3.2-PRIMARY AND SECONDARY HOMEOSTASIS

Question 1

What happens when there is excessive fibrinolysis or inadequate coagulation?

Answer 1

Bleeding

Question 2

What happens when there is excessive coagulation or inadequate fibrinolysis?

Answer 2

Thrombosis or vasoocclusion

Question 3

What condition results from the uncontrolled formation of thrombi in the vascular system, leading to vessel occlusion and organ deprivation of blood?

Answer 3

Vasoocclusion

Question 4

What term describes clinical conditions associated with excessive bleeding due to an inability to form adequate clots?

Answer 4

Hypocoagulation

Question 5

What is an example of hypocoagulation caused by an inherited defective coagulation mechanism?

Answer 5

Hemophilia

Question 6

What coagulation factor is deficient in Classic Hemophilia A?

Answer 6

Factor VIII

Question 7

What acquired conditions can lead to hypocoagulation?

Answer 7

DIC, liver disease, kidney disease

Question 8

What condition is associated with inappropriate thrombi formation that occludes normal blood flow?

Answer 8

Hypercoagulation or thrombosis

Question 9

What causes hypercoagulation?

Answer 9

A defect in or lack of activation of the fibrinolytic system

Question 10

What conditions are hypercoagulation commonly seen in?

Answer 10

Malignancy and surgical procedures

Question 11

What process involves the vascular system and platelets in response to vessel injury, leading to the formation of a platelet plug?

Answer 11

Primary hemostasis

Question 12

What is the purpose of primary hemostasis?

Answer 12

To rapidly stop initial bleeding after an injury

Question 13

What happens in the initial response of primary hemostasis?

Answer 13

Blood vessels contract (vasoconstriction) to seal the wound or reduce blood flow

Question 14

What do platelets do during primary hemostasis?

Answer 14

Adhere to the site of injury, secrete granule contents, and aggregate to form a platelet plug

Question 15

Why does the platelet plug formed in primary hemostasis need reinforcement?

Answer 15

To control major bleeding in the long term with fibrin

Question 16

What are some defects in primary hemostasis that can cause chronic hemorrhage?

Answer 16

Collagen abnormalities, thrombocytopenia, qualitative platelet disorders, von Willebrand disease

Question 17

What is the response of the coagulation process to vessel injury, leading to a stabilized fibrin clot?

Answer 17

Secondary hemostasis

Question 18

What are the key components of secondary hemostasis?

Answer 18

Coagulation factors

Question 19

What occurs when coagulation factors interact on the platelet surface?

Answer 19

Production of fibrin

Question 20

What stabilizes fibrin in secondary hemostasis?

Answer 20

Factor XIII

Question 21

What process involves the intrinsic and extrinsic coagulation pathways to form a stable fibrin clot?

Answer 21

Secondary hemostasis

Question 22

What type of enzymes are most coagulation proteins in plasma before activation?

Answer 22

Serine proteases

Question 23

What are zymogens (proenzymes) activated into during coagulation?

Answer 23

Enzymes that form complexes to activate other zymogens

Question 24

What enzyme converts fibrinogen into a localized fibrin clot?

Answer 24

Thrombin

Question 25

What type of injuries activate primary hemostasis?

Answer 25

Desquamation and small injuries to blood vessels

Question 26

What type of injuries activate secondary hemostasis?

Answer 26

Large injuries to blood vessels and surrounding tissues

Question 27

What components are involved in primary hemostasis?

Answer 27

Vascular intima and platelets

Question 28

What components are involved in secondary hemostasis?

Answer 28

Platelets and the coagulation system

Question 29

How does the response time differ between primary and secondary hemostasis?

Answer 29

Primary hemostasis is rapid and short-lived; secondary hemostasis is delayed and long-term

Question 30

What procoagulant substances are exposed or released in primary hemostasis?

Answer 30

Damaged or activated endothelial cells

Question 31

What serves as the activator in secondary hemostasis?

Answer 31

Tissue factor, exposed on cell membranes

Question 32

What physiological process removes insoluble fibrin deposits by enzymatic digestion?

Answer 32

Fibrinolysis

Question 33

What enzyme is responsible for degrading fibrin?

Answer 33

Plasmin

Question 34

What must be converted into plasmin to initiate fibrin degradation?

Answer 34

Plasminogen

Question 35

What activates the conversion of plasminogen to plasmin?

Answer 35

Tissue plasminogen activator (tPA)

Question 36

What are fibrin degradation products (FDPs) also known as?

Answer 36

Fibrin split products (FSPs)

Question 37

What does a high level of FDP/FSP indicate?

Answer 37

Inadequate clotting

Question 38

What happens first in hemostasis after vessel injury?

Answer 38

Vasoconstriction

Question 39

What controls vasoconstriction?

Answer 39

Vessel smooth muscle and chemicals secreted by platelets

Question 40

What step follows vasoconstriction in hemostasis?

Answer 40

Platelet adhesion

Question 41

What causes platelets to stick to exposed subendothelial connective tissue?

Answer 41

GPIb and von Willebrand factor (vWF)

Question 42

What occurs after platelet adhesion?

Answer 42

Platelet aggregation

Question 43

What mediates platelet aggregation?

Answer 43

GPIIb-IIIa complex and fibrinogen

Question 44

What step follows platelet aggregation in hemostasis?

Answer 44

Fibrin-platelet plug formation

Question 45

What happens during fibrin-platelet plug formation?

Answer 45

Coagulation factors interact on the platelet surface to produce fibrin

Question 46

What is the final step in hemostasis after vessel injury?

Answer 46

Fibrin stabilization

Question 47

What stabilizes the fibrin clot?

Answer 47

Coagulation factor XIII

Question 48

What neurogenic response occurs immediately after blood vessel injury (BVI)?

Answer 48

Vasoconstriction

Question 49

What happens when the smooth endothelial lining is broken?

Answer 49

Collagen is exposed, promoting platelet adhesion and thrombus formation.

Question 50

What coagulation pathway is initiated by collagen exposure?

Answer 50

Intrinsic coagulation pathway

Question 51

What is released from injured tissue to activate the extrinsic coagulation pathway?

Answer 51

Tissue thromboplastin

Question 52

What process is initiated by endothelial cells releasing tissue plasminogen activator (tPA)?

Answer 52

Fibrinolysis

Question 53

What is the role of platelet activation in vessel damage?

Answer 53

Forms a platelet plug and makes the platelet surface conducive to coagulation factor activation.

Question 54

Which coagulation pathways are activated in response to vessel damage?

Answer 54

Intrinsic and extrinsic pathways

Question 55

What is coagulation?

Answer 55

The process of solidifying fluid blood (plasma or whole blood) through coagulation factors.

Question 56

What is a visible coagulum?

Answer 56

A physical manifestation of fibrin formation.

Question 57

What components interact on the platelet surface to form a fibrin clot?

Answer 57

Plasma proteins, tissue factors, and calcium.

Question 58

What type of enzymes activate other specific factors in the coagulation sequence?

Answer 58

Serine proteases

Question 59

What activates the extrinsic coagulation pathway?

Answer 59

Tissue thromboplastin released from injured tissue cells.

Question 60

What activates the intrinsic coagulation pathway?

Answer 60

Exposure of subendothelial basement membrane and collagen.

Question 61

Which coagulation factors initiate the intrinsic pathway upon contact with the subendothelial surface?

Answer 61

Factor XII, Factor XI, HMWK, and prekallikrein.

Question 62

What marks the beginning of the common coagulation pathway?

Answer 62

Activation of Factor X to Factor Xa.