Hematology pimp session
This presentation is the property of its rightful owner.
Sponsored Links
1 / 131

Hematology Pimp Session PowerPoint PPT Presentation


  • 71 Views
  • Uploaded on
  • Presentation posted in: General

Hematology Pimp Session. 1. What is the sequence of the intrinsic pathway of coagulation?.

Download Presentation

Hematology Pimp Session

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Hematology pimp session

HematologyPimp Session


Hematology pimp session

1. What is the sequence of the intrinsic pathway of coagulation?


Hematology pimp session

Prekallikrein+ HMW kininogen + factor XII + exposed collagen → activates Factor XI → activates Factor IX +Factor VIII → activates Factor X + Factor V → converts prothrombin (Factor II) to thrombin → thrombin converts fibrinogen to fibrin


Hematology pimp session

2. What is the sequence of the extrinsic pathway of coagulation?


Hematology pimp session

Factor VII + tissue factor → activates Factor X +Factor V → converts prothrombin to thrombin → thrombin converts fibrinogen to fibrin


Hematology pimp session

3. Which factors are known as the labile factors (i.e. activity lost in stored blood)?


Hematology pimp session

Factors V and VIII


Hematology pimp session

4. Which factor has the shortest half-life?


Hematology pimp session

Factor VII


Hematology pimp session

5. What are the Vitamin K dependent factors?


Hematology pimp session

Factors II, VII, IX, and X and proteins C and S


Hematology pimp session

6. Which factor is the convergence point for both the extrinsic and intrinsic pathways of coagulation?


Hematology pimp session

Factor X


Hematology pimp session

7. PT measures the function of which factors?


Hematology pimp session

Factors II, V, VII, and X and fibrinogen


Hematology pimp session

8. PTT measures the function of which factors?


Hematology pimp session

Factors II, V, VIII, IX, X, XI, and XII and fibrinogen


Hematology pimp session

9. What 2 electrolytes are required for the formation of a platelet plug?


Hematology pimp session

Calcium and Magnesium


Hematology pimp session

10. What is the sequence of physiologic reactions that mediate hemostasis following vascular injury?


Hematology pimp session

1. Vasoconstriction

2. Platelet activation/adherence/aggregation

3. Thrombin generation


Hematology pimp session

11. Uremia leads to a downregulation of?


Hematology pimp session

GpIb, GpIIb/IIIA, and vWF


Hematology pimp session

12. What is the treatment of choice for uremic coagulopathy?


Hematology pimp session

Dialysis


Hematology pimp session

13. Which drug can be given to help correct platelet dysfunction from uremia, bypass, or ASA?


Hematology pimp session

Desmopressin(DDAVP)


Hematology pimp session

14. DDAVP and conjugated estrogens stimulate the release of?


Hematology pimp session

Factor VII and vWF


Hematology pimp session

15. What platelet count is needed before surgery?


Hematology pimp session

>50,000/mL


Hematology pimp session

16. What platelet count is associated w/ spontaneous bleeding?


Hematology pimp session

< 20,000/mL


Hematology pimp session

17. What platelet count suggests the prophylactic transfusion of platelets?


Hematology pimp session

<10,000


Hematology pimp session

18. What is Virchow’s triad?


Hematology pimp session

Stasis, endothelial injury, and hypercoagulability


Hematology pimp session

19. What is the most common cause of acquired hypercoagulability?


Hematology pimp session

Smoking


Hematology pimp session

20. What is the most common inherited hypercoagulablestate?


Hematology pimp session

Factor V Leiden


Hematology pimp session

21. What is the treatment for hyperhomocysteinemia?


Hematology pimp session

Vitamin B-12 and folate


Hematology pimp session

22. Name the prothrombin gene defect causing spontaneous venous thrombosis?


Hematology pimp session

Prothrombingene defect G20210A


Hematology pimp session

23. What is the normal life of a platelet?


Hematology pimp session

7-10 days


Hematology pimp session

24. What electrolyte is most likely to fall after the infusion of stored blood?


Hematology pimp session

Ionized calcium (citrate in stored blood binds serum calcium)


Hematology pimp session

25. How long can PRBCs be stored?


Hematology pimp session

~ 42 days or 6 weeks


Hematology pimp session

26. What is the most common blood product to contain bacterial contamination?


Hematology pimp session

Platelets (stored at room temperature)


Hematology pimp session

27. What type of bacteria is usually found in contaminated platelets?


Hematology pimp session

Gram-positives


Hematology pimp session

28. What is the most common bacteria found w/ blood product contamination?


Hematology pimp session

Gram negative rods (E. coli)


Hematology pimp session

29. Who would you transfuse with leukocyte reduced packed red blood cells?


Hematology pimp session

Patients with multiple reactions despite premedication with antipyretics, patients needing long term platelet support, and transplant candidates in order to prevent formation of HLA antibodies


Hematology pimp session

30. What are the indications for blood transfusion?


Hematology pimp session

Hgb< 10 w/ h/o CAD/COPD, Healthy symptomatic pt. w/ Hgb < 7, acute blood loss


Hematology pimp session

31. What is the approximate formula to convert Hct to Hgb?


Hematology pimp session

Hct/ 3 = Hgb


Hematology pimp session

32. 1 U PRBC should increase the Hgb and Hct by this much?


