Physiology of Hemostasis NRAN 80413 Casey Crow DNP, CRNA Quiz

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What is the primary function of platelets in hemostasis?

Form a platelet plug

Which type of vessel is hemostatic mechanisms most effective in dealing with bleeding?

Capillaries

What is the initial response to blood vessel damage in hemostasis known as?

Vascular spasm

What is the final common pathway in the coagulation cascade called?

Common pathway

Which of the following best describes fibrinolysis?

Breakdown of clot

What is the main function of undamaged endothelium in preventing clot formation?

Repelling clotting factors/platelets

What is the normal lifespan of platelets?

8-12 days

Which receptor is critical for platelet plug formation?

GPIIb-IIIa

Which molecule is a potent vasoconstrictor that promotes platelet aggregation?

Thromboxane A2

Which layer of the vessel wall contains the smooth muscle cells?

Tunica Media

What activates the Extrinsic Pathway of the clotting cascade?

Tissue Factor (TF)

Which factor is involved in activating the Intrinsic Pathway of the clotting cascade?

Factor VIII

What does the Final Common Pathway lead to the conversion of?

Fibrinogen to Fibrin

What process is regulated by plasma proteins like Plasminogen and inhibited by Antithrombin III?

Fibrinolysis

Which coagulation test assesses different pathways of clot formation?

aPTT

What does platelet count measure?

Number of Platelets in Blood

What is the pathophysiology of Disseminated Intravascular Coagulation (DIC)?

Formation of microvascular clots leading to thrombocytopenia and clotting factor depletion

Which of the following is a clinical manifestation of acute/overt Disseminated Intravascular Coagulation (DIC)?

Petechiae and mucosal bleeding

What is the primary amino acid substitution in Sickle Cell Disease (SCD) that leads to altered red blood cell (RBC) geometry and function?

Valine for glutamic acid on the beta globulin chain

Which of the following is a potential trigger for vaso-occlusive crisis in Sickle Cell Disease (SCD)?

Hypothermia

In Massive Blood Transfusion (MBT), what is the primary goal when treating acute coagulopathy?

Rapid delivery of blood products to maintain clotting factors

What is a key element in Massive Transfusion Protocol (MTP) that aims to interrupt the lethal triad in trauma patients?

Focus on correcting hyperthermia and acidosis

What does the acronym MTP stand for in relation to managing massive blood transfusions?

Massive Trauma Protocol

What is a common complication associated with Sickle Cell Disease (SCD) that presents with lung infiltrates and symptoms like chest pain and dyspnea?

Acute chest syndrome

'International Society of Thrombosis and Hemostasis Scoring System for DIC' is primarily utilized for assessing the severity of which condition?

(DIC) Disseminated Intravascular Coagulation

'Hemorrhage' is identified as a leading cause of preventable death after trauma, accounting for up to what percentage of deaths within the first 24 hours post-injury?

>50%

What is the primary goal of transfusion protocols during massive transfusion protocol (MTP)?

To achieve rapid hemostasis

In the context of sickle cell disease (SCD), what should be avoided in patients to prevent vaso-occlusive crises?

Avoiding hypoxemia

What is the significance of the ABC Score in the activation of massive transfusion?

Guides the initiation of a massive transfusion protocol

What is one of the key issues associated with stored blood that can complicate transfusions?

Increased potassium levels

What is the primary effect of PaO2 in the perioperative management of Hemophilia?

Reduces bleeding risk

What is the role of different blood products during a Massive Transfusion Protocol (MTP)?

Maintain adequate tissue oxygenation and hemostasis

Which factor plays a critical role in the anesthetic management of patients with Sickle Cell Disease (SCD)?

Maintaining normothermia

What is the main reason for avoiding sickle cell trait complications during anesthesia for patients with SCD?

To prevent painful vaso-occlusive crises

What is the key effect of MBT in massive transfusion protocols?

To correct coagulation abnormalities

What should be avoided when managing hemorrhage to prevent further deterioration according to the ABC Score?

Avoiding rapid volume resuscitation

What are the expected lab findings in Acquired von Willebrand Syndrome (AvWS)?

Prolonged activated partial thromboplastin time (aPTT) and low von Willebrand factor (vWF) antigen levels

What is the primary defect in von Willebrand Disease (vWD) types 1 and 2?

Impaired vWF synthesis or function

What is the role of Thromboelastography (TEG) in assessing coagulopathies?

Tests the visco-elastic properties of blood

What is the main treatment approach for patients with Hemophilia B?

Replacement therapy with factor IX concentrate

How does Factor V mutation contribute to resistance to anticoagulant effect on protein C?

Increases resistance to protein C inactivation

What does a base deficit measurement reflect in patients undergoing massive blood transfusion?

Amount of blood loss

Why are coagulation tests with long processing times not helpful in managing rapidly evolving blood loss?

They provide delayed results relative to the bleeding severity

What is the target mean arterial pressure (MAP) for resuscitation in patients undergoing massive blood transfusion?

< 60 mmHg

Test your knowledge on the physiology of hemostasis in NRAN 80413 with Casey Crow DNP, CRNA. Topics include platelets, blood vessel damage response, platelet plug formation, blood coagulation, fibrinolytic system, and coagulation tests.

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