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HEMATOLOGY 2 - LECTURE > BASIC PRINCIPLES OF HEMOSTASIS > Flashcards

BASIC PRINCIPLES OF HEMOSTASIS Flashcards

1
Q

Secondary Hemostasis is also known as …

A

Coagulation

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2
Q

It involves the enzymatic activation of series of plasma proteins in the coagulation system to form a fibrin meshwork.

A

Secondary hemostasis

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3
Q

Secondary hemostasis involves what in the coagulation system?

A

It involves the enzymatic activation of series of plasma proteins

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4
Q

Secondary hemostasis involves the enzymatic activation of a series of plasma proteins in what system?

A

in the coagulation system

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5
Q

Secondary hemostasis involves the enzymatic activation of a series of plasma proteins in the coagulation system to form what?

A

a fibrin meshwork

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6
Q

What is the event/step 4 in secondary hemostasis?

A

Fibrin-Platelet plug formation

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7
Q

In this event, coagulation factors interact on platelet surface to produce fibrin; fibrin-platelet plug then forms at site of vessel injury

A

Step 4: Fibrin-Platelet plug formation

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8
Q

What happens in Fibrin-Platelet plug formation?

A

Coagulation factors interact on platelet surface to produce fibrin; fibrin-platelet plug then forms at site of vessel injury

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9
Q

Coagulation factors interact on WHAT to produce fibrin?

A

PLATELET SURFACE

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10
Q

Coagulation factors interact on platelet surface to produce WHAT?

A

to produce fibrin

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11
Q

This forms at site of vessel injury

A

Fibrin-platelet plug

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12
Q

Fibrin-platelet plug then forms where?

A

forms at site of vessel injury

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13
Q

What is the event/step 5 in secondary hemostasis?

A

Fibrin stabilization

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14
Q

In this event, fibrin clot must be stabilized by Factor XIII

A

Fibrin stabilization

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15
Q

What happens in FIBRIN STABILIZATION?

A

Fibrin clot must be stabilized by Factor XIII

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16
Q

What must be stabilized by Factor XIII?

A

Fibrin clot

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17
Q

Fibrin clot must be stabilized by what factor?

A

Fibrin clot must be stabilized by Factor XIII

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18
Q

What factors stabilizes fibrin clots?

A

Factor XIII

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19
Q

What does Factor XIII do?

A

It stabilizes the fibrin clot

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20
Q

This is a process whereby, on vessel injury, plasma proteins, tissue factors, and calcium interact on the surface of platelets to form a stable fibrin clot.

A

Coagulation

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21
Q

In coagulation, upon vessel injury, what are the components that interact on the surface of the platelet to form a stable fibrin clot?

A
  • Plasma proteins
  • Tissue factors
  • Calcium
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22
Q

On vessel injury, plasma proteins, tissue factors, and calcium interact on the surface of platelets to form what?

A

to form a stable fibrin clot.

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23
Q

Platelets also interact with fibrin to form a stable platelet-fibrin clot.

True or False

A

TRUE

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24
Q

This is a mechanism consisting of a series of cascading reactions involving development of enzymes from their precursors which will further be converted to their activated state

A

Coagulation

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25
Q

Coagulation is a mechanism consisting of a series of what?

A

a series of cascading reactions

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26
Q

Coagulation is a mechanism consisting of a series of cascading reactions involving what?

A

involving development of enzymes from their precursors which will further be converted to their activated state.

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27
Q

In the development of enzymes, what do you call their precursors?

A

ZYMOGENS

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28
Q

Zymogens will further be converted to their ACTIVATED STATE called …

A

Serine proteases

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29
Q

This occurs in the surface of platelet/endothelial cell membrane/PPL & not in fluid phase.

A

Coagulation

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30
Q

Coagulatio occurs where?

A

surface of platelet/endothelial cell membrane/PPL (phospholipid)

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31
Q

How many coagulation factors have a roman numeral assigned to them?

A

I - XIII

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32
Q

What Coagulation Factor is Fibrinogen?

A

CF I

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33
Q

What is the Biochemistry of Factor I?

A

Glycoprotein

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34
Q

These factors have GLYCOPROTEIN as their biochemistry

5 + 2 = 7

A

Factors I, II, V, VII, VIII, IX, X

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35
Q

What coagulatio factors have plasma proteins as their biochemistry?

A
  • Prekallikrein
  • High Molecular Weight Kininogen (HMWK)
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36
Q

CF I is described as …

A

fibrinogen

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37
Q

What Coagulation Factor is Prothrombin?

A

CF II

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38
Q

CF II is preferrably described as …

A

Prothrombin

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39
Q

What is the Biochemistry of CF I?

A

Glycoproteins

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40
Q

What is the biochemistry of CF II?

A

Glycoproteins

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41
Q

What is the biochemistry of CF II?

A

Glycoproteins

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42
Q

What is the coagulation factor of the Tissue Factor?

A

CF III

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43
Q

CF III is preferrably described as …

A

TISSUE FACTOR

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44
Q

What is the synonym of Tissue Factor/CF III?

A

Tissue thromboplastin (TF and PPL)

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45
Q

What is the biochemistry of CF III?

A

Lipoprotein

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46
Q

What coagulation factor is Calcium?

A

CF IV

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47
Q

CF IV is preferrable described as…

A

Calcium

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48
Q

What biochemistry does CF IV have?

A

Metal ion

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49
Q

What coagulation factor is proaccelerin?

A

CF V

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50
Q

CF V is preferrably described as …

A

Proaccelerin

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51
Q

What is the synonym for Proaccelerin?

