1.3 Blood clotting & Blood types Flashcards

1
Q

What is Hemostasis

A
  • series of reactions to stop bleeding that has 3 phases that occur in rapid sequence

step 1: Vasucular spasm (smooth muscle constriction

step 2: platelet plug formation: injury to lining of essel exposes collagen fibers; platelets adhere -> platelet plug forms

step 3: coagulation, fibrin clot with trapped red blood cells

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2
Q

describe step 1 of hemostasis

A

vascular spasm

  • there are 3 stimuli that cause vasospasm
    1. direct injurt to vascular smooth muscle
    2. chemicals released by endothelial cells & platelets
    3. Reflexes initiated by local pain receptors

*Spasm becomes more efficient with increasing tissue damage -> more damage = inc vasospasm

*local response

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3
Q

describe step 2 of hemostasis

A
  • platelet plug formation
  • when clots not neeed, platelets don’t stick to intact endothelium because of PGI1 and NO
  • CD39 on surface of endothelial cells conv ADP -> AMP to prevent abnormal platelet activation

0 damage to endothelium allows platelts to bind to exposed collagen

  • von tillebrand factor inc bond by bindin to collagen and paltlets
  • after binding to collagen, platelets release ADP, serotonin and thromboxane A2 (ecosinoid, activates paltelets)

*VWF anf collagen activate paltelets when endothelial cell is damaged ( bc are under it)

  • Serotonin and TxA2 stimulate vasoconstriction reducing blood flow to wound (local vascular spasm)
  • ADP and TxA2 cause oher paltlets to become sticky and attach
  • platelet plug is limited to immedite area of injury bc of PGI2 and NO
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4
Q

describe step 3 of coagulation

A
  • ser of reactions that transforms blood to gel
  • coagulation follows intrinsic and extrinsic pathways
  • 3 steps of this reactions are:
  • > prothrombin activtor is formed
  • > prothrombin conv to thrombin
  • > thrombin catalyzes the joining of fibringogen into fibrin mesh
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5
Q

describe phase 1 of coagulation

A
  • prothrombin activator
  • triggered by tisue damaging events
  • invovled series of procoagulatns
  • each pathway cascades towards factor X
  • can be initiated by intrinsic or extrinsic pathway

*Once factor X has been activated, it complexes with Ca2+, PF3 (phosphatidylserine) and factor V to form prothrombin activator

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6
Q

describe the intrinsic pathway

A
  • vessel endothelium ruptrues -> exposes underling tissues (ex collagen)
  • plateleys cling and theri surfaces provide sites for mobilization of factors

Factor XII -> XIIa -> XI -> XIa -> IX –(Ca)–> IXa

  • PF3 released by aggregated platelets, IXa —(VIII -> VIIIa) –> IXa/VIIIa complex
  • this activates X, then X, PF3 and Ca form prothombin activator
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7
Q

describe the extrinsic pathway

A
  • tissue cell trauma exposes blood to tissue factor (protein in cell membrane)
  • tissue factor uses Ca2+ to activate Facotr VII that then directly activates factor X

OR can go via intrinsic & activate factor 9 (bypasses factor 11 and 12)

  • once X is activated, it then does same as intrinsic -> combiens with V, PR3 and Ca to fomr prothrombin factor
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8
Q

describe phase 2 of coagulation

A

pathway to trhombin

  • Prothrombin activator catalyzes the transformation of prothrombin to the active enzyme thrombin
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9
Q

descirbe phase 3 of coagulation

A
  • fibrin mesh
  • Thrombin catalyzes the polymerization of fibrinogen into fibrin
  • Insoluble fibrin strands form the structural basis of a clot
  • Fibrin causes plasma to become a gel-like trap

- Thrombin in the presence of Ca2+ activates factor XIII that:

  • Cross-links fibrin
  • Strengthens and stabilizes the clot
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10
Q

hemostasis summary

A
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11
Q

what is clot retration

A

stabilization of the clot by squeezing serum from the fibrin strands

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12
Q

what is clot repair

A

􏰂 Fibroblasts form a connective tissue patch

􏰂 Platelet-derived growth factor (PDGF) stimulates rebuilding of blood vessel wall

􏰂 Stimulated by vascular endothelial growth factor (VEGF), endothelial cells multiply and restore the endothelial lining

