMWH? | 1)Better predictability of anticoagulant effect at a given dose;therefore, less need for lab monitoring 2)Longer plasma half-life 3)Less effect on the hemostatic properties of the endothelium and platelets perhaps accounting for less hemorrhagic potential |
| (T or F) LMWH never need monitoring. | False. Patients with changing or decreased kidney function must be monitored. Also, very large or very small and pregnant patients may need dose adjustments |
| (T or F) LMWH is fully reversible with protamine. | False. LMWH is only partially reversible with protamine. |
| What is the half-life of heparin? | Varies by dose (average is 1-2 hours) |
| What is the half-life of LMWH? | 4-6 hours |
| What is the half-life of Fondaparinux (Arixtra)? | 15-18 hours |
| What pharmalogical agent reverses the effects of heparin? | Protamine |
| Are the anticoagulant effects of fondaparinux reversible? | No |
| How is LMWH excreted? | Renally |
| How is fondaparinux excreted? | Renally |
| How are the anticoagulant effects monitored by LMWH? | Anti-Xa assay |
| How are the anticoagulant effects monitored by fondaparinux (Arixtra)? | Anti-Xa assay |
| How is heparin administered? | IV or SQ |
| How is LMWH administered? | SQ |
| How is fondaparinux administered? | SQ |
| What is the half-life of Argatroban? | 39-51 mins |
| What is the half-life of Lepirudin? | 1.5 hours |
| What is the half-life of Bivalirudin? | 25 mins |
| Are the anticoagulant effects of Argatroban reversible? | No |
| Are the anticoagulant effects of Lepirudin reversible? | No |
| Are the anticoagulant effects of Bivalirudin reversible? | No |
| How is Argatroban excreted? | Metabolized by the liver |
| How is Lepirudin excreted? | Renally |
| How is Bivalirudin excreted? | Renally |
| How is Argatroban administered? | IV |
| How is Lepirudin administered? | IV |
| How is Bivalirudin administered? | IV |
| What is the half-life of warfarin? | 36-42 hours |
| What are the complications of warfarin therapy? | 1)Bleeding 2)Warfarin induced skin necrosis 3)Cholestatic jaundice 4)Nausea/vomiting 5)Alopecia 6)Mouth ulcers 7)Rash |
Created by:
UVAPATH4
Popular Medical sets