Notes in Chapter_02:_Hematology

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Published	07/07/2024	Three responses to vascular injury include {{c1::vasoconstriction}}, {{c2::platelet adhesion}}, and {{c3::thrombin}} generation
Published	07/07/2024	During the {{c2::in}}trinsic pathway, factor {{c1::12}} combines with exposed {{c3::collagen}}, {{c4::prekallikrein}}, and {{c5::HMW kininogen}}
Published	07/07/2024	In the {{c3::in}}trinsic pathway, the second step involves factor {{c1::12}} activating factors {{c2::11}} and {{c2::9}}
Published	07/07/2024	Factor {{c3::9}} activates factor {{c1::8}} and then factors {{c2::10}} and {{c2::5}}
Published	07/07/2024	The {{c4::ex}}trinsic pathway begins with {{c1::tissue trauma}} exposing {{c2::factor VII}} which is converted to {{c2::factor VII}}, w…
Published	07/07/2024	In the {{c4::ex}}trinsic pathway, factor {{c1::7}} activates factors {{c2::10}} and {{c2::5}}, which then converts {{c3::prothrombin}} to {{c3::t…
Published	07/07/2024	The {{c1::prothrombin}} complex consists of factors {{c2::10}}, {{c3::5}}, {{c4::platelet factor 3}}, and {{c5::Ca2+}}
Published	07/07/2024	Factor {{c1::10}} is inhibited by {{c2::tissue factor pathway inhibitor}}
Published	07/07/2024	Platelets are linked together with {{c1::fibrin}}, which binds {{c2::GpIIb}} and {{c2::GpIIIa}} receptors
Published	07/07/2024	{{c2::Fibrin}} is crosslinked by factor {{c1::13}}
Published	07/07/2024	Protein {{c1::C}} degrades factor {{c2::5}}, factor {{c2::8}}, and {{c3::fibrinogen}}
Published	07/07/2024	{{c1::tPA}} is naturally released from {{c3::endothelium}} and converts {{c2::plasminogen}} to {{c2::plasmin}}
Published	07/07/2024	Factor {{c1::7}} has the shortest half-life
Published	07/07/2024	The only coagulation factor NOT synthesized in the liver is factor {{c1::8}}
Published	07/07/2024	{{c1::Thromboxane}} triggers the release of {{c2::Ca2+}} from {{c3::platelets}}
Published	07/07/2024	The highest concentrations of {{c2::von Willebrand factor}} and factor {{c2::8}} are found in {{c1::cryoprecipitate::blood product}}
Published	07/07/2024	The highest concentrations of {{c2::all coagulation factors::coag factor(s)}}, protein {{c3::C}}, protein {{c3::S}}, and {{c4::anti-thrombin III::anti…
Published	07/07/2024	Factor {{c3::8}} and {{c4::von Willebrand factor}} are released from the endothelium with {{c1::desmopressin::drug}} or {{c2::conjugated estrogens::dr…
Published	07/07/2024	The best test to determine the {{c2::liver's synthetic}} function is {{c1::PT}}
Published	07/07/2024	{{c3::PTT}} does NOT measure factors {{c2::7}} and {{c1::13}}
Published	07/07/2024	For routine anti-coagulation, the ideal {{c1::PTT}} range is {{c2::60}}-{{c2::90}} seconds
Published	07/07/2024	For routine anti-coagulation (i.e vascular surgery), the {{c1::ACT}} should be {{c2::150}}-{{c2::200}} seconds
Published	07/07/2024	For {{c3::cardiopulmonary bypass}}, the {{c2::ACT}} should be >{{c1::480}} seconds
Published	07/07/2024	{{c1::INR}} of > {{c2::1.5}} is a relative contraindication for general surgical procedures
Published	07/07/2024	{{c2::INR}} of > {{c1::1.3}} is a relative contraindication to {{c3::central line}} placement, percutaneous {{c4::needle biopsies}}, and {{c5::eye}…
Published	07/07/2024	The most common cause of surgical bleeding is {{c1::incomplete hemostasis}}
Published	07/07/2024	The most common congenital bleeding disorder is {{c1::von Willebrand disease}}
Published	07/07/2024	Von Willebrand disease is due to a defect in adequate binding of vWF to {{c1::GpIb}}
