anticoagulant system

Question 1

function of plasmin

Answer 1

breaks down fibrin clots

Question 2

what activated plasminogen

Answer 2

kallikrein
factors 11/12a (procoag)
tPA

Question 3

FSP/FDP’s

Answer 3

fibrin degradation products

Question 4

what do elevated levels of FSP’s indicate

Answer 4

active clotting (fibrins being cut up)

Question 5

how do we measure serum plasmin levels

Answer 5

indirectly by measuring FSPs because if present means plasmin is working and clots are being broken

Question 6

protein s

Answer 6

activates C with help of thrombomodulin

Question 7

protein c

Answer 7

inactivates 5 and 8 a

Question 8

protein z

Answer 8

inactivates 10a

Question 9

antithrombin

Answer 9

inactivates thrombin (2a) and 10a

Question 10

TFPI

Answer 10

inactivates 7a (extrinsic pathway)

Question 11

thrombomodulin

Answer 11

converts thrombin (2a) into anticoagulant; helps protein S activate C

Question 12

what does small chain heparin inhibot

Answer 12

10 a

Question 13

Factor 5 liden disease

Answer 13

• mutant factor 5 but still works in cascade

- doesn’t respond to factor C (inhibition)..unimpeded coag and clots

Question 14

function of warfarin/coumadin

Answer 14

blocks vit k

Question 15

what lab test is used to evaluate effect of coumadin

Answer 15

PT time

Question 16

what is PT time used?

Answer 16

factor 7 has a shorter half life and is more sensitive to the effect of the CURRENT dose

Question 17

function of heparin

Answer 17

activates antithrombin

Question 18

function of antithrombin

Answer 18

inactivates thrombin and 10 a (converts pro to thrombin)

Question 19

type I HIT

Answer 19

non-immune
after 2 days
less fractionated, less likely to happen

Question 20

type II HIT

Answer 20

immune
day 4-10
binds to PF4 which marks platelets for destruction and secrete their chemical mediators stimulating thrombin leading to aggregation, low platelet count and leads to clots

Question 21

complications of Type II HIT

Answer 21

venous thromboembolism, skin, systemic (iV)

Question 22

thrombophilia

Answer 22

tendency to form blood clots inappropriately due to abnormalities in structure, abnormalities in amount circulating and abnormal circulating pro-coagulants

Question 23

factor 5 mutation

Answer 23

• normal procoagulant but doesn’t respond to protein c
• most common genetically acquired thrombophilia
• autosomal dominant

Question 24

III, Protein C and S deficiency

Answer 24

autosomal dominant
- homozygotes Coumadin for life
no OC

Question 25

antiphospholipid syndrome

Answer 25

• lupus anticoag and anti-cardiolipin
• women 30-40
• heterogenous group -no single test

Question 26

how to diagnose antiphosphlipid syndrome

Answer 26

one test must be positive in presence of clotting diathesis and be confirmed on two occasional no less than 12 weeks apart

Question 27

lupus anticoagulant

Answer 27

-pro thrombotic agent

interact with platelets increasing adhesion and aggregation