8. Haemostasis cont. Flashcards

1
Q

coagulation inhibitors

A
  • Tissue Factor pathway inhibitor
  • Antithrombin III (inhibits Xa and thrombin)
  • Protein C and S
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2
Q

what do protein c and s do

A

PS inactivates 5a and 8a
PC enhances PS
PC also enhaces fibrinolysis

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3
Q

what are PS and PC dependent on

A

vitamin K

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4
Q

what is antithrombin enhanced by

A

heparin

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5
Q

what does tissue plasminogen activator (tPA) do

A

involved in fibrinolysis
= activates plasminogen to PLASMIN
= which degrades fibrin

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6
Q

what is fibrin degraded into

A

fibrin degradation products (FDPs)

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7
Q

how does protein C enhance fibrinolysis

A

inactivates tPA inhibitor

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8
Q

what can FDP number tell us

A

if abnormal number of clots are being made
e.g. DVT

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9
Q

what else promotes plasminogen breakdown into plasmin

A

factor 12a

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10
Q

what is streptokinase

A

drug to break down plasminogen into plasmin
used to breakdown clots

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11
Q

what is used to control plasminogen into plasmin

A

plasminogen activator inhibitor (PAI-1)
= blocks tPA and factor 12

AND

alpha 2 - antiplasmin = inactivates plasmin

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12
Q

4 types of lab tests done to test haemostatic function

A
  • bleeding time
  • platelet count and function
  • prothrombin time (PT)
  • activated partial thromboplastin time (APTT)
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13
Q

Bleeding time

A
  • bp cuff
  • incision made
  • bleeding time measured
  • # normal is 3-8 mins
  • only done if suspected and tests already been done
  • tests for low platelet plug formation (thrombocytopenia)
  • not fibrin clot
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14
Q

platelet count and function

A
  • full blood count
  • bone marrow examination done IF issue with platelet count = shows production of platelets
  • PLATELET AGGREGOMETRY
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15
Q

what is platelet aggregometry

A

measures change in light absorbance as platelets aggregate
= can see if any problems with aggregation that could be from a mutation in glycoproteins

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16
Q

von willebrand assay

A

can be done to see number of vWB molecules and the type from platelet function tests

17
Q

which factors does PT test for

A

factors 7, 10, 5, prothrombin and fibrinogen

18
Q

normal PT time

A

10-14 seconds

19
Q

what can prolong PT time

A
  • liver disease
  • oral anticoagulant treatment (OAT) e.g. warfarin
20
Q

what is INR

A

international normalised ratio
= standardised version of PT

people taking warfarin need to test this often

21
Q

what does APTT test

A

everything PT does
AND 10, 5, prothrmobin and fibrinogen

22
Q

peolpe on which medication need to test APTT

A

heparin

23
Q

what is done to see the specific factor affected

A

both PT and APTT
- then by seeing which is prolonged, it can narrow down where problem lies
- then specific assays can be done