OBJECTIVES

Outline hematopoieses (blood cell production) from stem cells. State the physiological stimulating factors for the production of erythrocytes (red cells), leukocytes (white cells) and thrombocytes (platelets). List the normal range values and describe the physiological and clinical implications for abnormalities for the following types of laboratory data: - RBC - Red Cell Indices: MCV, MCH, RDW - Hgb & Hct - Hemoglobin A1C - Reticulocyte count - Sedimentation rate - Platelet count - PT, PTT, aPTT, INR - Bleeding time - Fibrinogen - Thrombin time - Fibrin split products - D-dimer - Anti factor Xa Diagram the coagulation cascade and indicate the importance to clinical practice. Describe the pharmacokinetics, pharmacodynamics and pharmacotherapeutics for the currently used anticoagulants, antiplatelets, thrombolytics, antifibrinolytics and stimulating hormones. List the current research on new (not yet released) hematologic agents. Outline the state of the science for human, synthetic and artificial blood products. Discuss how rhAPC (Xigris) is used in septic patients to decrease lethal clotting. Indicate the role the coagulation cascade has in the physiological response to sepsis and SIRS. State the current evidence based practice and clinical guidelines for the use of hematologic agents (anticoagulants, antiplatelets, and thrombolytics) in the treatment or prevention of acute stroke, acute MI, DVT and PE. Outline the pathophysiology, assessment, diagnosis and treatment options for common hematologic disorders: - DIC - HELLP - HIT - TTP & ITP - Sickle cell disease - Hemophilia - Von Willebrand disease Outline the pathophysiology, assessment, diagnosis and treatment options for common clotting disorders: - DVT - PE - Stroke - ACS - Hypercoagulable states (A-fib, smoking, obesity, HTN, DM, hyperlipidemia, immobility, sepsis) Indicate the rationale for DVT prophylaxis and rhAPC being part of the 16 surviving sepsis guidelines.