Eleanor Shared "Coagulation" - 8 Picmonics

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Coagulation

Coagulation Cascade
Secondary Hemostasis
Intrinsic Pathway
Partial Thromboplastin Time (PTT)
Heparin
Extrinsic Pathway
Prothrombin Time (PT)
Warfarin
Common Pathway
Thrombin
Convert Fibrinogen to Fibrin
Stabilizes the Platelet Plug
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2 mins
Heparin Indications
Indications
Acute Coronary Syndrome (ACS)
Prophylaxis
Pulmonary Embolism
Atrial Fibrillation
Used during Pregnancy
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1 min
Heparin Mechanisms
Mechanism of Action
Short Half-life
Antithrombin Activation Cofactor
Decrease Thrombin, Factor Xa
Side Effects
Bleeding
Heparin Induced Thrombocytopenia (HIT)
Antidote
Protamine Sulfate
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2 mins
Warfarin
Mechanism of Action
Interferes with Vitamin K-dependent Clotting Factors
Extrinsic Pathway
Bridge with Heparin
Indications
Chronic Anticoagulation
Side Effects
Bleeding
Necrosis
Cytochrome P450
Contraindications
Pregnancy
Antidote
FFP + Vitamin K
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Disseminated Intravascular Coagulation (DIC)
Pathophysiology
Bleeding state
Activation of clotting factors
Deficiency of clotting factors
Causes
Sepsis
Trauma
Obstetric complications
Acute Pancreatitis
Malignancy
Nephrotic Syndrome
Transfusion
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Von Willebrand Disease
Mixed platelet and coagulation disorder
Mechanism
Autosomal Dominant Condition Leading to Reduced vWF
Defect in platelet plug formation
Labs
Increased Bleeding Time
PTT increased
Factor VIII decreased
Normal platelet count
Treatment
DDAVP (synthetic vasopressin)
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1 min
Heparin Induced Thrombocytopenia (HIT)
Pathophysiology
5-10 Days After Heparin Exposure
Heparin-Platelet Factor 4 Complex
Autoantibodies Form Against Complex
Heparin-Platelet Factor 4-Antibody Complex Binds Platelets
Platelet Aggregation
Procoagulant Release
Symptoms
Thrombocytopenia
Diagnosis
Serotonin Release Assay (SRA)
Treatment
Stop Heparin, Start Direct Thrombin Inhibitor
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Hemolytic Uremic Syndrome (HUS)
Children
Pathophysiology
Preceded by Acute Diarrheal Illness
Endothelial Damage
Classic Triad of Symptoms
Microangiopathic Hemolytic Anemia (MAHA)
Thrombocytopenia
Renal Failure
Labs
Helmet cells
LDH
Treatment
Dialysis
Supportive
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2 mins

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