Intravascular Information and Courses from MediaLab, Inc.
These are the MediaLab courses that cover Intravascular and links to relevant pages within the course.
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| Clinical Significance No blood is found in the urine of healthy individuals although samples from menstruating females, frequently, but not always, test positive for blood. Hematuria is associated with renal or genital urinary disorders in which the bleeding is the result of irritation to the involved organs or trauma. Examples include renal calculi, pyelonephritis, glomerulonephritis, tumors, trauma or exposure to toxic chemicals or drugs and/or strenuous exercise. Hemoglobinuria may be due to the lysis of red cells within the urinary tract. If it is caused by intravascular hemolysis, the hemoglobin is then filtered through the glomeruli. In the normal individual, the hemoglobin molecule attaches to haptoglobin and in this way bypasses the kidney filtration system. When the hemoglobin/haptoglobin system is overwhelmed, as in cases of hemolytic anemia, severe burns, transfusion reaction, infection or strenuous exercise, hemoglobin passes into the urine. | View Page |
| Disseminated intravascular coagulation (DIC) is associated with all of the following clinical conditions except: | View Page |
| Review 1 Francois P. Vaudaux P. Foster TJ. Lew DP.:
Host-bacteria interactions in foreign body infections.
Infection Control & Hospital Epidemiology. 17:514-20, 1996Persistent staphylococcal infections are a major medical problem, especially when they occur on implanted materials or intravascular catheters.This review describes some of the recently discovered molecular mechanisms of Staphylococcus aureus attachment to host proteins coating biomedical implants.These interactions involve specific surface proteins, called bacterial adhesins, that recognize specific domains of host proteins deposited on indwelling devices, such as fibronectin, fibrinogen, or fibrin.Elucidation of molecular mechanisms of S. aureus adhesion to the different host proteins may lead to the development of specific inhibitors blocking attachment of S. aureus, which may decrease the risk of bacterial colonization of indwelling devices. | View Page |
| Which of the following coagulation disorders can be attributed to a genetic platelet disorder, where giant platelets are commonly seen in the peripheral smear of an affected patient? | View Page |
| Tests of Hemostatic Function – Fibrinogen Assay The fibrinogen assay performed in the clinical laboratory is a quantitative measure of factor I.
This assay is used to determine whether there is enough fibrinogen present to allow for normal clotting.
It is performed in cases of an unexpected, prolonged bleeding event, or an unexpected abnormal PT and/or APTT.
Additionally, it is also used to aid in the diagnosis of disseminated intravascular coagulation (DIC).
A normal reference range is typically around 200-400 mg/dl.
That range is significant because fibrinogen levels
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| Fibrin/Fibrinogen Degradation Products and D-dimers The presence of D-dimers in plasma or whole blood indicates that fibrin has been formed and degraded (fibrinolysis). Plasmin can also degrade intact fibrinogen, generating fibrinogen degradation products that are detected in fibrin/fibrinogen degradation products (FDP) assays. D-dimers and FDP can become elevated whenever the coagulation and fibrinolytic systems are activated. The presence of D-dimer confirms that both thrombin and plasmin have been generated since it can only be produced as the result of the plasmin degradation of fibrin. This makes the test for D-dimers more specific for fibrinolysis than the FDP test that also detects the products of the direct proteolysis of fibrinogen (fibrinogenolysis).The D-dimer test can be useful in the diagnosis of deep venous thrombosis (DVT) or pulmonary embolism (PE), two forms of venous thromboembolism (VTE). When the test is being used for this purpose, it is important that D-dimer levels are accurately measured and accurately reported because of the serious nature of this clinical decision. If the test is positive in a patient suspected to have DVT or PE, clinicians proceed with further diagnostic tests. If the test is negative, depending on the clinical situation and the sensitivity of the D-dimer assay, DVT or PE is considered unlikely and further diagnostic tests for DVT or PE might not be pursued. D-dimer is a sensitive, but not specific, diagnostic test for disseminated intravascular coagulation, and an indicator of increased risk of future myocardial infarction in patients evaluated for chest pain. | View Page |
| Coagulation Disorders - Acquired Disseminated Intravascular Coagulation (DIC) is best described as a disorder of consumption, because clotting factors are depleted from the blood. Basically, clotting occurs randomly throughout the body, as opposed to just in the localized areas where vascular damage has occurred, consuming clotting factors and other components such as platelets in the process. Symptoms may range from a mild bleed, to severe, profuse bleeding, primarily dependant upon the availability of clotting factors. As more and more coagulation factors and components are consumed, the disorder progresses and symptoms worsen. Most heavily impacted are the levels of factors I, V, and VIII as well as the number of available platelets. Clinically, DIC is detected via an elevated (positive) FDP, positive D-dimer test, a prolonged PT and APTT, plus the manifestation of hemorrhagic episodes. DIC is diagnosed as two primary types, acute and chronic. Acute DIC manifests in a few hours or a few days, has a high mortality rate, and is seen in infections, obstetric complications, liver disease, and tissue injury. Chronic DIC is a secondary condition to some other disease state. Once you treat the primary disease, this type of DIC will go away. Treatment is often factor replacement therapy through the use of fresh frozen plasma and/or cryoprecipitate. | View Page |
| Note the view of a peripheral blood smear in the photograph. Pictured are scattered acanthocytes, echinocytes, target cells, spherocytes, and schistocytes. The condition in which each of these atypical RBC's may be found in varying numbers in the same peripheral blood smear is: | View Page |
| Match the red cell shapes in each frame of the photograph with its most likely corresponding clinical condition. | View Page |
| The misshapened "spiked" erythrocytes included in the photograph may be found in each of the following conditions except: | View Page |
| The presence of erythrocytes with altered morphology (as photographed here) has a close association with each of the following conditions except: | View Page |
| Another Keratocyte Another example of a helmet cell is seen in the center of this field. Examples of conditions in which keratocytes can be seen include intravascular coagulation, microangiopathic hemolytic anemia, glomerulonephritis, and rejection of renal transplants. The diagnosis of these disorders is not based on the presence of keratocytes. | View Page |
| The peripheral blood smear noted in the photograph was held for morophological and clinical review as the total platelet count was 10,000/cumm. Conditions fitting this picture include: | View Page |