Published	07/07/2024	Von Willebrand disease type {{c1::I}} is due to {{c2::decreased}} vWF
Published	07/07/2024	Von Willebrand disease type {{c1::II}} is due to {{c2::defective}} vWF
Published	07/07/2024	The most common form of von Willebrand disease is type {{c1::I}}
Published	07/07/2024	Von Willebrand disease type {{c2::III}} is due to {{c1::complete absence of}} vWF
Published	07/07/2024	Von Willebrand disease type {{c1::III}} can NOT be treated with {{c2::desmopressin}}, so {{c3::cryoprecipitate}} is used instead
Published	07/07/2024	{{c3::BUN (uremia)}} >{{c2::60}}-{{c2::80}} inhibits {{c4::platelet}} function by preventing proper release of {{c1::vWF}}
Published	07/07/2024	{{c3::Heparin-induced thrombocytopenia}} is caused by Ig{{c2::G}} {{c1::heparin-platelet factor 4}} antibodies
Published	07/07/2024	{{c2::HIT}} forms a(n) {{c1::white::color}} clot
Published	07/07/2024	{{c2::Thrombosis}} while receiving heparin is highly suggestive of {{c1::HIT}}
Published	07/07/2024	The best diagnostic test for {{c2::HIT}} is {{c1::serotonin release assay}};can also test for {{c3::heparin-PF4 antibodies}}
Published	07/07/2024	{{c2::HIT}} is treated with cessation of heparin and starting {{c1::argatroban}}
Published	07/07/2024	HIT patients in general should NOT recieve platelet transfusion, unless platelets are < {{c1::50,000}} with {{c1::bleeding symptoms}}
Published	07/07/2024	{{c2::DIC}} can present similarly to ITP and TTP, but has abnormal PT, PTT, and a decreased {{c1::fibrinogen}} level
Published	07/07/2024	Aspirin should be stopped {{c1::7}} days before surgery
Published	07/07/2024	{{c2::Clopidogrel}} should be stopped {{c3::7}} days before surgery
Published	07/07/2024	Prior to {{c4::surgery}} or {{c3::coronary stent}} placement, {{c5::clopidogrel}} should be stopped and bridged with {{c2::eptifibatide}}
Published	07/07/2024	{{c3::Eptifibatide}} works by inhibiting {{c1::GpIIb/IIIa}}
Published	07/07/2024	{{c3::Clopidogrel}} works by {{c4::inhibiting::inhibiting or activating}} {{c1::ADP}} receptors
Published	07/07/2024	Coumadin should be stopped {{c1::7}} days prior to surgery and {{c2::heparin}} should be started as coumadin wears off
Published	07/07/2024	Non-traumatic {{c1::coumadin::drug}} bleeding is treated with {{c2::Vitamin K}} and {{c2::FFP}}
Published	07/07/2024	Traumatic {{c2::coumadin::drug}} bleeding is treated with {{c1::Prothrombin Complex Concentrate (PCC)}}
Published	07/07/2024	{{c4::Thrombolysis}} can occur after {{c1::prostate}} surgery due to release of {{c2::urokinase}}, which is treated with {{c3::aminocaproic acid}…
Published	07/07/2024	{{c2::Dabigatran}} should be stopped {{c1::2}}-{{c1::5}} days before surgery
Published	07/07/2024	{{c1::Apixaban}} should be stopped {{c3::2}}-{{c3::4}} days before surgery
Published	07/07/2024	{{c1::Rivaroxaban}} should be stopped {{c3::2}}-{{c3::4}} days before surgery
Published	07/07/2024	{{c2::Warfarin::anti-coagulant}} should be re-started {{c1::morning/evening::timeframe}} after surgery
Published	07/07/2024	{{c2::Most anti-coagulants::anti-coagulant}} should be re-started {{c1::1-3 days::time frame}} after surgery
Published	07/07/2024	Platelet count should be > {{c1::50,000}} prior to surgery and > {{c1::20,000}} after surgery
Published	07/07/2024	The best way to predict intra-operative bleeding risk is via {{c1::H&P}}
Published	07/07/2024	During an H&P, a history of abnormal bleeding after {{c1::tooth extraction::procedure}} or {{c2::tonsillectomy::surgery}} picks up 99% of patients…