A

Labile Factor

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52
Q

What factor is the labile factor?

A

CF V

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53
Q

Labile factor is also called …

A

proaccelerin

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54
Q

What biochemistry does proaccelerin have?

A

Glycoprotein

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55
Q

What coagulation factor is ommitted?

A

CF VI

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56
Q

CF VI is only the activated factor V

True or False

A

TRUE

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57
Q

What factor is the activated Factor V?

A

CF VI

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58
Q

What coagulation factor is Proconvertin?

A

CF VII

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59
Q

CF VII is preferraby described as…

A

Proconvertin

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60
Q

Activated Factor V is also called …

A

CF VI

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61
Q

What are the synonyms for CF VII?

A
  • Stable factor
  • Serum prothrombin
  • Conversion accelerator
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62
Q

Stable factor is also called …

A

CF VII

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63
Q

conversion accelerator is synonymous to …

A

Proconvertin

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64
Q

Serum prothrombin is synonymous to what?

A

CF VII

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65
Q

Tissue thromboplastin is synonymous to what factor?

A

CF III/Tissue factor

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66
Q

What biochemistry does Proconvertin have?

A

Glycoprotein

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67
Q

What coagulation factor is Antihemophillic Factor (AHF)?

A

CF VIII

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68
Q

CF VIII is preferrable described as…

A

Antihemophilic Factor

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69
Q

What is the synonym of CF VIII?

A
  • Antihemophilic Globulin
  • Antihemophilic Factor A
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70
Q

What is the synonym of CF VIII?

A
  • Antihemophilic Globulin
  • Antihemophilic Factor A
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71
Q

What biochemistry does Antihemophilic Factor have?

A

Glycoprotein

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72
Q

What coagulation factor is Plasma Thromboplastin Component (PTC)?

A

CF IX

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73
Q

CF IX is preferrably described as …

A

Plasma Thromboplastin Component (PTC)

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74
Q

What are the synonyms of CF IX?

A
  • Antihemophilic Factor B
  • Christmas Factor
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75
Q

Antihemophilic Factor B and Christmas Factor are synonyms for what?

A

CF IX/Plasma Thromboplastin Component (PTC)

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76
Q

What biochemistry does CF IX have?

A

Glycoprotein

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77
Q

What coagulation factor is Stuart-Prower Factor?

A

CF X

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78
Q

CF X is preferrably described as …

A

Stuart-Prower Factor

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79
Q

What are the synonyms for CF X?

A
  • Prower factor
  • Stuart Factor
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80
Q

What biochemistry does StuarT-Prower Factor have?

A

Glycoprotein

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81
Q

Prower Factor and Stuart Factor are synonyms for what?

A

CF X/Stuart-Prower Factor

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82
Q

What Coagulation Factor is Plasma Thromboplastin Antecedent (PTA)?

A

CF XI

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83
Q

CF XI is preferrably described as …

A

Plasma Thromboplastin Antecedent (PTA)

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84
Q

What are the synonyms for CF XI?

A
  • Antihemophilic Factor C
  • Rosenthal factor
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85
Q

Antihemophilic Factor C and Rosenthal Factor are synonyms for what factor?

A

CF XI/Plasma Thromboplastin Antecedent

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86
Q

What biochemistry does CF XI have?

A

B or gamma globulin

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87
Q

What coagulation factor is Hageman factor (HF)?

A

CF XII

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88
Q

CF XII is preferrable described as…

A

Hageman Factor

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89
Q

What are synonyms for CF XII?

A
  • Glass factor
  • Contact factor
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90
Q

Glass factor and contact factor are synonyms for what CF?

A

CF XII/Hageman Factor (HF)

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91
Q

What biochemistry does CF XII have?

A

Sialoglycoprotein

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92
Q

What CF has a Sialoglycoprotein biochemistry?

A

CF XII

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93
Q

What CF is Fibrin Stabilizing Factor (FSF)?

A

CF XIII

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94
Q

CF XIII is preferrably described as…

A

Fibrin Stabilizing Factor

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95
Q

What are the synonym for CF XIII?

A
  • Laki-Lorand Factor (LLF)
  • Fibrinase
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96
Q

Laki-Lorand Factor and Fibrinase are synonyms of what?

A

CF XIII

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97
Q

What biochemistry does CF XIII have?

A
  • Beta or Gamma Globulin
  • Transglutaminase/transamidase
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98
Q

What is the synonym for Prekallikrein?

A

Fletcher factor

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99
Q

Together with HMWK are part of the kallikrein & kinin systems & their primary function is in these systems

A

Prekallikrein

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100
Q

HMWK is an abbreviation for …

A

High Molecular Weight Kininogen

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101
Q

What are the synonyms for HMWK?

A
  • Fitzgerald factor
  • Williams factor
  • Flaujeac factor
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102
Q

This CF circulates in the plasma together with VWF and is referred to as FACTOR VIII complex

A

Factor VIII

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103
Q

Factor VIII circulates WHERE AND TOGETHER WITH WHAT ?

A

Factor VIII circulates in the plasma together with VWF

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104
Q

Factor VIII circulates in the plasma together with VWF and is referred to as WHAT?

A

FACTOR VIII complex

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105
Q

It is the carrier for Factor VIII

A

vWF

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106
Q

vWF is the carrier for what factor?

A

Factor VIII

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107
Q

This factor functions for platelet adhesion

A

vWF

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108
Q

What is the function of the vWF?

A

Functions for platelet adhesion

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109
Q

vWF has a higher mol.wt than FVIII

True or False

A

TRUE

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110
Q

What is the mol. wt of the vWF?

