BVI, W VI

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what is Virchow's triad and when is it seen?: 1. endothelial injury
2. hypercoagulable state
3. circulatory stasis
*seen in clotting disorders
name some diseases that contribute to a hyperthrombotic state (5): 1. DM
2. hypertension
3. hyperlipidemia
4. cancer
5. obesity
name some medications that contribute to a hypercoaguable state (4): 1. OCs
2. HRT
3. Thalidomide
4. Cox-2 inhibitors
what are some mechanical factors that contribute to a prothrombitic state? (3): 1. surgery
2. immobilization
3. trauma
anticoagulant therapies can target either the arterial or the venous side. for each of the following therapies: state what side they affect. 1. Aspirin 2. tPA 3. heparin 4. warfarin 5. clopidogrel: 1. arterial
2. arterial or venous
3. venous
4. venous
5. arterial
which clotting factor does LMWH inhibit?: factor IIa
(also factor Xa)
what test is used to monitor heparin?: PTT
1. which type of clot is known as a red clot? 2. which type of clot is known as a white clot?: 1. venous clot (contains primarily fibrin)
2. arterial clot (contains primarily platelets)
what is the major complication seen in antiphospholipid antibody syndrome?: increased arterial and venous thrombotic risk
what are the two therapies for antiphospholipid antibody syndrome?: 1. aspirin
2. warfarin
what are the clinical risks of an antithrombin III, protein C or S deficiency?: DVT/PE
pregenancy associated with a high risk
what is administered as therapy for hyperhomocysteinemia?: folate
B6
B12
what test is elevated in a case of DVT or PE?: D-Dimer
therapies for DVT? (2): tPA
Heparin
which anticoagulant cannot be used during pregnancy?: Warfarin
(Heparin can be used b/c it doesn't cross the placenta)
whay are first trimester miscarriages more common in hypercoagulable states?: blood clots form in the placenta
what are some classic clinical s/s seen in disorders of platelet and blood vessel wall interaction?: 1. epistaxis
2. external bleeding everywhere!
3. iron deficiency
with what deficiency would you see the "fingerprint sign"? (spontaneous bruising): disorders of fibrin generation
describe the bleeding seen in disorders of fibrin formation.: - internal bleeding
- delayed bleeding (ie. in surgery)
- hematuria
- iron deficiency NOT a feature
how does a resting platelet become activated?: by coming into contact with collagen
what happens when a platelet is activated?: 1. pseudopods form
2. granules "shoot out" via cannalicular system (need Ca++ for this to occur)
3. activated platelets then spit out ADP to activate surrounding platelets
what molecule binds platelets together?: fibrinogen
(via glc IIB/IIIa receptors)
what molecule binds platelets to the vessel wall?: vWF
(glc Ib is recepor on plts)
besides collagen and ADP, what other molecules can stimulate platelet aggregation? (4): 1. Thrombin
2. Thromboxane A2
3. platelet activating factor
4. epinephrine
describe the primary and secondary waves of platelet aggragation...: 1. primary wave - activated by collagen
2. secondary wave - activated by already activated platelets (they spit out ADP which activates surrounding plts)
a damaged endothelial cell releases __________, which activates the extrinsic coagulation cascade.: tissue factor
fibrin generation is restricted to the sites of injury. why?: this prevents generalized thrombosis / DIC
1. A red topped blood collection tube contains ? 2. what happens to blood when it enters the tube?: 1. nothing
2. blood coagulates, forming a serum level and a clot level
1. a "tiger topped" tube contains? 2. blood looks like?: 1. coagulation activating gel
2. blood also separates into serum and clot
1. a green topped tube contains? 2. blood looks like?: 1. heparin
2. NO CLOT
1. a purple tube contains? 2. blood looks like?: 1. EDTA (Ca++ binder)
2. NO CLOT
(EDTA removes Ca++ from plasma; plts can't bind to clotting factors without Ca++ = no clot)
1. A yellow top tube contains? 2. blood looks like?: 1. citrate
2. same as purple tube
when blood is in a tube and it doesn't clot - what layers does it separate into?: plasma (fibrinogen and clotting factors)

RBCs
1. PTT measures the clotting time of which pathway? 2. PT measures clotting time of which pathway?: 1. intrinsic
2. extrinsic
the TT test is a direct measure of?: thrombin (IIa) activity
inheritance pattern of vWD?: autosomal dominant
hemophilia A is primarily a disorder of?: factor VIII
(fibrin generation)
inheritance pattern of hemophilia A?: XL
hemophilia A displays changes in which lab test?: prolonged PTT
inheritance pattern of severe (type III) vWD?: autosomal recessive
type III vWD presents with what lab abnormality?: prolonged PTT
Hemophilia B is a deficiency of?: factor IX
(fibrin generation disorder)
hypofibrinogenemia is a deficiency in?: factor I
inheritance pattern of hypofibrinogenemia?: autosomal dominant
lab test changes seen in hypofibrinogenemia?: prolonged PTT, PT
(hemorrhagic and thrombotic risk)
inheritance pattern of factor two deficiency: autosomal recessive
lab test changes seen in factor II deficiency?: prolonged PT, PTT
lab test seen in factor VII deficiency?: prolonged PT
factor VII deficiency in neonates carries an increased risk of?: neonatal CNS bleed
inheritance pattern of protein C or S deficiency?: autosomal dominant
factor V Leiden deficiency is associated with?: increased risk of DVT, PE
(risk of arterial disease not increased)
describe the levels of the following in early DIC 1. coagulation factors 2. D-Dimer 3. PTT 4. platelets: 1. increased
2. increased
3. decreased
4. normal
describe the levels of the following in late DIC 1. coagulation factors 2. D-Dimer 3. PTT/PT 4. platelets: 1. decreased
2. increased
3. increased
4. decreased
this protozoa causes...? Naegleria: amoebic meningioencephalitis
this protozoa causes...? Trympanosoma brucei: african sleeping sickness
this protozoa causes...? Trympanosoma cruzi: Chagas disease
this protozoa causes...? Leischmania donovani: leischmaniasis
this protozoa causes...? Plasmodium: malaria
this protozoa causes...? Toxoplasma gondii: toxoplasmosis
this flatworm causes? Schistosoma: schistosomiasis
this filarial roundworm causes? Wucheraria bancrofti, Brugia malayi: elephantiasis
this filarial roundworm causes? Loa loa: calabar swelling
this filarial roundworm causes? Onchocera volvulus?: river blindness
main symptoms and presentation of amoebic meningioencephalitis caused by Naegleria fowleri?: - enters body via nasal mucosa
- meningioencephalitis causing death within one week
reservoir of Trypanosoma brucei (af. sleeping sickness)?: Tse-tse fly
reservoir for Trypanosoma cruzi?: Reduviid bug
two phases of chagas disease? difference between the two?: 1. Acute phase - periorbital edema, fever
2. chronic phase - UNDETECTABLE PARASITEMIA, causes cardiomyopathy, autoimmune disease
what type of cells does Leischmania prefers to infect and where do they "live?": macrophages in the skin and viscera
insect vector for leischmania: sandfly
what is the sole mammalian reservoir of plasmodium species?: human

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