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2 Path Unit > 10/2 Hemorrhage and Thrombosis > Flashcards

10/2 Hemorrhage and Thrombosis Flashcards

1
Q

What are the 5 general causes of hemorrhage?

A
  1. trauma2. Tumor3. Ulcer4. Necrosis5. Depletion of hemostatic factors
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2
Q

What are pinpoint hemorrhages in the skin where supposedly the platelets don’t work? can they be found elsewhere?

A
  1. Petechiae2. yes, a picture shows them in intestinal mucosa
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3
Q

What is the order in regards to size–smallest to largest– of hemorrhage into the skin?

A

Petechiae<Ecchymoses

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4
Q

What is a localized collection of clotted blood into a space or potential space? What color is it in gross biopsy?

A
  1. Hematoma2. Blackish
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5
Q

What is the name for tarry black stools? what region of body is bleeding?

A
  1. Melena2. upper GI bleed
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6
Q

What is the name for bloody stools?

A

hematochezia

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7
Q

What is occult bleeding?

A

small amount of bleeding into the stools that is only detectable by chemical tests

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8
Q

What is the name for nose bleeds?

A

epitaxis

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9
Q

What is the name for bleeding between normal menstrual cycles?

A

metorrhagia

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10
Q

What is the name for excessive menstrual blood loss?

A

menorrhagia

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11
Q

Review or memorize the following general steps towards a clot formation?

A

vessel injury–> tissue factor activates coagulation cascade–>thrombin generation—> fibrin generation–> clot

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12
Q

Where are the proenzymes stored for coagulation cascade before they are activated?

A

They are circulating (many are created in liver)

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13
Q

What factor is fibrin (the final product of coagulation cascade) cross linked by?

A

Factor XIII

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14
Q

What is the coagulation cascade activated by?

A

Tissue factor (thromboplastin) when vessel is damaged

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15
Q

What does tissue factor bind/complex to? What does this complex activate?

A
  1. Factor VII and VIIa2. Factors IX and X
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16
Q

What does factor Xa do?

A

Converts a small amount of prothrombin to thrombin

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17
Q

What factors does thrombin activate?

A
  • V to Va-
    VIII to ViIIa-
    XI to XIa
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18
Q

What does XIa activate?

A

lots of thrombin

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19
Q

What does thrombin do?

A

converts fibrinogen to fibrinconverts Factor XIII to XIIIa

20
Q

Does the intrinsic or extrinsic pathway deal with factor VII?

A

Extrinsic–started with tissue injury

21
Q

What test measures the intrinsic pathway? extrinsic pathway?

A

1.PTT2. Prothrombin Time

22
Q

On what factor does the intrinsic pathway and extrinsic pathway converge on?

A

X

23
Q

Where is Von willebrand factor made?

A

endothelial cells and megakaryocytes

24
Q

Where is tissue plasminogen activator synthesized?

A

endothelial cells

25
Q

Where is Facotr VIII made?

A

endothelial cells

26
Q

What are the 3 main components to regulate the coagulation cascade?

A

Protein C and S pathwayAntithrombinTissue plasminogen pathway inhibitor

27
Q

What does protein C and S do to factors V and VIII? What else does it neutralize?

A
  1. Inactivates them2. Plasminogen activator inhibitor
28
Q

What does antithrombin do? What is it enhanced by?

A
  1. antithrombin blocks the serine active site of thrombin and other serine proteases(factors IXa, Xa, and XIa)2. heparin
29
Q

What does TFPI down regulate?

A

the initiation of the coagulation network

30
Q

What breaks down the fibrin polymer? what does it produce?

A

PlasminProduces d-dimers

31
Q

What activates plasmin?

A

Tissue plasminogen activator tPA

32
Q

What is a blood clot within a blood vessel?

A

Thrombi

33
Q

What are the 3 reasons for why blood clots in vivo?

A
  1. abnormalities of the blood vessel2. alterations of blood constituents3. aberrations of the blood flow
34
Q

What causes thrombi?

A

Abnormal blood or a hypercoaguable state-acquired-deficiency of natural coagulants

35
Q

What is lupus anticoagulant a sign of?

A

antiphospholipid antibody syndrome

36
Q

What is the most common cause of acquired thrombophilia that can be tested for in the lab>?

A
  1. antiphospholipid antibody syndrome
37
Q

What are the 3 key findings of antiphopholipid antibody syndrome?>

A
  1. venous and arterial thrombus2.recurrent fetal loss3. thrombocytopenia
38
Q

Does lupus anticoagulant prolong or decrease phospholipid coagulation tests?

A

Prolongs

39
Q

Does lupus anticoagulant always occur with lupus erythematosus

A

no, only 10%

40
Q

What is Factor V leiden?

A

mutation in Factor V. Unable to be cleaved by activspted

41
Q

Review the following list of things that contribute to inherited thrombophilia—

A 
prothrombin gene muation
protein C deficiency
protein S
Antithrombin deficiency
hyperchomocystenemia
Dysfibrinogenemia
42
Q

What are 5 clinical features of thrombophilic patent?

A
  1. Family History of thrombus
  2. Thrombosis at a young age
  3. idiopathic thrombus
  4. thrombosis after trivial provocation
    5 thrombosis in an unusual site
43
Q

What type of thrombi is white, made from platelets and fibrin, and if they become occlusive lead to infarction?

A

Arterial thrombi

44
Q

What type of thrombi is red and made of cellular elements ad fibrin

A

?venous thrombi

45
Q

What are lines of zahn?

A

Attached to a wall and imply thrombus at a site of blood flow.

46
Q

What are the 4 fates of thrombus?

A

propagation embolization dissolution organization

47
Q

Under which fate of thrombus can occluded vascular flow be re-established?

A

Organizational fate

2 Path Unit (14 decks)

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