A

500,000-20,000,000 Daltons to 260,000 Daltons only

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111
Q

Each VWF is a large multimeric protein of 240,000 Daltons subunit each.

True or False

A

TRUE

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112
Q

Deficiency in AHF or a dysfunctional AHF results in WHAT?

A

Hemophilia A

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113
Q

Hemophilia A is a result of what?

A

A deficiency in AHF or a dysfunctional AHF

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114
Q

A deficiency in VWF or a dysfunctional molecule results in what?

A

VWD

Von Willebrand Disease

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115
Q

VWD is a result of what?

A

A deficiency in VWF or a dysfunctional molecule

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116
Q

What is the manifesation of VWD and Hemophilia A?

A

BLEEDING

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117
Q

This is a mineral & play a big role in impt stages of coagulation. Removal of this ion will prevent coagulation.

A

Factor IV (Calcium)

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118
Q

Factor VIII is also known as

A

vWF COMPLEX

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119
Q

customary designation for the combination of factor VIII and VWF.

A

Factor VIII/VWF

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120
Q

binds activated factor IX to form the complex of VIIIa-Ixa which digests and activates factor X.

A

Factor VIII

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121
Q

procoagulant factor VIII, transported on VWF.

A

Factor VIII

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122
Q

Factor VIII deficiency is called …

A

Hemophilia A.

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123
Q

An epitope that is the antigenic target for the VWF immunoassay

A

VWF:Ag

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124
Q

Factor VIII coagulant activity as measured in a clot-based factor assay

A

Factor VIII: C

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125
Q

Assays to measure VWF activity

Most VWF activity assays measure the presence of high molecular weight VWF multimers, which are the most active multimers in platelet adhesion.

TRUE OR FALSE

A

TRUE

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126
Q

This is to distinguish qualitative and quantitative VWF deficiency

A

assays measure VWF activity, which is compared to VWF: Ag

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127
Q

A quantitative ristocetin cofactor activity; also called VWF activity

A

VWF:Rco

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128
Q

VWF activity is measured by what?

A

measured by the ability of ristocetin to cause agglutination of reagent platelets by the patient’s VWF.

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129
Q

This is a collagen binding assay, a second VWF activity assay

A

VWF:CB

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130
Q

Large multimers bind immobilized target collagen, predominantly what collagen?

A

Collagen III

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131
Q

It is an automated nephelometric activity assay that employs latex microparticles and monoclonal anti-glycoprotein I-VWF receptor

A

VWF: Immunoactivity

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132
Q

This is a third method for assaying VWF activity.

A

VWF: Immunoactivity

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133
Q

This is an activity assay that employs ristocetin-triggered binding of recombinant glycoprotein 1b (GP1b), detected by LIA or CLIA

A

VWF:GP1bR-

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134
Q

VWF:GP1bR is an activity assay that employs ristocetin-triggered binding of recombinant glycoprotein 1b (GP1b), detected by WHAT?

A

detected by LIA or CLIA

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135
Q

This is an activity assay that employs recombinant gain-of-function GP1b

A

VWF:GP1bM

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136
Q

This binds the VWF A1 domain without the need for ristocetin

A

VWF:GP1bM

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137
Q

The VWF:GP1bM reaction is detected using what?

A

LIA

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138
Q

RIPA stands for what?

A

Ristocetin-induced platelet aggregometry

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139
Q

This assay uses ristocetin and patient’s own platelets, in contrast to the VWF-Rco, which uses reagent platelets

A

RIPA

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140
Q

This assay is modified by using low ristocetin concentrations to identify VWD subtype 2B in which multimers exhibit increased avidity for the platelet receptor site.

A

RIPA

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141
Q

RIPA is also called

A

ristocetin response curve

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142
Q

This is a group-consumed during coagulation process, absent in serum but present in plasma

A

Thrombin-sensitive group/ Fibrinogen group

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143
Q

What is not needed for the synthesis of Thrombin-sensitive group/Fibrinogen group?

A

Vit K

144
Q

This group is not adsorbed by BaSO4 or Al(OH)3

A

Thrombin-sensitive group/ Fibrinogen group

145
Q

Test used to differentiate factor deficiency from disorder of circulating anticoagulants.

A

Differential Tests of Activated Partial Thromboplastin Time (DAPTT)

146
Q

In APTT, if result becomes normal, then there is

A

Factor deficiency

147
Q

In APTT, if result is not from factor deficiency, then there is/are

A

circulating anticoagulants

148
Q

What is the formula to identify the deficient factor?

A

Pt’s plasma+ adsorbed plasma (with Factors V &VIII) or Pt’s plasma + serum(with Factors XI &XII),then re-run APTT.

149
Q

Another modification of APTT which is done by mixing the patient’s plasma with commercially available correcting reagents, Factor VIII and IX reagents.

A

Differential Partial Thromboplastin Time (DPTT)

150
Q

What are the commercially available correcting reagents used in DPTT?

A

Factor VIII and IX reagents

151
Q

In DPTT, if there is prolonged result, how would you correct it?

A

PTT is corrected with Factor VIII (Hemophilia A) and PTT is corrected with Factor IX (Hemophilia B)

152
Q

In DPTT, if there is partially corrected result, what are the reagents used and what type of hemophilia is associated?

A

both Factor VIII and Factor IX reagents, Hemophilia C

153
Q

Simple test for the deficiencies in factors of the INTRINSIC and COMMON pathways of coagulation as well as presence of inhibitors to these factors (anticoagulants).

A

Partial Thromboplastin Time

154
Q

Partial Thromboplastin Time is a simple test for deficiencies in factors of what pathways?

