bradtPA Posted November 24, 2008 Share Posted November 24, 2008 Why is Hemophilia uncommon in women? Hemophilia A is a resessive sex linked trait found on the X chromosome. Men only have one X chromosome, and therefore have a 50% chance of expression if the mother is a carrier or 100% chance if the mother is a hemophiliac. Women must have the gene on both X chromosomes to express the disease since it is recessive, therefore making it rarer in women. For any others out there, what factor is defective in Hemophilia A? Quote Link to comment Share on other sites More sharing options...
Prospective PA Posted November 24, 2008 Share Posted November 24, 2008 (edited) Just a guess...a lowly PRE PA here...women are carriers of the gene for hemophilia passing it on only if they have the gene for it 50/50 chance with X and Y in girls make it less likely...Men who havethe gene pass it on and male babies can recieve it ...only the X chromosome is the carrier... Yeah??? Edit: Darn Brad...you said it much better than I did...LOL...but thats the jist of what I meant! And you arefaster to reply!! Edited November 24, 2008 by Prospective PA Edit comment Quote Link to comment Share on other sites More sharing options...
bradtPA Posted November 24, 2008 Share Posted November 24, 2008 Just a guess...a lowly PRE PA here...women are carriers of the gene for hemophilia passing it on only if they have the gene for it 50/50 chance with X and Y in girls make it less likely...Men who havethe gene pass it on and male babies can recieve it ...only the X chromosome is the carrier... Yeah??? Edit: Darn Brad...you said it much better than I did...LOL...but thats the jist of what I meant! And you arefaster to reply!! One small error you have above. Men can't pass on X chromosomes to male babies, only to women. Transmission goes from male hemophiliac to female carrier, who passes it on to her sons 50% of the time.... Quote Link to comment Share on other sites More sharing options...
Prospective PA Posted November 24, 2008 Share Posted November 24, 2008 LOL...Typo! I knew that! Thanks though1 Quote Link to comment Share on other sites More sharing options...
kirkc18 Posted November 25, 2008 Share Posted November 25, 2008 Im thinking Factor 8 mutation is the culprit for Hemophlilia A however I also am thinking 10 but Im sticking with 8 LOL Quote Link to comment Share on other sites More sharing options...
bradtPA Posted November 25, 2008 Share Posted November 25, 2008 Im thinking Factor 8 mutation is the culprit for Hemophlilia A however I also am thinking 10 but Im sticking with 8 LOL Correct. Hemophilia A is factor 8 deficient. Quote Link to comment Share on other sites More sharing options...
meaux Posted November 25, 2008 Share Posted November 25, 2008 And there is also hemophilia B which factor 9, VwF disease, which is a platelet disorder, but related to 8. factor 10 is in the common pathway. Quote Link to comment Share on other sites More sharing options...
andersenpa Posted January 2, 2009 Share Posted January 2, 2009 What is the anti-inflammatory equivalency between prednisone and hydrocortisone? Quote Link to comment Share on other sites More sharing options...
Guest ttayl362 Posted January 2, 2009 Share Posted January 2, 2009 Well I don't know how much you want to credit me seeing how I am a lowly pre PA-S but here is what I came up with. I took Pharm in undergrad so I know the lingo for the most part and understand how to read the literature (for whatever that is worth). So here goes nothing. The anti-inflammatory activity of prednisone is approxaimately four times that of hydrocortisone on a weight-weight basis. I cut the comparison below from: http://arthritis.about.com/cs/steroids/a/corticosteroids_2.htm "According to The Pill Book (Bantam Books), using 5 mg of prednisone as the basis for comparison, equivalent doses of the other corticosteroids are: 0.6 mg-0.75 mg of betamethasone 25 mg of cortisone 0.75 mg of dexamethasone 20 mg of hydrocortisone 4 mg of methylprednisolone 5 mg of prednisolone 4 mg of triamcinolone" That site also has a cool little converter for equivalent dosages of other corticosteriods. I hope that was what you were looking for. Sorry for wasting your time if it wasn't.:D Quote Link to comment Share on other sites More sharing options...
andersenpa Posted January 3, 2009 Share Posted January 3, 2009 Heh I know the answer already....this "pimping" thread is just a back-and-forth Q&A about random minutiae. One of the rules- no googling! For next time....... Quote Link to comment Share on other sites More sharing options...
rcdavis Posted January 3, 2009 Share Posted January 3, 2009 (edited) We all are concerned about dvt/pe and hypercoagulable states. And as Andersen states, w/o google, can you list the lab eval for thrombophilia? (eg what tests would you order?) Edited January 3, 2009 by rcdavis Quote Link to comment Share on other sites More sharing options...
