2) Primary hemostasis

Question 1

coag tube of choice

Answer 1

Na citrate

Question 2

factors used up in serum

Answer 2

fibrinogen
prothrombin
V
VIII
XIII

Question 3

4 categories of coagulation-related proteins circulating in inactive form

Answer 3

• procoagulants
• inhibitors of coagulation
• profibrinolysins
• inhibitors of fibrinolysis

Question 4

3 stages of hemostasis

Answer 4

• primary
• secondary
• fibrinolysis

Question 5

goal of hemostasis

Answer 5

patient doesn’t bleed or form systemic clots

Question 6

what happens when capillaries are injured?

Answer 6

seal directly
lack a vessel wall and collagen fibers; no coagulation

Question 7

structure of the blood vessel from inside to outside

Answer 7

• endothelial cells
• subendothelium, contains elastic tissues and collagen
• smooth muscle cells, allowing constriction/dilation

Question 8

role of the blood vessel wall in clot formation

Answer 8

• vasoconstriction
• collagen exposure
• ADP release
• tissue factor release

Question 9

released by platelets and contribute to vasoconstriction

Answer 9

serotonin
TXA2

Question 10

2 functions of vasoconstriction

Answer 10

• decrease blood loss
• increase local concentration of procoagulants

Question 11

function of ADP

Answer 11

released from endothelial damage
activates plts

Question 12

if a lot of TF is released…

Answer 12

coag factors can all be used, leading to DIC

Question 13

4 functions of plts

Answer 13

• fill small gaps between endothelial cells (maintains vascular integrity)
• formation of primary plt plug
• provides surface for fibrin generation (phospholipids)
• release PDGF to heal injured vessels

Question 14

4 steps of primary plt plug formation

Answer 14

• vasoconstriction
• adhesion
• aggregation
• consolidation

Question 15

explain linkages in adhesion and aggregation

Answer 15

adhesion = [collagen of subendothelium + vWF + GPIb/IX on plt]

aggregation = [GPIIb/IIIa + fibrinogen + GPIIb/IIIa]

Question 16

adhesion causes plts to release…

Answer 16

ADP, which activates more plts

Question 17

what happens to plts when they are activated?

Answer 17

shape change
discoid → spiny sphere
Ca is required

Question 18

agents that induce plt activation

Answer 18

plt agonists
collagen
thrombin
ADP
TXA2

Question 19

if stimulus from plt agonists is weak…

Answer 19

plts return to their original shape

Question 20

platelet ——— is reversible if the stimulus by agonists is weak, but becomes irreversible after…

Answer 20

aggregation

plts degranulate (requiring Ca)

Question 21

Ca released during aggregation activates the microfilament ————-

Answer 21

thrombasthenin

Question 22

thrombasthenin results in…

Answer 22

exposure of PF3 on plts membrane
consolidation

Question 23

tightening of plt plug

Answer 23

consolidation

Question 24

function of consolidation

Answer 24

decreases plug permeability

Question 25

plts contribute ——-, the surface that the secondary hemostasis cascade begins on

Answer 25

PF3