A

Intrinsic and Common pathways

155
Q

Test where standardized foreign surface is introduced(activator)

A

Activated Partial Thromboplastin Time (APTT)

156
Q

What is the reference interval for PTT?

A

40-100 seconds

157
Q

What are the 2 tests cannot detect deficiencies in Factor XIII & platelets?

A

PTT and APTT

158
Q

Tests that are useful in monitoring heparin or I.V. anticoagulant therapy and more sensitive than coagulation time.

A

PTT and APTT

159
Q

There is a decrease in inflammation,trauma, stress & pregnancy in thrombin-sensitive group/ Fibrinogen group

True or False

A

false

INCREASE

160
Q

There is a decrease in inflammation,trauma, stress & pregnancy in thrombin-sensitive group/ Fibrinogen group

True or False

A

false

INCREASE

161
Q

What are the causes of an abnormally shortened result in APTT?

A

partial clotting of the blood
high levels of Factor III
an activated coagulation system as in DIC
the presence of platelets in the plasma.

162
Q

What is the reference interval of APTT?

A

25-35 seconds

163
Q

It is a test with more sensitive method than the coagulation time of whole blood.

A

Plasma Recalcification Time

164
Q

This test may reveal abnormality which is not detectable by the determination of the clotting time of venous blood.

A

Plasma Recalcification Time

165
Q

What is the activator used in activated recalcification time?

A

0.25 M CaCl2

166
Q

FV & VIII are susceptible to denaturation & reduced in amt in stored plasma

TRUE OR FALSE

A

TRUE

167
Q

What is the reference interval for Plasma Recalcification Time?

A

Less than 50 seconds

168
Q

This is present in both serum &plasma(not consumed on coagulation)

A

Prothrombin group/Vit.K dependent group

169
Q

Fibrinogen group is also called …

A

Thrombin-sensitive group

170
Q

Which test has the principle, “the time necessary for fresh blood to form a clot when incubated at 37̊C in the presence of “surface contact” activation”.

A

Activated Coagulation Time of Whole Blood

171
Q

Promthrombin group is also called …

A

Vit. K dependent group

172
Q

What test measures overall activity of the intrinsic clotting system?

A

Activated Coagulation Time of Whole Blood

173
Q

What is the reference interval of Activated Coagulation Time of Whole Blood?

A

1-2 minutes

174
Q

Vit.K is needed for the synthesis of prothrombin group/vit. K dependent group

true or false

A

TRUE

175
Q

This group can be adsorbed by BaSO4 & Al(OH)3

A

Prothrombin group/Vit. K dependent group

176
Q

These drugs cause a functional decrease by producing PIVKAs( proteins induced by Vit K antagonists) & if measured by immunologic test rather than functional test will be present in normal amounts. Stable in stored plasma.

A

Vit. K def and coumarin drugs w/c compete with Vit.K

177
Q

Vit. K def and coumarin drugs w/c compete with Vit.K cause what?

A

a functional decrease

178
Q

What are the tests for Phase I and II of Coagulation?

A

The Coagulation Test
- Micro Methods
- Macro Methods

179
Q

This test is superior for there is less contamination of the plasma with tissue fluids when blood is drawn from a vein.

A

Macro methods (from Coagulation test)

180
Q

Vit. K def and coumarin drugs w/c compete with Vit.K cause a functional decrease by producing what?

A

by producing PIVKAs

181
Q

Method that has the principle, “the time required for freshly collected blood to form a firm clot in standardized glass tubes at 37̊C.”

A

Lee-White Method or Whole Blood Clotting Time

182
Q

PIVKAs stand for?

A

proteins induced by Vit K antagonists

183
Q

What is the Reference interval of Lee-White Method or Whole Blood Clotting Time?

A

5-10 minutes

184
Q

What method similar to Lee-White method only that more blood sample is tested.

A

Howell’s Method

185
Q

This group is stable in stored plasma.

A

Prothrombin group/Vit. K dependent group

186
Q

What is the Reference interval of Howell’s Method?

A

10-15 minutes

187
Q

It tests the composite action of all plasma factors acting simultaneously.

A

Coagulation Test

188
Q

It is a measure of the ability of the blood to clot and is not influenced by the platelet functions other than PF3.

A

Clotting time

189
Q

It measures only the time required for the formation of the traces of thrombin sufficient to produce a visible clot.

A

Clotting time

190
Q

Vit. K def and coumarin drugs w/c compete with Vit.K cause a functional decrease by producing PIVKAs( proteins induced by Vit K antagonists) & if measured by functional test rather than immunologic test will be present in normal amounts.

TRUE OR FALSE

A

FALSE

measured by immunologic test rather than functional test

191
Q

Vit. K def and coumarin drugs w/c compete with Vit.K cause a functional decrease by producing PIVKAs( proteins induced by Vit K antagonists) & if measured by functional test rather than immunologic test will be present in normal amounts.

TRUE OR FALSE

A

FALSE

measured by immunologic test rather than functional test

192
Q

What are the 2 Micro Methods used in Coagulation test?

A
  1. Slide or Drop Method
  2. Capillary or Dale and Laidlaw’s Method
193
Q

“Short draw” specimens ( specimens with smaller volume than the minimum specified by the manufacturer generates what result?

A

erroneously PROLONGED results

194
Q

“Short draw” specimens ( specimens with smaller volume than the minimum specified by the manufacturer generates what result?

A

erroneously PROLONGED results

195
Q

Admixture with tissue juice will generate what result?

