Coagulation
Where is factor VIII made?
Liver, lung capillaries
What is the most common hemolytic anemia inherited
Hereditary Spherocytosis
What is the R time?
time takes for clot to start forming?
norm 5-10 min
Can you give heparin to a patient that has experienced HITT before?
if type I,
CONTRAINDICATED in type II
you have a patient that needs FFP to reverse the warfarin before surgery... weights 50 kg. how much?
250-400 ml
warfarin reversal is 5-8 ml/kg
vWfactor binds to platelets how?
Gp1b Receptors on platelet surface
Acute chest syndrome is PNA like complication with pulmonary infiltrates plus one of the following: list 5
chest pain,
temp >38.5,
tachypnea
Wheezing
cough
what would a TEG look like in the 1st stage of DIC?
short R time- hypercoaguable
High MA
What is the most common inherited coagulation disorder?
Von willebrands dx
What factors are in cryo?
1, 8, 13, vwf
What coagulation component stops tPa and urokinase from activating plasminogen to plasmin
Plasminogen activator inhibitor 1 & 2
What is the primary cause of MACROCYTIC anemia
Folate & vitamin B12 def
caused from ETOH & malabsorption
If you had a large (long) alpha angle on your teg, what would you do?
give CRYO
its a problem with fibrinogen
b/c it checks the speed of fibrin formation
What lab would be the best to measure a liver patient's bleeding tests?
viscoelastography
PT/PTT do not reflect the hematologic state
If you give 1 unit of platelets, how much will the platelet count go up?
5000-10,000
What is the normal ACT?
90-150 (slides
90-120 (APEX)
What is the d/o where blood viscocity is high, and perfusion decreased with HCT >55%
polycythemia
If your pt had low platelets, how would you expect your teg to look?
MA would be smaller (vertical amp)
What do you treat hemophilia A with ?
B. factor 9:PT concentrate, factor 9a, FFP
C. rarely needed, but FFP, XI:protrombin concentrate or recombinant XIa
What is the dose for cryoprecipitate?
1 u/5kg
will raise fibrinogen by approx 100 mg/dL
What does the aPTT check?
Instrinsic pathway
(all FACTORS except 3 & 7)
What are the 4 disorders of rbc metabolism?
1. Embeden-Meyerhof
2. Methemoglobin reductase
3. Luebering-Rapaport
4. Phosphogluconate
What is the Rtime + the time to MA?
For pt with thrombocytopenia, what is the goal for platelet count before surgery- minimally?
Minor surgery 25,000
Major 50,000
Neuro 100,000
Why do we transfuse a patient?
1. replace the clotting factors
2. replace the fluid
3. increase O2 carrying capacity