andersenpa Posted January 3, 2009 Share Posted January 3, 2009 Ah.....davis has his pimp hat on again.....oh yeah...... Quote Link to comment Share on other sites More sharing options...
kirkc18 Posted January 3, 2009 Share Posted January 3, 2009 CBC PT INR PTT May be more not sure Quote Link to comment Share on other sites More sharing options...
rcdavis Posted January 3, 2009 Share Posted January 3, 2009 many more. real example. pt with febrile acute gastroenteritis. normal bmp. cannot get / do cbc because, literally, clots in tube by second or third tube rotation in techs hands. and clots prevent either machine of hand performance. which tests would you like? Quote Link to comment Share on other sites More sharing options...
kirkc18 Posted January 4, 2009 Share Posted January 4, 2009 Haven't had much in way of lab ed yet coming up next semester but also C protein level, APC resistance, antithrombin 3 level and tests for connective tissue disorders like lupus plus previously mentioned. Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 4, 2009 Moderator Share Posted January 4, 2009 C protein level, APC resistance, antithrombin 3 level and tests for connective tissue disorders like lupus plus previously mentioned. lupus anticoagulant factor, not ana. fortunately where I work we have something called a "stroke in the young panel" that includes all the esoteric coag studies..... Quote Link to comment Share on other sites More sharing options...
rcdavis Posted January 4, 2009 Share Posted January 4, 2009 MOST EXCELLANT; APCR (Activated Protein C Resistence), -- if ratio is low, then what? Lupus anticoagulant anticardiolipin antibodies IgG and IgM Antithrombin acitvity Fasting homocysteine Factor VII acitivt Protein C and Protein S activity Prothrombin 20210A mutation ------- so, what do you do if the APC is low, and comadin and heparin affect the Lupus anticoagulant differently, any idea how? (eg which leg of the test is effected by which anticoagulant?) Quote Link to comment Share on other sites More sharing options...
kirkc18 Posted January 4, 2009 Share Posted January 4, 2009 Heparin to start then warfarin for long term control. Heparin makes antithrombin more effective but cant remember how while coumadin helps prevent some clotting factors from being made. Is that what you're looking for? Quote Link to comment Share on other sites More sharing options...
rcdavis Posted January 4, 2009 Share Posted January 4, 2009 nope, (though you are right on the heparin-->coumadin progression for anticoagulation.. and the theory behind that will be the discussion of a later postng). What I was interested in is the two clot phase of the Lupus Anticoagulant. Think "russell viper"... Quote Link to comment Share on other sites More sharing options...
kirkc18 Posted January 4, 2009 Share Posted January 4, 2009 (edited) Ok Im purely guessing but heparin will effect diluted russel viper test and coumadin will effect kaolin clotting time test ? Edited January 5, 2009 by kirkc18 accidental repeat Quote Link to comment Share on other sites More sharing options...
rcdavis Posted January 4, 2009 Share Posted January 4, 2009 Close. Time to look up: Lupus Anticoagulant (PTT-LA) clot and Dilute RussellViper venon time (DRVVT) Quote Link to comment Share on other sites More sharing options...
kirkc18 Posted January 5, 2009 Share Posted January 5, 2009 coumadin decreases availabilty of factor X which makes the test take longer to clot because russel viper venom attaches and activates factor X in presence of phospholipids and factor V. The heparin makes antithrombin 3 change conformation and pull out activated factor X so this keeps the blood from staying clotted once it starts. I think thats what you're looking for. Quote Link to comment Share on other sites More sharing options...
rcdavis Posted January 5, 2009 Share Posted January 5, 2009 PRETTY GOOD. now, if the APCR ratio is now, what do you check to r/o as congentially acquired problem? Quote Link to comment Share on other sites More sharing options...
kirkc18 Posted January 5, 2009 Share Posted January 5, 2009 factor 5 leiden gene mutation ( have a friend with this) Quote Link to comment Share on other sites More sharing options...
rcdavis Posted January 5, 2009 Share Posted January 5, 2009 Exactly. good job. so: APCR (Activated Protein C Resistence), -- if ratio is low, ==> Leiden fV. mutation Lupus anticoagulant (if LA-PTT clot prolonged- check thrombin to assess for heparin-.. if DRVVT prolonged, suspect coumadin) anticardiolipin antibodies IgG and IgM Antithrombin acitvity Fasting homocysteine Factor VII acitivty Protein C and Protein S activity Prothrombin 20210A mutation and this will pretty much cover the basic work up for thrombophillic states. Now (and Andersen may have covered this): Why does one start anticoagulation with heparin or LMWH rather than simply starting on coumadin? Quote Link to comment Share on other sites More sharing options...
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