A

“SHORTENED “ results

196
Q

This group is not consumed on coagulation & are not dependent on Vit.K for their synthesis.

A

Contact group

197
Q

This anticoagulant may be required for specimens for molecular diagnostic testing, such as testing for Factor V Leiden mutation.

A

EDTA

198
Q

This gel tubes may be used for molecular diagnosis as specified by the institution

A

acid citrate dextrose (ACD, yellow closure) and dipotassium EDTA (K2EDTA), white closure)

199
Q

Contact group is unstable

true or false

A

false

stable

200
Q

This anticoagulant suppress in vitro platelet or coagulation activation for specialty assays such as the platelet activation marker platelet factor 4 ( PF4) or the coagulation activation marker thrombin- antithrombin complex (TAT).

A

Citrate theophylline adenosine dipyridamole (CTAD, blue closure)

201
Q

This anticoagulant may be necessary to produce accurate platelet counts in cases of platelet satellitosis (satellitism) as substitute for specimens collected in EDTA.

A

Heparin

202
Q

This group is not adsorbed out of plasma by BaSO4 & Al(OH)3

A

Contact group

203
Q

If samples are left at room temp. for an extended time, what factors are likely to deteriorate?

A

Factors V &VIII

204
Q

PK and HMWK also function in fibrinolysis.

True or false

A

TRUE

205
Q

What factors and blood component tend to be prematurely activated at refrigerator temp.( 1-6C) and large multimer VWF may be precipitated.

A

Factors VII & XI, platelets

206
Q

What type of plasma may be stored at -4 C or lower for at least several weeks w/out loss of most factors?

A

Platelet Poor Plasma (PPP)

207
Q

What are the FOUR classifications of Coagulation Factors as to FUNCTION?

SCST

A
  1. Serine protease
  2. Cofactors/Accelerators
  3. Substrate
  4. Transglutaminase/Transamidase
208
Q

Thawing of plasma should be done rapidly in what temp?

A

37C incubator or water bath

209
Q

True or False: Thawed plasma cannot be refrozen

A

True

210
Q

What factors are involved in enzymes, serine protease?

A-six

A

kallikrein, IIa, VIIa,IXa,Xa,XIa,XIIa

Table: Prekallikrein, Serine Protease Ia, IXa, Xa, XIa, Factor XIIIa

211
Q

True or False: Changes in the pH of samples can affect values by shortening clotting time

A

False.
PROLONGING clotting time

212
Q

What factors are involved in cofactors/accelerators?

A

Tissue factor (from the membranes of fibroblasts & smooth muscle cells, Factors Va, VIIIa, HMWK)

213
Q

What factors are involved in cofactors/accelerators?

A

Tissue factor (from the membranes of fibroblasts & smooth muscle cells, Factors Va, VIIIa, HMWK)

Table: Factor V (Labile Factor), Factor VIII:C (AHF)

214
Q

What factors are included in Substrate?

A

Fibrinogen/Factor I

215
Q

True or False.
Changes in pH are mediated by the loss of CO2 from the sample. As CO2 is lost, the pH of the sample decreases (acidic).

A

False. increases (alkalinized)

216
Q

What factor is included in Transglutaminase/transamidase?

A

Factor XIII

217
Q

What factor is included in Transglutaminase/transamidase?

A

Factor XIII

218
Q

This solution protect samples against such loss for a period of time. RBC if not exposed to air have a buffering effect, too.

A

buffered citrate solution in evacuated tubes

219
Q

Normal samples collected in evacuation tubes & stored unopened at room temp. for as long as how many hours?

A

6 hours

220
Q

True or False. In phlebotomy, release the tourniquet as soon as the blood enters the 1st tube( within 1 minute) or the syringe

A

True

221
Q

Tubes with blood should be how many percent of the evacuation’s tube volume.

A

+/ - 10%

222
Q

True or False. All tubes used for coagulation studies should have non-contact surface

A

True

223
Q

This institution recommends 0.105- 0.109 M sodium citrate (3.2%) as anticoagulant

A

Clinical and Laboratory Standards Institute (CLSI )

224
Q

What are the THREE classifications of Coagulation Factors by Physical Properties?

FPC

A
  1. Fibrinogen/Thrombin sensitive group
  2. Prothrombin/Vitamin K dependent group
  3. Contact group
225
Q

What is the recommended dilution of sodium citrate according to CLSI?

A

1:10

226
Q

What is the recommended dilution of sodium citrate according to CLSI?

A

1:10

227
Q

What are the Coag factors included in Contact group?

A

XII, XI, Prekallikrein, HMWK

228
Q

True or False. Buffering stabilizes pH & increases stability of labile factors.

A

True

229
Q

True or False. Samples of patients with high hematocrits contain more plasma.

A

False. less plasma

230
Q

Specimens (whole blood)should be centrifuged within how many hour/s after obtaining the sample?

A

1 hour

231
Q

After centrifugation, plasma shd. be separated immediately with what kind of pipettes?

A

plastic or siliconized pipettes

232
Q

What are the Coag factors included in Fibrinogen/Thrombin-sensitive goup

last factor with a roman numeral; in between last factor

A

I, V, VIII, XIII

233
Q

True or False. Only 2/3 of the plasma layer shd be aspirated & stored in a stoppered plastic or siliconized tube.

A

False. 3/4

234
Q

True or False. The buffering effect of red cells is lost once the sample is centrifuged and exposed to air.

A

True

235
Q

Testing should be done immediately on centrifuged samples or the plasma should be stored at 6C not to exceed 2 hrs.

A

False. 4C

236
Q

Plasma should not be frozen if testing can be done within how many hours after collection?