Published	07/07/2024	The most common symptom with {{c2::platelet}} disorders is {{c1::epistaxis}}
Published	07/07/2024	The most common symptom with {{c2::bleeding}} disorders is {{c1::menorrhagia}}
Published	07/07/2024	{{c2::Thrombotic}} events secondary to {{c3::hyperhomocysteinemia}} are treated with {{c1::folic acid}} and {{c1::B12}}
Published	07/07/2024	{{c1::Factor V Leiden mutation}} is responsible for {{c2::30}}% of spontaneous venous thromboses and is treated with {{c3::heparin}} and {{c3::wa…
Published	07/07/2024	{{c1::Prothrombin}} gene mutation {{c2::G20210 A}} is treated with {{c3::heparin}} and {{c3::warfarin}}
Published	07/07/2024	Protein {{c1::C}} or {{c1::S}} deficiency is treated with {{c2::heparin}} and {{c2::warfarin}}
Published	07/07/2024	{{c1::Anti-thrombin III}} deficiency is treated with {{c2::FFP}} or {{c2::recombinant version of the protein}}, followed by {{c3::heparin}}, and …
Published	07/07/2024	Dysfibrinogenemia and dysplasminogenemia are treated with {{c1::heparin}} and {{c1::warfarin}}
Published	07/07/2024	During cardiopulmonary bypass, a(n) {{c2::consumptive}} coagulopathy can be initiated by factor {{c3::XII}} (aka {{c3::Hageman}} factor),which is…
Published	07/07/2024	Patients with {{c4::anti-phosopholipid antibody}} syndrome have {{c1::increased::increased or decreased}} {{c2::PTT::lab test}} and are hyp{{c3::…
Published	07/07/2024	Patients with anti-phospholipid syndrome are treated with {{c1::heparin}} and {{c1::warfarin}}
Published	07/07/2024	In {{c1::anti-phospholipid}} syndrome, the PTT {{c2::does NOT:: does or does NOT}} correct with {{c3::FFP}}, has a false {{c4::posi}}ti…
Published	07/07/2024	Patients with {{c2::protein C deficiency::coagulopathy}} are susceptible to warfarin-induced {{c3::skin necrosis}}, which is treat…
Published	07/07/2024	Prior to surgery, {{c2::polycythemia vera}} patients should have a(n) {{c3::hematocrit}} < {{c1::48}}
Published	07/07/2024	Prior to surgery, {{c2::polycythemia vera AND essential thrombocythemia}} patients should have a(n) {{c3::platelet count}} < {{…
Published	07/07/2024	{{c2::Virchow's}} triad is {{c1::stasis}}, {{c1::endothelial injury}}, and {{c1::hypercoagulability}} and constitutes the 3 most c…
Published	07/07/2024	The main risk factor for arterial thrombosis is {{c1::endothelial damage}}
Published	07/07/2024	Patients with their {{c1::first::1st/2nd/3rd}} post-operative DVT should receive {{c2::warfarin}} for {{c3::6 months::timeframe}}
Published	07/07/2024	Patients with their {{c1::second::1st/2nd/3rd}} post-operative DVT should receive {{c2::warfarin}} for {{c3::12 months::timef…
Published	07/07/2024	Patients with their {{c1::third::1st/2nd/3rd}} post-operative DVT should receive {{c2::warfarin}} for {{c3::the rest of their…
Published	07/07/2024	Patients with a significant post-operative PE should recieve {{c1::warfarin}} for {{c2::the rest of their life::time frame}}
Published	07/07/2024	If a patient is being anticoagulated and has a PE, the next step in management is {{c1::IVC filter}}
Published	07/07/2024	IVC filter should be placed {{c2::inf}}erior to the {{c1::renal}} veins
Published	07/07/2024	Patients with an IVC filter can still get a PE from the {{c1::upper extremities}}
Published	07/07/2024	IVC filter indications include a(n) {{c2::free-floating}} DVT, ilio{{c1::femoral}} DVT, or ilio{{c1::caval}} DVT
Published	07/07/2024	IVC filter for a {{c1::deep femoral}} DVT is controversial
Published	07/07/2024	Patients with a PE who have contraindications to anti-coagulation are treated with {{c1::IVC filter}}
