Lauren Shared "CPR 4" - 43 Picmonics

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CPR 4

Clotting Overview
Characteristics
Endothelial Cells are Damaged
Platelets Respond to Exposed Collagen and Stick
Platelets Release Recruiting Factors
More Platelets are Attracted
Soluble Fibrinogen Turns to Insoluble Fibrin
Fibrin Seals the Clot
Clot Dissolves
Liver Produces Clotting Factors
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2 mins
Platelet Lab Value
150,000-400,000 Micro L
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40 secs
Cell Surface Proteins - B Cells
Ig
CD19
CD20
CD21
CD40
MHC II
B7
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1 min
Erythropoietin
Mechanism
Stimulates RBC Production
Indications
Chronic Renal Failure
Anemia
Side Effects
Increased Risk of Thrombosis
Pelvic and Limb Pain
Hypertension
Considerations
Do Not Shake
Monitor Hemoglobin (Hgb) Weekly
May Accelerate Tumor Progression
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2 mins
Hemoglobin
Hemoglobin Has Four Iron Hemes
Lots Of Hemoglobin In Red Blood Cells
High O2 Levels Increase O2 Binding
High Temperature Reduces O2 Binding
High CO2 Levels Reduce O2 Binding
Low pH Reduces O2 Binding
Myoglobin Binds Oxygen in Muscle
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2 mins
Hemoglobin (Hgb) Lab Values
Men: 13 - 17 g/dL
Women: 12 - 16 g/dL
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46 secs
G6PD Deficiency
X-linked Recessive
Hemolytic Anemia
Inflammatory Response
Fava Beans
Sulfonamides
Primaquine
Anti TB Drugs
Heinz Bodies
Bite Cells
Prevalent Among African Americans due to Increased Malarial Resistance
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2 mins
Aspirin
Indications
Fever
Pain and Headache
Cardiovascular Disease (CAD)
Mechanism of Action
Irreversible inhibition of COX-1 and COX-2
Suppress Thromboxanes and Prostaglandins
NSAID
Side Effects
Reye's Syndrome
Tinnitus
Peptic Ulceration
Mixed Acidosis/Alkalosis
Nephropathy
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2 mins
Bleeding Time Lab Values
2-7 Minutes
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40 secs
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
Glanzmann Thrombasthenia
Pathophysiology
Autosomal Recessive or Acquired as an Autoimmune Disorder
Deficiency of Glycoprotein IIb/IIIa (Gp IIb/IIIa) Receptor
Defective Platelet-to-Platelet Aggregation
Symptoms
Mucous Membrane Bleeding (Gingival Bleeding)
Easy Bruising
Increased Bleeding Time
Normal Platelet Count
Considerations
Avoid NSAIDs
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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 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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2 mins
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
PT/PTT Lab Values
Prothrombin Time (PT)
10-14 seconds
Activated Partial Thromboplastin Time (PTT or aPTT)
25-35 seconds
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1 min
INR Lab Value
0.8-1.2 Normal Range
Warfarin
2.0-3.0
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1 min
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
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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2 mins
Warfarin Antidotes
Antidotes
Vitamin K
Fresh Frozen Plasma
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58 secs
Bernard-Soulier Syndrome
Mechanism
Autosomal Recessive
Deficiency of Glycoprotein Ib (GpIb) Receptor
Symptoms
Mucosal Membrane Bleeding
Menorrhagia
Easy Bruising
Labs
Large Platelets
Increased Bleeding Time
No Platelet Agglutination with Ristocetin
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3 mins

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