A

2 hours

237
Q

What are the coag factors in Prothrombin/Vit. K dependent group?

A

II, VII, IX, X, PC, PS

238
Q

What are the coag factors in Prothrombin/Vit. K dependent group?

A

II, VII, IX, X, PC, PS

239
Q

They bind, stabilize & enhance the activities of their respective enzymes.

A

Cofactors/Accelerators

240
Q

What is an example of a cofactor that triggers the extrinsic pathway.

A

thromboplastin

241
Q

Thromboplast is composed of what?

A

composed of tissue juice & PPL

242
Q

thrombomodulin, PS, PZ are also cofactors.

tRUE OR FALSE

A

TRUE

243
Q

This comes from endothelial cells
& controls PC

A

Thrombomodulin

244
Q

Thrombomodulin is fibrinolytic

True or false

A

FALSE

antifibrinolytic

245
Q

Thrombomodulin is fibrinolytic

True or false

A

FALSE

antifibrinolytic

246
Q

This binds to thrombin & alters its substrate preference.

A

Thrombomodulin

247
Q

This catalyzes the formation of covalent bonds between the carboxy terminals of gamma chains from adjacent D domains in the fibrin polymer

A

Transglutaminase

248
Q

Transglutaminase catalyzes the formation of covalent bonds between what ?

A

between the carboxy terminals of gamma chains from adjacent D domains

249
Q

With the exception of platelet function tests, plasma for coagulation tests should be what type of plasma?

A

platelet poor/ ordinary plasma

250
Q

Transglutaminase catalyzes the formation of covalent bonds between the carboxy terminals of gamma chains from adjacent D domains in the what?

A

in the fibrin polymer.

251
Q

Transglutaminase catalyzes the formation of covalent bonds between the carboxy terminals of gamma chains from adjacent D domains in the what?

A

in the fibrin polymer.

252
Q

What are the FOUR stages in Coagulation?

A
  1. Contact Phase
  2. Activation of the common pathway
  3. Conversion of prothrombin to thrombin
  4. Formation of a stable fibrin clot
253
Q

Prothrombin is what factor?

A

Factor II

254
Q

Thrombin is what factor?

A

Factor IIa

255
Q

In some books, there are only 3 stages only

What are the THREE stages of Coagulation?

A
  1. Thromboplastin generation
  2. Conversion of prothrombin to thrombin
  3. Conversion of fibrinogen to a stable fibrin clot by thrombin
256
Q

This is the phase wherein there is exposure of collagen/subendothelium

A

Contact Phase

257
Q

This pathway is activated by the release of Factor III (TF/Tissue Thromboplastin) into the plasma from injured tissues (collagen injury)

A

Extrinsic Pathway

258
Q

This is the pathway wherein activation occurs when a vessel is injured, exposing the subendothelial tissues, basement membrane and collagen.

A

Intrinsic Pathway

259
Q

This is the pathway wherein activation occurs when a vessel is injured, exposing the subendothelial tissues, basement membrane and collagen.

A

Intrinsic Pathway

260
Q

The instrinsic pathway will lead to the activation of what factors?

pH CF

A
  • “contact factors”
  • Factor XII
  • HMWK
  • prekallikrein.
261
Q

For some tests, centrifugation of samples is at what degrees?

A

2-4C

262
Q

plasma double centrifuged to achieve a platelet count of less than 5,000/uL.

A

platelet free plasma

263
Q

Required for certain coagulation tests such as for LA where it is optimal for specimens to be frozen.

A

platelet free plasma

264
Q

Plasma required for all coagulation testing. It may be frozen.

A

platelet poor plasma

265
Q

plasma centrifuged at 50 x g to achieve a platelet count of 200,000/uL.

A

platelet rich plasma

266
Q

This is an assembly molecule( membrane) needed in almost all phases of the intrinsic pathway.

A

Platelet Factor 3

267
Q

Plasma used for light transmission platelet aggregometry

A

platelet rich plasma

268
Q

What platelet factor 3 in particular is an assembly molecule( membrane) needed in almost all phases of the intrinsic pathway?

A

phosphatidylserine, in particular

268
Q

Blood prep: 4.5 ml blood +0.5 ml 0.109M sodium citrate. Store in refrigerator not more than 2 hrs.

A

Patient’s plasma

269
Q

Blood prep: 2ml of plasma + 0.2 ml adsorbing reagent ( BaSO4/ Al(OH)3. Centrifuge at 3000 rpm for 3 mins. Refrigerated plasma should be used within 2 hrs.

A

Adsorbed normal plasma

270
Q

It is called INTRINSIC since most factors here are in the blood.

TRUE OR FALSE

A

TRUE

271
Q

It is called INTRINSIC since most factors here are in the blood.

TRUE OR FALSE

A

TRUE

272
Q

Blood prep: collect plasma in the usual manner then incubate at 37 C for 24 hrs. Store in aliquots at -20 C.

A

Aged normal plasma

273
Q

This pathway starts with the activation of Factor X to Factor Xa by the intrinsic & extrinsic pathways. Then, Factor Xa in the presence of Factor Va,Ca,PPL( prothrombinase complex) activates Protthrombin to Thrombin

A

COMMON PATHWAY

274
Q

The common pathway starts with the activation of what?

A

with the activation of Factor X to Factor Xa

275
Q

Blood prep: collect serum in the usual manner. Allow to stand at room temp. For 24 hrs. Divide in aliquots and freeze.

A

Aged normal serum

276
Q

The common pathway starts with the activation of Factor X to Factor Xa by what?

A

by the intrinsic & extrinsic pathways.

