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do any of the inherited thrombotic disorders lead to arterial thromboses?
which 2 inherited clotting disorders increase VTE?
Homozygous factor V leiden
do you treat inherited thrombotic disorders?
preg -> heparin
active thrombus -> LMWH and warfarin
what is coumarin?
what is the prognosis of homozygous antithrombin deficiency?
death in utero
genetics of antithrombin deficiency?
people with antithrombin deficiency get a VTE before the age of what?
how much does the risk of thrombosis increase in antithrombin deficiency?
when do you treat, and with what, antithrombin deficiency?
if preg -> LMWH
if heart surg using cardiopulmonary bypass -> antithrombin transfusion pre-op
what does antithrombin do?
inactivates activated factors
-> hinders thrombosis
how do heparin and fondaparinux work?
what do deficiencies in protein C or protein S do?
-> prothrombotic state
X5 risk of thrombosis
talk about protein C/S?
dependent on which vit
role in coag
need vit K for synthesis
they are natural anticoagulants by:
-reducing thrombin generation
what percentage of the following have factor V leiden:
c) v rare
what is the genetic change in factor V leiden?
gain of function mutation
stops cleavage and thus inactivation of factor Va
what is the risk increase of thrombosis in factor V leiden?
X50 in rare heterozygotes
what is APS?
what is the cause of APS?
antiphospholipid antibodies vs the attached proteins
what tests are used to diagnose APS?
ELISA for the autoAb
DRVVT (?lupus anticoagulant)
what two autoAbs do you search for with ELISA testing in APS?
anti-beta2 glycoprotein I Ab
what complication of preg is assoc with APS?
name a non-inherited cause of increased risk of VTE and arterial thrombi?
complications of APS?
VTE and art thrombosis
normally if someone has a Hx of stroke they are put on aspirin, what do you give them if they have APS?
APS is linked to what autoimmune conditions?
what is sjogren's?
autoimmune attack of exocrine glands
what is the DRVVT used in testing for lupus anticoagulant for APS?
Dilute russell viper venom test
what is DIC?