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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
- antithrombin deficiency
do you treat inherited thrombotic disorders?
- no unless:
- 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
- -deactivating factors
what percentage of the following have factor V leiden:
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?
- anticardiolipin Ab
- 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
- pre eclampsia
- livedo reticularis
- transverse myelitis
- skin necrosis
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?
- systemic sclerosis
- temporal arteritis
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 would you like to do?
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