Published	07/07/2024	If high clinical suspicion of PE (chest pain, sob, hypoxia), the next step is {{c1::give heparin bolus (prior to getting CT)}}
Published	07/07/2024	If a patient with PE is in shock despite {{c1::ionotropes::drug class}} and {{c1::pressors::drug class}}, the next step is {{c2::open remova…
Published	07/07/2024	PEs most commonly originate from the {{c1::ilio-femoral}} region
Published	07/07/2024	{{c3::Heparin::drug}} increases the activity of {{c2::anti-thrombin III}} by {{c1::1000}} fold
Published	07/07/2024	The half-life of heparin is {{c1::60-90 minutes}}
Published	07/07/2024	The biggest risk factors for protamine anaphylactic reaction are {{c1::NPH insulin use}} and {{c2::previous protamine exposure}}
Published	07/07/2024	If patient uses NPH insulin or has previous protamine exposure, their risk of an anaphylactic reaction is roughly {{c1::1}}%
Published	07/07/2024	Does protamine reverse low molecular weight heparin?{{c1::No}}
Published	07/07/2024	Low molecular weight heparin has a {{c1::lower}} risk of HIT(higher or lower)
Published	07/07/2024	Long-term use of {{c1::heparin::anti-coagulant}} can cause {{c3::osteoporosis}} and {{c2::alopecia}}
Published	07/07/2024	{{c2::Heparin::anti-coagulant}} is metabolized by the {{c1::reticuloendothelial}} system
Published	07/07/2024	{{c2::Heparin::anti-coagulant}} is metabolized by {{c1::splenic macrophages::cell}}
Published	07/07/2024	{{c2::Argatroban::anti-coagulant}} is metabolized in the {{c3::liver}} and has a mechanism of action via inhibition of {{c1::thrombin}}
Published	07/07/2024	The half-life of argatroban is {{c1::50}} minutes
Published	07/07/2024	{{c1::Bivalirudin}} is metabolized in the {{c2::blood (via protease enzymes)}} and has a mechanism of action via inhibition of {{c3::thrombin}}
Published	07/07/2024	{{c2::Hirudin}} is derived from {{c1::leeches}} and is a(n) {{c3::irre}}versible {{c4::thrombin}} inhibitor
Published	07/07/2024	The most potent inhibitor of {{c2::thrombin}} is {{c1::hirudin}}
Published	07/07/2024	{{c1::Ancrod}} is derived from {{c2::Malayan pit viper venom}} and has a mechanism of action via {{c3::tPA release}}
Published	07/07/2024	Although {{c3::heparin}} is mostly metabolized in the {{c2::spleen::organ}}, patients who have had splenectomy do NOT generally ha…
Published	07/07/2024	Patients recieving {{c2::tPA::anti-coagulant}} should be monitored via a(n) {{c1::fibrinogen::lab}} level
Published	07/07/2024	Patients on {{c4::tPA::anti-coagulant}} who have a(n) {{c2::fibrinogen}} level {{c3::less::less or greater}} than {{c1::100}} are at a …
Published	07/07/2024	{{c4::tPA::anti-coagulant}} is absolutely contraindicated if patients have had {{c2::CVA}} or {{c3::neurosugery}} within {{c1::3 months::time-frame}}
Published	07/07/2024	A major contraindication to tPA is {{c1::lef}}t heart {{c2::thrombus}}
Published	07/07/2024	In patients who have had a recent organ {{c1::biopsy}}, tPA is majorly contraindicated
Published	07/07/2024	Patients on warfarin with a CHADSVASc score of < {{c1::2}}-{{c1::3}} do not need to be bridged prior to surgery
Published	07/07/2024	CHADSVASc score > {{c1::4}}-{{c1::5}} should have a heparin bridge prior to surgery
Published	07/07/2024	Intraoperative administration of {{c3::cryoprecipitate}} is indicated with a(n) {{c2::fibrinogen}} level of <{{c1::50}}-{{c1::100}}
Published	07/07/2024	Intra-operative bleeding exacerbated by {{c2::uremia}} can be mitigated by administration of {{c1::cryoprecipitate}} since it contains {{c1::von Wille…
