Alvin Shared "General Path" - 14 Picmonics
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General Path
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
2 mins
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
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
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
2 mins
Vitamin K
- Sources
- Dark Green Leafy Vegetables
- Synthesized by Intestinal Flora
- Mechanism
- Activated by Epoxide Reductase
- Gamma Carboxylation of Glutamate
- Activation of Clotting Factors II, VII, IX, X, Protein C and S
- Considerations
- Deficiency with Broad Spectrum Antibiotics
- Neonatal Hemorrhage with Increased PT and aPTT
- Warfarin is a Vitamin K Antagonist
4 mins
Vitamin E (Alpha-tocopherol)
- Mechanism
- Antioxidant
- Indications
- Fat Malabsorption Syndrome
- Alpha-TTP Deficiency
- Side Effects
- Bleeding
- Considerations
- Increased Risk Hemorrhagic Stroke
- Limit Doses < 200 IU per Day
- Nuts and Whole Grains
- Vegetable Oils
2 mins
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)
1 min
PT/PTT Lab Values
- Prothrombin Time (PT)
- 10-14 seconds
- Activated Partial Thromboplastin Time (PTT or aPTT)
- 25-35 seconds
1 min
Innate Immunity Cellular Response
- Characteristics
- Natural Killer Lymphocytes Attack Abnormal Cells
- Neutrophils in Blood
- Infected Cells Release Interferon
- Complement Proteins Lyse Pathogens/Infected Cells
- Dendritic Cells in Tissue
- Macrophages in Tissue
2 mins
Humoral Adaptive Immunity
- Characteristics
- B Cell Binds Free Floating Antigen
- B Cell Presents Antigen to Helper T Cell
- Helper T Cells Help B Cells Develop Antigen Specificity
- Plasma B Cells Secrete Antibodies
- Memory B Cells Cause Faster Secondary Response
2 mins
Hypersensitivity Type I
- Previous Antigen Exposure
- Immediate Reaction
- IgE Cross-linking
- Presensitized Mast Cells
- Histamine Release
- Vasodilation
- Anaphylaxis
- Allergies
- Treatment
- Epinephrine
1 min
Hypersensitivity Type II
- Cytotoxic
- IgM or IgG antibody-mediated
- Membrane Attack Complex (MAC)
- Mechanism
- Opsonization
- Complement Activation
- NK Cells
- Testing
- Direct Coombs test
- Indirect Coombs Test
1 min
Hypersensitivity Type III
- Immune Complex
- Antigen-antibody (IgG) complex activates complement
- Neutrophils release lysozomal enzymes
- Examples
- Arthus Reaction
- Serum Sickness
- Systemic Lupus Erythematosus (SLE)
1 min
Hypersensitivity Type IV
- Delayed-Type Hypersensitivity
- T Cell Mediated
- Antibody Independant
- Macrophages Activated
- Examples
- Transplant Rejection
- PPD Skin Test
- Contact Dermatitis
1 min
