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Kaplan Qbank USMLE



Author9 Posts
  #1

72 yo lady diagnosed with AF ,past medical history is irrelavent .soon after warfarin therapy the patient hospitalizsed with severe skin and subcutaneous fat necrosis ! which of the following processes are responsible for this patient's condition :

a-prothrombin conversion

b-fibrinogen conversion

c-factor VIIa activity

d-factor XIa activity

e-protein C synyhesis

f-factor IX synthesis

  #2

eeeeeeeeeeee

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As a general rule, the better it felt when you said it, the more trouble it's going to get you into.

  #3

e.protein c synthesis....
warfarin prevents gamma carboxylation so prevents release of factors...
factor 7 and prt C hav shortest half-lives....so prt C decreases....induces a litl coagulation responsible for skin ulceration


  #4

angel23 wrote:
e.protein c synthesis....
warfarin prevents gamma carboxylation so prevents release of factors...
factor 7 and prt C hav shortest half-lives....so prt C decreases....induces a litl coagulation responsible for skin ulceration

Thats why I hated step1 so much, to much detail. And lets not talk about molecular biology.

___________________
As a general rule, the better it felt when you said it, the more trouble it's going to get you into.

  #5

E


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Every disaster hides an opportunity. Even if you are on the right track, you will get run over if you just sit there.

  #6

E


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Great works are performed not by strength, but by perseverance.

  #7

Protein C has a short half life (6 hours). When patients are placed on Warfarin, protein C activity falls to zero activity in 6 hours, causing a hypercoagulable state due to increased activity of factors V and VIII.

This causes cutaneous vessel thrombosis and concomitant skin necrosis. This is common in heterozygote carrier of protein C deficiency placed on Warfarin because they only have 50% protein C activity.


___________________
Great works are performed not by strength, but by perseverance.

  #8

E. Protein C synthesis


  #9

e-protein C synyhesis


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