1 Flashcards
CURRENT PATHWAY
- Extrinsic Tenase Complex activates _____ in Intrinsic and ____ in Common
- Thrombin 3 negative feedbacks
- activates factor ____ & ___ which can activate factor X in common pathway
- can also activate factor ____ - Thrombin cleaves _____ into _______
- Thrombin activates ____ with calcium
- this crosslinks w/ fibrin monomers to create ________
- when they cross link this will activate _________
- IX = intrinsic; X = common
- Thrombin 3 negative feedbacks
- IX&X
- V - fibrinogen to fibrin monomers
- XIIII
- polymerized fibrin clot
- covalently crosslinked fibrin clot
- thrombin is important to jump in _______
- thrombin can also act as inhibitors by excess thrombin by releasing proteins ____ & ___
- destroys factor ___ &___ so no more thrombin - dissolution of clot by plasmin
- derived from
- produced by the
- Intrinsic
- Proteins S&C
- V & VIII - FIBRINOLYSIS
- plasminogen
- liver
activation of plasminogen to plasmin
1. Intrinsic activation
2. Extrinsic activation
3. Exogenous activation
functions of plasmin:
1. promotes _____
2. activates the ______
3. cleaves factor _____
activation of plasminogen to plasmin
1. XIIa-Kallikrein-HMWK
2. t-PA (tissue plasminogen activator)
3. urokinase & streptokinase
functions of plasmin:
1. clot dissolution
2. complement system
3. factor XIIa
Fibrin (& Fibrinogen) Degradation Products:
1. Early degradation (high)
2. Late degradation (low)
3. Effects of FDP
- w/ anticoagulant
- inhibit fibrin polymerization
- inhibits thrombin
- X and Y
- D and E
- inhibits coagulation
- X and Y
- Y and D
- Fragment E
_____: insoluble protein
- Fibrinogen
- components - Fragment X = _______; Fragment Y =______
- further degradation, _________
______: soluble protein
1. this monomer with plasmin, degrades into ______ & ____ complex first
- _____ = _____
- _____ = _____
2. further degradation, _____, ____, ____
- important for testing marker for thrombosis
FIBRINOGEN
1. Fibrinogen
- D-E-D COMPLEX
2. Fragment X = D-E-D COMPLEX; Fragment Y = D-E COMPLEX
3. FRAGMENTS D&E
FIBRIN
1. YY & DXD COMPLEX
- YY = E-D COMPLEX
- DXD = D DIMER & E COMPLEX
2. DED COMPLEX, E, AND D-DIMER
- D-DIMER
needle gauge
1. used in coagulation tests(2)
- inches
2. G19 inches
3. for child adult, friable, hardened veins
4. syringe with winged (3)
5. in practice (2)
syringe: _____ or ______
temperature :
1. most tests are performed at
2. factors that deteriorate at room temp.
3. refrigerator temp. affects:
4. PT plasma samples when capped are stable for ____hrs at ____
5. APTT samples are stable for ____hrs if stored at _____ (avg)
needle gauge
1. G20-21
- 1-1.25
2. 1 or 1.25 inches
3. G23
4. G20, G21, G23
5. G21 & G23
syringe: plastic syringe or silicone-coated
temperature :
1. 37C
2. 5&8
3. vWF, 7,11
4. 24hrs at room temp
5. 4hrs at 4-20C (8C)
syringe hub
19
20
21
22
23
24
25
26
ANTICOAGULANT
1. _____ & _____ (black top)
2. ratio
3. 3.2% types moles
- glass
- plastic
4. if patient hct >55%, adjust w/ what formula
- 19 = cream
- 20 = yellow
- 21 = green
- 22 = black
- 23 = light blue (Routine needle)
- 24 = red
- 25 = dark blue
- 26 = brown
- 3.2% sodium citrate; 3.8% sodium citrate
- 9:1
3.
- 0.105moles
- 0.109moles - C = (0.00185) (V) (100-H)
SAMPLE PREP
PPP (test = _____)
1. uL
2. centrifugation
3. collect ____ layer only
4. test immediately because exposure to air changes the pH due to loss of ______ (____pH)
5. store at ___ but not exceed to ___
- or rapid freezing to _____
6. _____ plasma
PRP (test = _____)
1 centrifuge
2. separate _____ of sample
PPP (Activated Partial Thromboplastin Time)
1. <10,000/uL
2. 2000 x g for 10mins
3. upper 3/4 of plasma layer
4. loss of carbon dioxide (increased pH)
5. 4C; 2hrs
- -20C
6. citrated plasma
PRP (platelet aggregation)
1. 60-100 x g for 10mins at room temp
2. upper portion
Sources of Errors Affecting Coagulation Tests
- blood volume is inadequate causing _______
- ____ in specimen
- upper part is pinkish
- _____ phlebotomy
- increased bilirubin; increased triglycerides
- excess anticoagulant
- clot
- hemolysis
- traumatic phlebotomy
- icterus; lipemia
Tests for Intrinsic & Common Pathway
______: measures the time required for whole blood to clot after it has been removed from the body
1. _____ (micromethod): RV
2. _____ (macromerhod): RV
3. _____ (capillary method): RV
_____: whole blood contains all components necessary to produce necessary to produce a clot when put into glass tube
1. by adding activator like _____
2. keeping blood at constant ____
3. RV
_____: time required for blood to clot after addition of calcium
1. RV for PRP
2. RV for PPP
3. If both are used, PRP should clot ___ before PPP
Coagulation Time
1. Slide Method (micromethod): 2-4mins
2. Lee & White Method (macromerhod): 7-15mins
3. Dale & Laidlaws method (capillary method): 2-4mins
Activated Clotting Time
1. Diatomite
2. 37C
3. 75-120s
Plasma Recalcification Test
1. 100-150s
2. 130-240s
1. 20s
______: for routine screening, for detecting the presence of circulating anticoagulant, and for monitoring HEPARIN therapy
- type of specimen
- plasma should be separated immediately after centrifugal since heparin interacts w/ plasma that can cause _______ - also measure factors present in the common pathway, except ____ & _____
- principle: EXCEPT for _____ & _____, PPP contains all the coagulation factors needed for generation of intrinsic prothrombinase
- serve as platelet substitute - APTT reagents
- ______
-______ (platelet substitute)
- activators (3) - RV
Activated Partial Thromboplastin Time
- CITRATED PPP
- Heparin Induced Thrombocytopenia - platelet and factor XIII
- Ca++ and Platelet Phospholipid
- incomplete thromboplastin - APTT reagents
- 0.025M Calcium chloride
- Phospholipid
- Kaolin, Celite, Ellagic acid - 25-35s