277
Q

The common pathway starts with the activation of Factor X to Factor Xa by what?

A

by the intrinsic & extrinsic pathways.

278
Q

Blood prep: 9 parts blood + 1 part 3.2% sodium citrate(0.109 M ). Centrifuge at 3000 for 30 mins.

A

Platelet-poor plasma (ppp)

279
Q

Blood prep: Mix blood as in PPP. Centrifuge at 1500 rpm for 5 mins.

A

Platelet-rich plasma (PRP)

280
Q

What are the acquired hereditary inhibitors?

F I V

A

Anti-VIII
Anti-IX, anti-X, anti-V, anti-I, anti-XIII and anti-vWF

281
Q

Factor Xa in the presence of what factors activates Prothrombin to Thrombin?

A

Factor Va, Ca, PPL (prothrombinase complex)

282
Q

What is the acquired non-hereditary inhibitor associated with postpartum, autoimmune disorder?

A

Anti-VIII

283
Q

What is the acquired non-hereditary inhibitor related to Streptomycin therapy?

A

Anti-V

284
Q

They are essential for the assembly of 3 membrane complexes leading to the generation of thrombin.

A

Vit . K dependent procoagulants

285
Q

What is the acquired non-hereditary inhibitor related to Isoniazid therapy?

A

Anti-XIII

286
Q

Anticoagulant with no clinical manifestation. It neutralizes the PPL reagent in APTT resulting to its prolonged result.

A

Lupus anticoagulant

287
Q

Enumerate the Non-hereditary acquired inhibitors

A

Anti-VIII-postpartum, autoimmune disorder
Acquired vWF disease
Anti-IX
Anti-XI
Anti-V- related to Streptomycin therapy
Anti-XIII- related to Isoniazid therapy
Lupus anticoagulants-no clinical manifestation. It neutralizes the PPL reagent in APTT resulting to its prolonged result.

288
Q

What is the non-enzymatic cofactor of Vit K dependent procoagulants?

A

Vit K dependent serine protease

289
Q

Anticoagulant like PS is also a cofactor in the regulation and control of coagulation. It is a cofactor to Z-dependent protease inhibitor (ZPI)

A

Protein Z-dependent protease inhibitor- Serpin-

290
Q

Anticoagulants which is more active when heparin is present.

A

Protein C Inhibitor- Serpin

291
Q

In Vit. K dependent procoagulants, this is bound to the negatively charged PPL membranes of activated platelets/TF –bearing cells.

A

Calcium

292
Q

Anticoagulant which is a slow reacting thrombin inhibitor which inhhibits Factor XIa and Xa.

A

Alpha1 Antitrypsin/ Alpha 1 protease inhibitor

293
Q

Anticoagulant which inactivates Factor XIIa and kallikrein, Factor XIa and plasmin.

A

C1 inhibitor

294
Q

Calcium is bound to the positively charged PPL membranes of activated platelets/TF –bearing cells.

TRUE OR FALSE

A

FALSE

negatively charged

295
Q

Calcium is bound to the positively charged PPL membranes of activated platelets/TF –bearing cells.

TRUE OR FALSE

A

FALSE

negatively charged

296
Q

Anticoagulant which came from endothelial cells, and also expressed on platelets;lipoprotein associated inhibitor(LACI) that inhibits Xa, binds TF:VIIa.The principal regulator of the TF pathway.

A

Extrinsic Pathway Inhibitor/ Tissue Factor Pathway Inhibitor

297
Q

Calcium is bound to the negatively charged PPL membranes of what?

A

of activated platelets/TF –bearing cells.

298
Q

Anticoagulant that forms complex with thrombin, kallikrein, thus inhibiting their activities.

A

Alpha 2 Macroglobulin-Serpin

299
Q

Anticoagulant that inhibits thrombin rapidly in the presence of dermatan sulfate, heparin sulfate, or heparin.

A

Heparin cofactor II (HC II)- Serpin

300
Q

major inhibitor of thrombin and Factor Xa.Its activity is enhanced by heparin to 2000x. The mfirst to be identified and the first to be assayed routinely.

A

Antithrombin III/ antithrombin- a Serpin

301
Q

In Vit. K dependent procoagulants, what are the composition of each complex?

PIE

A
  1. Prothrombinase
  2. intrinsic tenase
  3. extrinsic tenase
302
Q

Anticoagulant that inactivates the clotting cascade by inducing thrombin to activate PC. Produced by endothelial cells.

A

Thrombomodulin

303
Q

Anticoagulant which is a vitamin K dependent protein and also produced by the liver. This functions to enhance binding of Protein C to phospholipid surfaces and increase the rate of Factors Va and VIIIa inactivation by Protein C.

A

Protein S

304
Q

True or False. When plasma C4bBP increases, additional PS is bound & free PS levels become proportionally decreased, wc may increase risk of thrombosis.PS is also a cofactor of TFPI.

A

True

305
Q

This composition of the vit K dependent procoagulant complex is composed of Factor VIIa and TF

A

extrinsic tenase

306
Q

Anticoagulant produced by the liver and is a major inhibitor of blood coagulation. This inactivates Factors VIII:C and Va in the presence of cofactor Protein S. a Vit.K dependent protein.

A

Protein C

307
Q

This composition of the Vit K dependent procoagulant complex activates FX to Xa wc are components of intrinsic tenase and prothrombinase.

