39 Questions
Which factor inhibits thrombin-induced activation of factor VIII?
Factor V
What is the main component of a thrombus?
Fibrin strands
Which condition is a contraindication for administering unfractionated heparin (UFH)?
Malignant hypertension
What is the main manifestation of clot formation in the venous circulation?
Pulmonary embolism (PE)
What complex inhibits the activity of thrombus arising from the systemic circulation in the pulmonary blood vessels?
UFH-antithrombin complex
Which condition is a contraindication for administering heparin due to its potential to induce bleeding?
Hemophilia
Which factor mediates clot formation in deep vein thrombosis (DVT)?
Thrombin (IIa)
What should be done if major bleeding occurs during unfractionated heparin therapy?
Discontinue therapy immediately and start IV protamine sulfate infusion over 10 minutes.
What are common symptoms of bleeding associated with heparin therapy?
Passing of bright red blood through the rectum and chest pain
What does inability to supervise and monitor treatment constitute a contraindication for unfractionated heparin (UFH)?
Higher contractions leading to higher blood flow
What should be used if venous circulation needs reversal of unfractionated heparin's effects?
IV protamine sulfate
Which condition is associated with venous stasis?
Heart failure
What is the advantage of LMWHs over UFH?
Less need for routine laboratory monitoring
Which drug is FDA approved for prevention and treatment of VTE?
Warfarin
What does warfarin therapy monitor using INR?
Blood clotting (target: 2 to 3 for DVT or PE)
What do thrombolytic agents do?
Activate plasmin to degrade the fibrin matrix
Which drug binds to antithrombin to exert its anticoagulant effect?
Fondaparinux sodium
What is the major advantage of LMWHs over UFH in terms of clearance?
Dose-independent clearance
What is a risk factor for venous thromboembolism?
Immobilization for ≥3 days during hospital admission
Which drug has no direct effect on previously circulating clotting factors or formed thrombi?
Warfarin
What does warfarin inhibit to exert its anticoagulant effect?
Vitamin K–dependent production of clotting factors II, VII, IX, and X, proteins C and S.
What plays a key role in the coagulation cascade by enhancing platelet aggregation?
Thrombin
What are symptoms of deep vein thrombosis (DVT)?
Swelling of the leg and skin warmth
Which factor mediates clot formation in deep vein thrombosis (DVT)?
Factor Xa
What complex inhibits the activity of thrombus arising from the systemic circulation in the pulmonary blood vessels?
Activated protein C
What plays a key role in the coagulation cascade by enhancing platelet aggregation?
Thrombin
What is the main manifestation of clot formation in the venous circulation?
Swelling of the leg
"Thrombolytic agents are proteolytic enzymes that:"
Activate Plasmin
"Venous stasis" is associated with which condition?
Deep vein thrombosis
What is the main reason for not giving heparin to patients with severe liver disease and elevated prothrombin time (PT)?
Heparin can induce bleeding
Which drug is used for reversal of unfractionated heparin's effects in the venous circulation?
IV protamine sulfate
What is a contraindication for administering unfractionated heparin (UFH) due to its potential to induce bleeding?
Malignant hypertension
What does inability to supervise and monitor treatment constitute a contraindication for unfractionated heparin (UFH)?
Inability to supervise and monitor treatment
What is the main manifestation of clot formation in the venous circulation?
Complete or partial obstruction of pulmonary blood flow
What plays a key role in the coagulation cascade by enhancing platelet aggregation?
Factor V
What complex inhibits the activity of thrombus arising from the systemic circulation in the pulmonary blood vessels?
UFH-antithrombin complex
What drug binds to antithrombin to exert its anticoagulant effect?
LMWHs
What should be used if venous circulation needs reversal of unfractionated heparin's effects?
IV protamine sulfate
Which factor mediates clot formation in deep vein thrombosis (DVT)?
Factor Xa
Study Notes
Coagulation and Anticoagulation
- Protein C inhibits thrombin-induced activation of factor VIII.
Thrombus Formation
- The main component of a thrombus is a platelet plug.
- The main manifestation of clot formation in the venous circulation is swelling.
Contraindications for Heparin Administration
- Severe liver disease and elevated prothrombin time (PT) are contraindications for administering unfractionated heparin (UFH) due to its potential to induce bleeding.
- Inability to supervise and monitor treatment constitutes a contraindication for unfractionated heparin (UFH).
Deep Vein Thrombosis (DVT)
- Factor Xa mediates clot formation in deep vein thrombosis (DVT).
- Symptoms of DVT include pain, swelling, and warmth.
Heparin Therapy
- If major bleeding occurs during unfractionated heparin therapy, protamine sulfate should be administered.
- Common symptoms of bleeding associated with heparin therapy include bruising, petechiae, and easy bleeding.
Low-Molecular-Weight Heparins (LMWHs)
- The advantage of LMWHs over unfractionated heparin (UFH) is that they have a more predictable dose response and lower incidence of thrombocytopenia.
- The major advantage of LMWHs over UFH in terms of clearance is that they are eliminated more slowly and have a longer half-life.
Warfarin Therapy
- Warfarin therapy monitors the international normalized ratio (INR).
- Warfarin inhibits vitamin K-dependent clotting factors to exert its anticoagulant effect.
Thrombolytic Agents
- Thrombolytic agents are proteolytic enzymes that dissolve thrombi.
- Thrombolytic agents do not have a direct effect on previously circulating clotting factors or formed thrombi.
Risk Factors and Associations
- Venous stasis is associated with venous thromboembolism.
- A risk factor for venous thromboembolism is immobilization.
Coagulation Cascade
- Thrombin plays a key role in the coagulation cascade by enhancing platelet aggregation.
- The pulmonary vascular endothelium complex inhibits the activity of thrombus arising from the systemic circulation in the pulmonary blood vessels.
- Heparin binds to antithrombin to exert its anticoagulant effect.
Test your knowledge of thrombus formation and deep vein thrombosis (DVT) with this quiz. Explore the factors involved in clot formation, the composition of thrombus, and its manifestation as pulmonary embolism (PE).
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