CM IV Exam 5 Heme Rheum
Presentations & Highlights
1. Clotting cascade results in formation of - from
fibrinogen: fibrin
2. Coagulation initiated by pathway and amplified
by the
pathway: extrinsic / intrinsic
3. T/F: Every procoagulant step has one or more
anticoagulants: true
4. where is the site of bleeding w/ coagulation disorders: deep
5. are there petechiae in coagulation d/o: no
6. are there bruises w/ coagulation d/o: yes - large and deep
7. T/F bleeding after cut/scratch is common in coagulation
d/os: false
8. What scenarios lead to excess severe bleeding in
coagulation d/o: trau- ma/surgery
9. T/F Hemarthrosis and muscle bleeding is common in
coagulation d/o: true
10. petechiae are common w/ what type of d/o: platelet
11. T/F Petechiae do not blanch: TRUE [if they do blanch, think
angioma]
,12. T/F petechiae are palpable: FALSE - if they are think
vasculitis
13. common skin finding typical of coagulation factor
disorders [large discol- oration/bruise on skin]: Ecchymoses
14. excess bleeding spontaneously or following trauma
- inc aPTT
- normal PT
- normal hemogram: HEMOPHILIA A
tx: factor 8 replacement
DDVAP, tranexamic acid, epsilon aminocaproic acid
15. Hemophilia A is an hemorrhagic disorder
resulting from a congenital deficit of factor , an essential
clotting factor.: x-linked
factor VIII [8]
16. What factor is hemophilia B: Factor IX [9]
17. - Hemophilia B is primarily inherited via an
pattern.: X-linked recessive
18. - Hemophilia B is more/less? common than
hemophilia A.: less
,19. bleeding [spontaneous or trauma] hemarthroses [knees,
elbows, ankles, shoulders[ intracranial hemorrhage
contractures compartment syndrome pseudotumors
extra cranial bleeds
- increased aPTT
- normal PT: HEMOPHILIA B
factor IX [9] replacement
20. sick individual [cancer, sepsis, OB complications, trauma,
etc]
- bleeding [oozing] from multiple sites [catheter, IV,
vagina/rectum, gingiva, trauma]
- skin lesions, purpura, petechiae, cyanosis
- bleeding + clotting signs
- increased PT
- increased PTT
- decreased fibrinogen
- low plts
- schistocytes present: DIC
treat underlying cause
, manage hypovolemia manage hypoxemia
Heparin
FFP
plts
depending on fibrinogen levels
21. What is required for synthesis of vit K: 2, 7, 9, 10, protein C
&S
22. What are some causes of vit K deficiency: malnutrition
biliary obstruction
malabsorption
ABx
23. what's a good source of vit K: green vegetables
[also synthesized by intestinal flora]
24. Liver disease can cause decreased synthesis of what 6
things?: 2 7 9 10
11 & fibrinogen
25. what INR with no bleeding should you omit the dose of
warfarin and give vit K?: INR 5-9 + no bleeding
26. INR > ; serious bleeding
Presentations & Highlights
1. Clotting cascade results in formation of - from
fibrinogen: fibrin
2. Coagulation initiated by pathway and amplified
by the
pathway: extrinsic / intrinsic
3. T/F: Every procoagulant step has one or more
anticoagulants: true
4. where is the site of bleeding w/ coagulation disorders: deep
5. are there petechiae in coagulation d/o: no
6. are there bruises w/ coagulation d/o: yes - large and deep
7. T/F bleeding after cut/scratch is common in coagulation
d/os: false
8. What scenarios lead to excess severe bleeding in
coagulation d/o: trau- ma/surgery
9. T/F Hemarthrosis and muscle bleeding is common in
coagulation d/o: true
10. petechiae are common w/ what type of d/o: platelet
11. T/F Petechiae do not blanch: TRUE [if they do blanch, think
angioma]
,12. T/F petechiae are palpable: FALSE - if they are think
vasculitis
13. common skin finding typical of coagulation factor
disorders [large discol- oration/bruise on skin]: Ecchymoses
14. excess bleeding spontaneously or following trauma
- inc aPTT
- normal PT
- normal hemogram: HEMOPHILIA A
tx: factor 8 replacement
DDVAP, tranexamic acid, epsilon aminocaproic acid
15. Hemophilia A is an hemorrhagic disorder
resulting from a congenital deficit of factor , an essential
clotting factor.: x-linked
factor VIII [8]
16. What factor is hemophilia B: Factor IX [9]
17. - Hemophilia B is primarily inherited via an
pattern.: X-linked recessive
18. - Hemophilia B is more/less? common than
hemophilia A.: less
,19. bleeding [spontaneous or trauma] hemarthroses [knees,
elbows, ankles, shoulders[ intracranial hemorrhage
contractures compartment syndrome pseudotumors
extra cranial bleeds
- increased aPTT
- normal PT: HEMOPHILIA B
factor IX [9] replacement
20. sick individual [cancer, sepsis, OB complications, trauma,
etc]
- bleeding [oozing] from multiple sites [catheter, IV,
vagina/rectum, gingiva, trauma]
- skin lesions, purpura, petechiae, cyanosis
- bleeding + clotting signs
- increased PT
- increased PTT
- decreased fibrinogen
- low plts
- schistocytes present: DIC
treat underlying cause
, manage hypovolemia manage hypoxemia
Heparin
FFP
plts
depending on fibrinogen levels
21. What is required for synthesis of vit K: 2, 7, 9, 10, protein C
&S
22. What are some causes of vit K deficiency: malnutrition
biliary obstruction
malabsorption
ABx
23. what's a good source of vit K: green vegetables
[also synthesized by intestinal flora]
24. Liver disease can cause decreased synthesis of what 6
things?: 2 7 9 10
11 & fibrinogen
25. what INR with no bleeding should you omit the dose of
warfarin and give vit K?: INR 5-9 + no bleeding
26. INR > ; serious bleeding
