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This is the formation of excessive amount of clot (fibrin and/or platelet derived) within the vessel lumen causing vessel occlusion.
Thrombosis
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A very high FVIII concentration can induce what?
Thrombosis
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What helps to maintain the balance in hemostasis (between coagulation and fibrinolysis)?
Regulatory Mechanisms
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Which type of thrombosis (veinous or arterial) is coagulation based? WHich is platelet-derived?
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How does Arterial Thromboemobolic Disease primarily manifest? What are the two clincial symptoms? What are the two treatments?
- MI & Stroke
- "Cold Extremities" & Gangrene of Extremity
- Anti-Platelet Drugs & Heparin
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What color is a thrombus in an artery? In a vein?
- White
- Red (has trapped RBCs and platelets)
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Deep Vein Thrombosis in more common than _____ and _______ combined.
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What is the leading cause of childbirth death in North America, as well as the most common preventable hospital death?
Pulmonary Embolism
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Coagulation generates VTE and then breakdown of fibrin clot forms ________. These become elevated in blood after the formation of a VTE, and are usually lower in patients without VTE. Therefore, we use this assay to rule out VTE.
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This is a set of genetic abnormalities and/or acquired conditions which predisposes the individual to an increased risk of thromboembolic disease. This presents with mainly venous thrombosis, and usually manifests in young adults (20-50 years). The cause of the thrombotic presentation is usually spontaneous and an inciting event. This is a complex genetic disease -- there is no single cause. There is a standard treatment for all causes.
Thrombophilia
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The two molecular causes of Thrombosis are a loss of function, caused by a deficit in ______________, and a gain in function, caused by an increase in ___________.
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This is caused by an inability of patient's plasma to be inhibited by Activated Protein C (APC). There is a mutation of the APC cleavage site in what factor, and what is this known as?
Factor VLeiden
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The highest prevalence of abnormalities in patients with VTE is caused by what?
Unknown Cause
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This mutation increases Prothrombin levels. The mechanism is longer surviving mRNA. This is a genetic abnormality.
Prothrombin-UT 20210 Mutation
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In this syndrome, there is a heterogeneous family of auto-antibodies (lupus anticoagulant) against the PL-Protein Complex. The majority are asymptomatic, but about 30% of patients develop thrombosis. This can be transient or long term. Thrombosis and obstetrical complications can arise, including a.rterial, venous, and recurrent fetal loss
Anti-Phospholipid Syndrome or Lupus Anticoagulant
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Most of the transient cases of Anti-Phospholipid Syndrome, or Lupus Anticoagulant, is due to what? What are the long-term cases due to?
- Viral Infection
- Auto-immune or unknown
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What lab test is done for Anti-Phospholipid Syndrome, or Lupus Anticoagulant?
LA Panel -- do three tests, need at least one positive; must be present on 2 occassions at least 12 weeks apart to be long-term
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When is the optimum time to do a work-up on a Thrombophilia patient?
When they are asymptomatic and are not on any therapy
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Heparin-induced thrombocytopenia is an immune-mediated activation of platelets. It results in ___________ due to platelet and coagulation activations.
Thrombosis
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How is Heparin-Induced Thrombocytopenia tested in the lab?
- Detection of Antibody: ELISA
- Functional Antibody Tests: Serotonin (14C) Release Assay
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