Hematology pimp session

Should increase Hgb by 1 g/dL and Hct by ~3-4%


Hematology pimp session

33. What happens during a type and screen?


Hematology pimp session

Patient's blood is screened for antibodies and blood type is determined


Hematology pimp session

34. What happens during a type and cross?


Hematology pimp session

Pts. blood is sent to the blood bank and cross-matched for specific donor units for possible transfusion


Hematology pimp session

35. What fluid cannot be infused with PRBC and why?


Hematology pimp session

Lactated Ringer's; Calcium in LR may result in coagulation w/in IV line


Hematology pimp session

36. Most common cause of transfusion hemolysis?


Hematology pimp session

Clerical error leading to ABO incompatibility


Hematology pimp session

37. What is the treatment for transfusion hemolysis?


Hematology pimp session

Stop transfusion; fluids; Lasix; alkalinize urine w/ bicarbonate; pressors as needed


Hematology pimp session

38. How long does it take for Vitamin K to take effect?


Hematology pimp session

6 hours


Hematology pimp session

39. How long does it take for FFP to work?


Hematology pimp session

Immediately


Hematology pimp session

40. How long do the effects of FFP last?


Hematology pimp session

6 hours


Hematology pimp session

41. What does cryoprecipitate contain?


Hematology pimp session

vWF, Factor VIII, and fibrinogen


Hematology pimp session

42. What does FFP contain?


Hematology pimp session

All factors including labile Factors V and VIII, AT-III, protein C and S


Hematology pimp session

43. What is the best method for detecting pts. at risk for bleeding?


Hematology pimp session

A complete history and physical exam


Hematology pimp session

44. What is the most common congenital bleeding disorder?


Hematology pimp session

Von Willebrand's disease


Hematology pimp session

45. What factor is deficient in hemophilia A?


Hematology pimp session

Factor VIII


Hematology pimp session

46. What is the preoperative treatment for hemophilia A?


Hematology pimp session

Factor VIII infusion to 100% normal preoperative levels


Hematology pimp session

47. What factor is deficient in Hemophilia B?


Hematology pimp session

Factor IX


Hematology pimp session

48. What is the treatment for hemarthrosis in a pt. w/ hemophilia A?


Hematology pimp session

Initial therapy includes Factor VIII, joint rest, cold packs (3-5 days) and a compression dressing (3-5 days); Followed by active range of motion exercised 24 hrs. after Factor VIII therapy.


Hematology pimp session

49. What receptor deficiency is found in Glanzmann's thrombocytopenia?


Hematology pimp session

GpIIb/IIIareceptor deficiency; platelets can not bind to each other


Hematology pimp session

50. What receptor deficiency is found in Bernard Soulier disease?


Hematology pimp session

GpIbreceptor deficiency; platelets can not bind to collagen


Hematology pimp session

51. What are the desired platelet counts and Hct for a pt. with polycythemia vera before an elective operation?


Hematology pimp session

Plt< 400,000/mL and Hct < 48%


Hematology pimp session

52. What protein does Heparin bind to for its anti-coagulation effects?


Hematology pimp session

Anti-thrombin III; Heparin-antithrombin III complex then binds factor IX, X, XI


Hematology pimp session

53. What is the half-life of heparin?


Hematology pimp session

60-90 minutes


Hematology pimp session

54. What is the dose of protamine to reverse 100 U or 1 mg of heparin?


Hematology pimp session

1-1.5 mg


Hematology pimp session

55. What signs will you see in a protamine reaction?


Hematology pimp session

Bradycardia, hypotension, and decreased heart function


Hematology pimp session

56. How does warfarin induced skin necrosis occur?


Hematology pimp session

Protein C and S have a shorter half life than Factors II, VII, IX, and X. Coumadin leads to a decrease in Protein C and S before the other factors leading to a hypercoagulable state


Hematology pimp session

57. Pts. with this deficiency are at increased risk for Warfarin induced skin necrosis?


Hematology pimp session

Protein C deficiency


Hematology pimp session

58. What is the desired activated clotting time for routine anticoagulation?


Hematology pimp session

150-200 seconds


Hematology pimp session

59. What is the desired activated clotting time for cardiopulmonary bypass?


Hematology pimp session

400 seconds


Hematology pimp session

60. What INR is a contraindication to intramuscular injection?


Hematology pimp session

INR > 1.5


Hematology pimp session

61. What are the absolute contraindications to the use of thrombolytics?


Hematology pimp session

Recent CVA (<2 months), intracranial pathology, and active internal bleeding


Hematology pimp session

62. What are the indications for an IVC filter?


Hematology pimp session

Pts. who have undergone a pulmonary embolectomy, pts. with documented PE while anticoagulated, pts. with free floating femoral, ileofemoral, IVC DVT, pts. with contraindication to anticoagulation, and pts. at high risk for DVT (head injured/orthopedic injured on prolonged bed rest)"


Hematology pimp session

63. What is Argatroban?


Hematology pimp session

A synthetic direct thrombin inhibitor derived from L-arginine


Hematology pimp session

64. What is Hirudin?


Hematology pimp session

An irreversible direct thrombin inhibitor derived from leeches


Hematology pimp session

65. What is Ancrod?


Hematology pimp session

Malayan pit viper venom that stimulates tPA release


  • Login