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patho 2 coag
| Question | Answer |
|---|---|
| What causes disorders of coagulation | defects or deficiencies of one or more clotting factors or CV problems leading to thromboembolic disease |
| Vit K is indispensable in the synthesis and regulation of normal production of | coag factors 2,7,9,10,and anticoag factors protein C and S |
| Two things can cause abnormal formation of factors or deficiency | liver disease(hepatitis, cirrhosis, and acute yellow atrophy)and deficiency of vit. K |
| One of the most prevalent causes of VIT K deficiency | failure of the liver to secrete bile > decreased absorption of vit K |
| pretreatment with vit K for surgery w/ pts w/ liver disease..route and time frame? | 4-8 h before surg, injected |
| Hemophilia A (classic) | most common, def. of factor 8(anti-hemphilic factor)X-linked recessive. affects males transmitted by females |
| Hemophilia B(Christmas disease) | deficiency of factor 9, X linked recessive trait clinically indistinguishable from factor 8 def |
| hemophilia C | factor 11 deficiency, autosomal recessive, both males and females, bleeding less severe |
| Treatment for bleeding Hemophiliac | Plasma, cryo, and factor 8 |
| Thrombocytopenia..platelet count? | <100K |
| platelet count <50K | increased risk of hemorrhage with minor trauma |
| platelet count <10-15K | spontaneous bleeding occurs (petechiae, ecchymosis, purpuric spots, bleeding from mucous membranes |
| platelet count <10K | severe bleeding-fatal in GI tract, CNS or resp system |
| causes of decreased platelets | massive blood trans(>10units in 24h)or secondary to other cond. Bone marrow rep.or hypoplasia. also HIT |
| Thrombocytopenia interferes with hemostasis by | preventing the formation of the platelet plug but also stopping the coag cascade |
| Thrombocytopenic purpura | small purplish blotches on the skin, bleeding from many venules or capillaries resulting in small hemmorhages,idiopathic or dev after blood trans. |
| Immune thrombocytopenic pupura(ITP) | common in adult females, sx..bleeding, wt loss, h/a, fever---HIV increase risk for the disease |
| Treatment for ITP | fresh whole blood transfusion, predisone, splenectomy |
| Thrombocythemia (thrombocytosis) | platelet ct >400K asymptomatic until count reaches 1 mil w/ intravasc.thrombosis, hemorhage, or other patho cond appear |
| primary thrombocynthemia | myeloproliferative condition w/ splenomegaly, periodic thrombosis or hemorrhage, h/a, and paresthesia |
| secondary thrombocynthemia | freq. seen in lung, colon, and stomach CA |
| treatment of thrombocynthemia | platelet pheresis together w/ myelosuppresive therapy |
| In sickle cell anemia what causes increased thrombosis? | HbS is exposed to low O2, RBC's sickle and crystals form,can't pass through capillaries, cells rupture=>icterus=>^thromb.=>hemolytic anemia=>decreased O2 transport=>dec.[O2]=>more sickle cells form |
| DIC | acquired clinical syndromew/ increased protease activityin the blood caused by unregulated release of thrombin w/ subsequent fibrin formation and accelerated fibrinolysis |
| DIC results from | large amounts of traumatized or dying body tissue that release great quantities of tissue factor into the blood thus activating clotting. |
| clinical conditions assoc w/ DIC | Arterial hypot, hypoxemia, acidemia, stasis of capillary BF |
| DIC is precipitated by | endothelial damage, tissue damage, direct activation of coag. factor X, but most common cause is infection..gram - bact, fungi, protozoa and viruses |
| Why does DIC cause hemorrhage? | The amt of thrombin entering the circulationduring DIC exceeds the ability of the body's antithrombins(prot C and S and AT 3) to regulate it which results in an unrestricted clot formation that uses up all clot. factors=>hemorrhage |
| clinical manifestations of DIC | simultaneous bleeding at least at 3 unrelated sites with microvascular thrombosis=>improper perfusion and organ system dysfunction |
| thromboembolic disease effects on arterial system | forward occlusion, ischemia, necrosis, gangrene |
| Thromboembolic disease effect on venous system | Deep vein thrombosis=>pulmonary thromboembolism |
| DIC treatment | remove underlying cause, restoration of proper coag-fibrinolysis balance(heparin, platelets, other coag factors)and maintenance of organ viability |
| Major Etiologies of DIC | OB complications, trans rxn, infections, leukemia,crush injuries, acute liver disease, IABP, vascular disorders |
Created by:
jenbirne69
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