Basic Principles Of Hemostasis

Question 1

______ involves the enzymatic activation of series of plasma proteins (procoagulants) in the coagulation system to form fibrin meshwork

Answer 1

Secondary hemostasis

Question 2

______ 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

Answer 2

Coagulation

Question 3

Activated state of proenzymes is called?

Answer 3

Serine proteases

Question 4

_____ occurs on the surface of platelet/endothelial cell membrane (platelet plug) & not on the fluid phase

Answer 4

Coagulation

Question 5

_____ circulates in the plasma with vwf and is referred to as factor viii complex

Answer 5

Factor VIll

Question 6

_____ is composed of large multimeric glycoprotein that participates in platelet adhesion and transports factor viii

Answer 6

Von willebrand factor

Question 7

_____ are stored in the alpha granules in platelets and in weibel - palade bodies in ECs

Answer 7

Von willebrand factor (vwf)

Question 8

Deficiency in factor viii or its dysfunction results in _____

Answer 8

Hemophilia A

Question 9

Deficiency in VWF or a dysfunctional molecule results in?

Answer 9

Von willebrand disease (VWD)

Question 10

_______ is a mineral & play a big role in the important stages of coagulation

Answer 10

Factor IV (calcium)

Question 11

Enumerate the 3 acute phase reactants

Answer 11

Fibrinogen
HMWK
Prothrombin

Question 12

_____ represents the antigenic properties of factor viii measured by immunoassays

Answer 12

Factor VWF:Ag-

Question 13

_____ the property of VWF which causes platelet aggregation in the presence of ristocetin

Answer 13

Ristocetin co-factor activity

Question 14

_______ consumed during coagulation, absent in serum but present in plasma. Vit. K not needed for their synthesis. Not absorbed by BaSO4 or Al(OH)3. Increased in inflammation, trauma, stress & pregnancy.

Answer 14

Thrombin-sensitive group/Fibrinogen group

Question 15

______ is present in both serum and plasma (not consumed by coagulation), well-preserved in stored plasma. Vit. K needed for their synthesis, can be absorbed by BaSO4 & Al(OH)3.

Answer 15

Prothrombin group/Vit. K dependent group

Question 16

_____ is a therapeutic inhibitor of Vit. K

Answer 16

Coumadin drugs

Question 17

_____ is the basis for the oral anticoagulant ( warfarin, Coumadin) therapy

Answer 17

Vit. K antagonism

Question 18

Enumerate the components of extrinsic tenase

Answer 18

VIIa
Tissue Factor
PPL
Ca

Question 19

Enumerate the components needed for intrinsic tenase

Answer 19

IXa
VIIIa
PPL
Ca

Question 20

Enumerate the components needed for prothrombinase

Answer 20

Xa
Va
PPL
Ca

Question 21

____ is composed of factors XI, XII, prekallikrein, and HMWK.

Answer 21

Contact group

Question 22

_____ is a non-enzymatic cofactor

Answer 22

HMWK

Question 23

Enumerate the serine proteases

Answer 23

Kallikrein
IIa
VIIa
IXa
Xa
XIa
XIIa

Question 24

Enumerate the cofactors/accelerators

Answer 24

Tissue factor
Va
VIIIa
HMWK

Question 25

Give the factor involved in substrate and transglutaminase/transamidase (note that both factors is different)

Answer 25

Substrate- factor I Transaglutaminase/transamidase - factor XIII

Question 26

Enumerate the coagulation factors involved in contact group

Answer 26

XII XI Prekallikrein HMWK

Question 27

Enumerate the coagulation factors involved in prothrombin group/Vit. K dependent group

Answer 27

II VII IX X

Question 28

Enumerate the coagulation factors involved in fibrinogen group/thrombin sensitive group

Answer 28

I V VIII XIII

Question 29

_____ bind, stabilize & enhance the activities of their respective enzymes

Answer 29

Cofactors/Accelerators

Question 30

____ is the one that triggers tha extrinsic pathway

Answer 30

Thromboplastin

Question 31

_____ is an activated coagulation factors which are the main players to produce fibrin clot

Answer 31

Serine proteases

Question 32

Enumerate in order the 4 stages in coagulation

Answer 32

1.Contact phase 2. Activation of the common pathway 3. Conversion of prothrombin to thrombin 4. Formation of stable fibrin clot

Question 33

______ is an assembly molecule needed in almost all phases of the intrinsic pathway

Answer 33

Phosphatidylserine

Question 34

Why is it called INTRINSIC?

Answer 34

Because most factors involved here are found in the blood

Question 35

This pathway starts with the activation of factor X to factor Xa by the intrinsic and extrinsic pathways.

Answer 35

Common pathway

Question 36

Activation occurs when a vessel is injured, exposing the subendothelial tissues, basement membrane and collagen

Answer 36

Intrinsic pathway

Question 37

Activated by the release of factor III into the plasma from injured tissues (collagen injury)

Answer 37

Extrinsic pathway

Question 38

____ is a marker for thrombin generation

Answer 38

Prothrombin fragment 1.2

Question 39

True or False: the 3 pathways do not fully describe how coagulation occurs physiologically

Answer 39

TRUE

Question 40

Two phases of coagulation

Answer 40

Initiation Propagation

Question 41

____ occurs in TF-expressing cells, produces 3-5% of the total thrombin generated

Answer 41

Initiation

Question 42

_____-occuring in platelets, which produces 95% or more of the total thrombin

Answer 42

Propagation

Question 43

Normal physiologic coagulation requires these 2 cell types:

Answer 43

1. Cell that express TF (extravascular) 2. Platelets (intravascular)

Question 44

The 6N terminal assembles to form a bulky central region called

Answer 44

E domain

Question 45

The 3 carboxyl terminals on each outer end of the molecule assembles to form two…

Answer 45

D domains

Question 46

The cleaved fibrinogen is called

Answer 46

Fibrin monomer

Question 47

In vivo, the endpoint of coagulation mechanism is ____

Answer 47

Stable fibrin clot

Question 48

In vitro, the endpoint detected is ____

Answer 48

Fibrin polymer

Question 49

_____ is the primary serine protease of the fibrinolytic system

Answer 49

Plasmin

Question 50

______ is the main enzyme of the coagulation pathway

Answer 50

Thrombin

Question 51

_____ is a protein produced by the liver and is a major inhibitor of blood coagulation.

Answer 51

Protein C

Question 52

______ is a Vit. K dependent protein and also produced by the liver.

Answer 52

Protein S

Question 53

______Inactivates the clotting cascade by inducing thrombin to activate PC

Answer 53

Thrombomodulin

Question 54

T or F: When plasma C4bBP level increases, additional PS is bound and free PS levels become proportionally decreased, wc may increase the risk of thrombosis.

Answer 54

True

Question 55

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

Answer 55

Antithrombin III/ antithrombin- a Serpin

Question 56

Laboratory measurement of TAT is used as an indicator of _____

Answer 56

thrombin generation

Question 57

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

Answer 57

Heparin cofactor II (HC II)

Question 58

____ inactivates Factor XIIa and kallikrein, Factor XIa and plasmin.

Answer 58

C1 inhibitor

Question 59

________ - no clinical manifestation. It neutralizes the PPL reagent in APTT resulting to its prolonged result, which is why this is investigated by the physician.

Answer 59

Lupus anticoagulants

Question 60

Enumerate the acquired hereditary inhibitors

Answer 60

Anti-VIII Anti-IX anti-X anti-V Anti-I anti-XIII anti-VWF

Question 61

Enumerate the non- hereditary acquired inhibitors

Answer 61

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