Published	07/07/2024	{{c2::Surgicel}} is an organized {{c3::regenerated cellulose matrix}} compound, that works by activating the coagulation cascade, application of …
Published	07/07/2024	Although {{c2::Surgicel::hemostatic agent}} is absorbed in {{c3::14 days::time-frame}}, two long-term complications include {{c1::adhesion}} and {{c1:…
Published	07/07/2024	{{c3::Gelfoam::hemostatic agent}} and {{c3::Surgifoam::hemostatic agent}} are derivatives of {{c2::porcine}} {{c1::collagen}}
Published	07/07/2024	{{c2::Surgifoam}} (and {{c2::Gelfoam}}) have a {{c3::neutral::high or low}} pH and thus do NOT activate {{c1::thrombin}}, therefore it must be mo…
Published	07/07/2024	{{c2::Gelfoam}} and {{c2::Surgifoam::hemostatic agents}} are absorbed in {{c1::6 weeks::timeframe}}
Published	07/07/2024	IV {{c3::Transexamic acid::hemostatic agent}} can dramatically reduce intra-operative blood loss,however it is contraindicated in patients with {…
Published	07/07/2024	Patients aged {{c2::61}}-{{c2::74}} have a {{c3::Caprini::DVT}} score of {{c1::2}}
Published	07/13/2024	{{c4::Dabigatran}} can be reversed with {{c3::idarucizumab (Praxbind)}}, if unavailable it can be reversed with {{c2::aPCC or PCC}} ({{c1::5…
Published	07/07/2024	{{c1::500}} units of PCC has the same factor equivalent to {{c1::2}} units of fresh frozen plasma
Published	07/07/2024	After administering PCC you should also administer {{c2::vitamin K}} {{c1::IV or oral::route}}
Published	07/07/2024	Prothrombin complex concentrate consists of factors {{c1::2, 7, 9, and 10}}
Published	07/07/2024	Prothrombin complex concentrate lasts ~{{c1::8}} hour(s)
Published	07/07/2024	Aspirin-induced bleeding can be partially reversed with {{c1::desmopressin}}
Published	07/07/2024	Although desmopressin is used in uremic bleeding, the downside is that the drug quickly undergoes {{c1::tachyphylaxis}}
Published	07/07/2024	Xarelto is a brand name for {{c1::rivaroxaban}}
Published	07/07/2024	Eliquis is a brand name for {{c1::apixaban}}
Published	07/07/2024	Pradaxa is a brand name for {{c1::dabigatran}}
Published	07/07/2024	Amicar is a brand name for {{c1::aminocaproic acid}}
Published	07/07/2024	Integrilin is a brand name for {{c1::eptifibatide}}
Published	07/07/2024	Plavix is a brand name for {{c1::clopidogrel}}
Published	07/07/2024	Hirulog is a brand name for {{c1::hirudin}}
Published	07/07/2024	Angiomax is a brand name for {{c1::bivalirudin}}
Published	07/13/2024	How long should you hold non-vitamin K dependent oral anticoagulants (dabigatran, rivaroxaban, apixaban) before surgery?{{c1::48 hours}}
Published	07/13/2024	How long should you hold aspirin before elective surgery?{{c1::Can be maintained through most elective surgical procedures when compareing the risk of…
Published	07/13/2024	How long should P2Y12 inhibitors (clopidogrel, prasugrel, ticragrelor) be held for elective surgery?{{c1::5-10 days}}
Published	07/13/2024	Fast way to reverse warfarin{{c1::PCC}}
Published	07/13/2024	How to reverse non-vitamin K oral anticoagulants (dabigatran, rivaroxaban, apixaban){{c1::PCC, vitamin K}}
Published	07/13/2024	Antidote for {{c1::rovaroxaban}} is {{c2::andexanet alpha}}
Published	07/13/2024	Most common complication of hemangioma{{c1::Ulceration}}
Published	07/13/2024	Thrombin activates and cleaves which factors?{{c1::Activates factors V and VIII as well as plateletsCleaves fibrinogen into fibrin}}
Published	07/13/2024	{{c1::Fibrin}} combines with platelets to form a platelet plug
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