A

extrinsic tenase

308
Q

Converts Factor XIII to XIIIa

A

Procoagulant

309
Q

Induces platelet activation and aggregation

A

Procoagulant

310
Q

Activates cofactor VIII to VIIIa

A

Procoagulant

311
Q

Via autocatalysis converts Prothrombin to Thrombin

A

Procoagulant

312
Q

Binds antithrombin to inhibit serine proteases

A

Coagulation Inhibitor

313
Q

Binds to thrombomodulin to activate protein C (inhibits Va & VIIIa)

A

Coagulation Inhibitor

314
Q

Induces cellular chemotaxis

A

Tissue Repair

315
Q

Stimulates proliferation of smooth muscle and endothelial cells.

A

Tissue Repair

316
Q

This formation marks a critical event in the hemostatic process.

A

Thrombin formation

317
Q

This composition of the vit K dependent procoagulant complex is composed Factor IXa and its cofactor Factor VIIIa

A

intrinsic tenase

318
Q

This composition of the vit K dependent procoagulant complex activates Factor X to Xa but much more efficiently than TF:VIIa complex

A

intrinsic tenase

319
Q

Give the 4 actions of Thrombin (CAEI)

A

Converts fibrinogen to fibrin
Activates Factor XIII to Factor XIIIa
Enhances the activity of Factors V & VIII
Induces platelet aggregation.

320
Q

In vivo, the endpoint of coagulation mechanism is what?

A

stable fibrin clot

321
Q

In vitro( coagulation tests), the end point detected is

A

fibrin polymer

322
Q

This composition of the Vit K dependent procoagulant complex is composed of Factor Xa and its cofactor Factor Va

A

Prothrombinase

323
Q

acute phase reactants whose level increases in inflammation, trauma, stress, infections. (FPFV)

A

Fibrinogen, Prothrombin, Factor VIII, VWF

324
Q

This happens in the presence of PPL and Ca.

A

Prothrombinase

325
Q

Prothrombinase converts what?

A

prothrombin to thrombin

326
Q

They absorb, transport and release abundant fibrinogen.

A

Platelets’ alpha granules

327
Q

This converts prothrombin to thrombin in a multistep hydrolytic process that releases thrombin and a peptide fragment

A

Prothrombinase

328
Q

The primary serine protease of the fibrinolytic system, also becomes covalently bound via lysine moieties

A

Plasmin

329
Q

peptide fragment called …

A

prothrombin fragment 1.2 (F1.2)

330
Q

This is a marker for thrombin generation.

A

Prothrombin fragment 1.2 (in plasma)

331
Q

A serine protease that ultimately hydrolyzes & activates bound plasminogen to initiate fibrinolysis.

A

TPA (Tissue Plasminogen Activator)

332
Q

Prothrombin fragment 1.2 in plasma is a marker for what?

A

marker for thrombin generation

333
Q

What factor catalyzes the formation of covalent bonds between the carboxy terminal of gamma chain from adjacent D domains?

A

Factor XIII

334
Q

When there is thrombin generation, fibrinolysis will follow, then coagulation.

TRUE OR FALSE

A

FALSE

coagulation will follow, then fibrinolysis

335
Q

When there is thrombin generation, fibrinolysis will follow, then coagulation.

TRUE OR FALSE

A

FALSE

coagulation will follow, then fibrinolysis

336
Q

a plasma protein involved in cell adhesion

A

fibronectin

337
Q

They form to provide an insoluble meshwork of fibrin polymers linked by their D domains.

A

Multiple cross-links

338
Q

Fibrinogen Structure and Fibrin Formation measurement

A

340kD, 200-400mg/dL

339
Q

The alpha granules of platelets transport and release what?

A

fibrinogen

340
Q

What transports and releases fibrinogen?

A

alpha granules of platelets

341
Q

This molecule is a mirror- image dimer,with each half consisting of 3polypeptide designated as alpha,beta,and gamma united by disulfide bonds

A

Fibrinogen

342
Q

Fibrinogen is a molecule that is a mirror- image dimer,with each half consisting of how many polypeptides?

A

3 polypeptides

343
Q

factor that has the shortest plasma half-life at 6 hours

A

Factor VII

344
Q

The three polypeptides of fibrinogen is designated as what?

A

designated as alpha,beta,and gamma

345
Q

Fibrinogen is a molecule is a mirror- image dimer,with each half consisting of 3polypeptide designated as alpha,beta,and gamma united by what?

A

disulfide bonds.

346
Q

Factor that is non-Vitamin K dependent and is not affected by dietary Vitamin K deficiency

A

Factor V

347
Q

The 6 amino terminal assemble to form a bulky central region called the what?

A

E domain

348
Q

The carboxy terminal assemble at the 2 ends of the molecule to form what?

A

2 D domains.

349
Q

This cleaves from the protruding amino terminal of fibrinopeptides A &B.

A

thrombin

350
Q

Thrombin cleaves from the protruding amino terminal of what?

A

of fibrinopeptides A &B

351
Q

An acute phase reactant that frequently becomes elevated in early or mild liver disease

A

Fibrinogen

352
Q

. Each of the 2 alpha & beta chains,reducing the overall mol.wt. by 10,000D

True or False

A

TRUE

353
Q

The cleaved fibrinogen is called

A

FIBRIN MONOMER

354
Q

Factors used to differentiate Liver disease from Vitamin K deficiency

A

Factors V and VII

355
Q

The exposed alpha & beta chain ends (E domain) have an immediate affinity for portions of the D domain of neighboring monomers spontaneously polymerizing to form fibrin polymer.

true or false

A

true

356
Q

Test that duplicates thrombin time test except that venom of the reptile Bothrops atrox is substituted.

A

Reptilase time

HEMATOLOGY 2 - LECTURE (9 decks)

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