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13
Q

what limits clot growth and formation

A
  • two mechanisms
  • swift removal of clotting factors and inhibition of activated clotting factors
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14
Q

how is thrombin inhibited

A
  • Fibrin acts as an anticoagulant by binding thrombin and preventing its:
  • > positive fedback effects of coagulation
  • > ability to speed up production of prothrombin activator via factor V
  • > acceleration of the intrinsic pathway by activating plateelts
  • thrombin not absorbed to fibric is inactivated by anti thombin III

- heparin another anticoagulant, also inhibits thrombin activity

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15
Q

how is plateelt adhesion prevented

A

* Unnecessary clotting is prevented by endothelial lining the blood vessels

  • platelet adhesino prevented by
  • > The smooth endothelial lining of blood vessels
  • > Heparin, NO and PGI2 secreted by endothelial cells
  • > Vitamin E quinone, a potent anticoagulant
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16
Q

what is a thrombus

A

*thromboembolytic condition

  • thrombus = a clot that develops and persists in an unbroken blood vessel
  • thrombi can block circualtion resulting in tissue death
  • coronary thrombossi = thrombus in blood vessel of heart
17
Q

what is an embolus

A

*Thromboembolytic Conditions

Embolus = a thrombus freely floating in the blood stream

  • > Pulmonary emboli can impair the ability of the body to obtain oxygen
  • > cerebral emboli can cause strokes

^ those names refer to where the thrombus things its resting palce

18
Q

what is hemophilia

what are the types

A
  • hereditary bleeding disorder caused by lack of clotting factors

􏰂 Hemophilia A - most common type (83% of all cases) due to a deficiency of factor VIII

􏰂 Hemophilia B - due to a deficiency of factor IX

􏰂 Hemophilia C - mild type, due to a deficiency of factor XI

* factors are part os intrsinic pathway -> this disoredr not liekly to affect extrsinic

*will get a lot of microbloods that are hard to control (intrsinc path controls that0

19
Q

can you go back and do the highlight factors i literally cant rn

A
20
Q

what are human blood groups

A

RBC membranes have glycoprotein antigens on their external surfaces

antigens are : unqiue to individual, recognized as foreign if transfused into another individual, promotrs agglutination (refered to as agglutinogens)

*Presence or absence of these antigens is used to classify blood groups

21
Q

Humans have __ varieties of naturally occurring RBC antigens

A

30

22
Q

most common blood groups?

what are other blood groups?

A

ABO and RH groups cause vigorous transfusion reactions when they are improperly transfused -> most commonly known

  • Other blood groups (M, N, Dufy, Kell, and Lewis) are mainly used for legalities
23
Q

describe the ABO blood groups

A

consists of:

  • two antigens (A and B) on surface of RBCs and two antibodies in plasma (Anti-A and anti-B)
  • Agglutinogens and their corresponding antibodies cannot be mixed without serious hemolytic reactions

* B has anti A, A has anti B, O has noth anti B and A

24
Q

describe the RH blood groups

A
  • 8 diff Rh agglutinogens, 3 of which (C, D and E) are common (if have one of these you are RH +
  • presence of Rh agglutinogens on RBCs is indicated as Rh+
  • anti-Rh antibodies are not spontaneously formed in Rh- individuals
  • if an Rh– individual receives Rh+ blood, anti-Rh antibodies form
  • A second exposure to Rh+ blood will result in a typical transfusion reaction

*if give RH-, Rh+ blood they will form antibosies -> upon second exposure to Rh+ will have a transfusion reaction

25
Q

describe Hemolytic Disease of the Newborn

A
  • Rh– mother becomes sensitized when exposure to Rh+ blood (ex if Rh+ baby, during brith process, would impact a second pregancy with Rh+ baby)
  • Rh+ antibodies of a sensitized Rh– mother cross the placenta and attack and destroy the RBCs of a Rh+ baby
  • RhoGAM can prevent Rh– mother from becoming sensitized (Blocks interaction)
  • Treatment involves pre-birth and transfusions after birth
26
Q

what are transfusion reactions

A

Donor’s cells are attacked by the recipient’s agglutinins causing:

  • > Diminished oxygen-carrying capacity
  • > Clumped cells that impede blood flow
  • > Ruptured RBCs release Hb into the bloodstream
  • Circulating Hb precipitates in the kidneys causing renal failure