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

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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
Factor VII + tissue factor → activates Factor X +Factor V → converts prothrombin to thrombin → thrombin converts fibrinogen to fibrin
6. Which factor is the convergence point for both the extrinsic and intrinsic pathways of coagulation?
10. What is the sequence of physiologic reactions that mediate hemostasis following vascular injury?
1. Vasoconstriction

2. Platelet activation/adherence/aggregation

3. Thrombin generation

13. Which drug can be given to help correct platelet dysfunction from uremia, bypass, or ASA?
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
Pts. blood is sent to the blood bank and cross-matched for specific donor units for possible transfusion
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.
51. What are the desired platelet counts and Hct for a pt. with polycythemia vera before an elective operation?
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
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)"