coagulopathy




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  • Intrinsic (aPTT)

    • 8: hemophilia A, classic hemophilia
    • 9: hemophilia B, xmas disease
    • 11, 12
    • associated: PK (prekallikrein), HMWK (high molecular weight kininogen)
    • antiphospholipid syndrome
  • Extrinsic (PT)

    • 7
    • PT test (note: contains heparinase)
    • INR = PT patient / PT normal
  • Common (both)

    • 1 fibrinogen: low in DIC
    • (2)a (pro)thrombin: argatroban, dabigatran
    • 5
    • 10: heparin, -Xaban, fondaparinux
    • associated: phospholipids
    • TT (thrombin time) measures thrombin + fibrinogen -> fibrin
  • Other factors

    • 13 (crosslinks fibrin)
    • thrombomodulin
    • plasmin(ogen) degrades fibrin
  • VWD

  • platelet disease

  • Warfarin

    • inhibits vitamin K
    • VitK factors: 2, 7, 9, 10, protein C, S, Z
    • Bridge with heparin bcz protein C & S drops first
  • Factor bleeding threshold

    • 50-100 mg/dL fibrinogen
    • 20-30% prothrombin
    • 15-20%: 5, 7, 10, 11, combined 5+8, combined VitK
    • 2-5%: 13