Blood Flashcards
1
Q
blood has an essential role in maintaining what?
A
homeostasis
2
Q
what are some primary functions of blood?
A
- transport
- acid-base balance
- protection
3
Q
how is blood important for the transport?
give examples?
A
blood serves as a medium in which nutrients, waste products and hormones may be transported.
4
Q
what is the normal pH range for blood?
A
7.3-7.45
5
Q
Blood is comprised of what types of body fluids?
A
both ECF (plasma) & ICF (what is found inside the blood cells)
6
Q
in terms of % how much of the body is composed of blood?
A
around 7%
7
Q
what does it mean to have normovolemia?
A
normal blood volume
8
Q
what does it mean to have hypovolemia?
A
lower blood volume
9
Q
what does it mean to have hypervolemia?
A
higher blood volume
10
Q
what is hematocrit?
A
the % of blood volume that is occupied by RBC
11
Q
if your hematocrit is of 45% and your total blood volume occupied by RBC is of 2.25L, then how much volume is occupied by plasma?
A
- 45=2.25
- 55=?
?= 2.75
12
Q
what is the composition of plasma?
A
- > 90% H20
- Na+ Cl- (K+, HCO3-) (Ca2+, Mg 2+, PO4 2-)
- Glucose, AA, lipids (cholesterol, phospholipids & tryglycerides) O2, CO2
- proteins (7%)
13
Q
what proteins can be found in the plasma?
A
- albumins
- globulins
- fibrinogen
14
Q
how does the ISF differ from the plasma?
A
due to the higher concentration of protein in the plasma
15
Q
what are some methods used to separate the proteins found in plasma?
A
Differential precipitation by salts
Sedimentation in ultracentrifuge
Electrophoretic mobility
Immunological characteristics
16
Q
identify the following separation method
fractionation method based on movement of charged particles along a voltage gradient
A
electrophoresis
17
Q
what factors influence the rate of migration when using electrophoresis?
A
- number and distribution of charges
- molecular weight of the proteins
18
Q
how can we identify the molecule/protein with the smaller molecular weight in electrophoresis?
A
the smaller weight enables to travel at a greater distance and hence will be observed to be the furthest away from initial content being tested (near positive side) however it is to be noted that one molecule may have a small molecular weight bu have a positive charge causing it to travel less far down.
19
Q
which plasma protein travels at the fastest rate and is found in the greatest amount?
A
-albumin
20
Q
how many different globulins can be found
A
-4 types
a1, a2, B, Y
21
Q
where is fibrinogen generally found?
A
between the B and Y globulins
22
Q
what is fibrinogen important in?
A
blood clothing
23
Q
what is serum?
why is it used?
A
plasma without the clothing proteins
much easier to study
24
Q
what is different when observing a serum electophoretic pattern?
A
it will lack a fibrinogen peak
25
why is it important to be able to read electrophoretic patterns
useful in clinical setting to depict diseases
26
how can we identify renal diseases from electrophoretic patterns
albumin peak is blunted (lost in urine)
27
where are antibodies carried in?
in Y globulin
28
what would be observed in the case of someone with a bacterial infection’s electrophoretic pattern?
the Y globulin would peak higher due to the higher demand for antibodies due to the presence of bacteria
29
where do the plasma proteins come from?
-most produced by the liver (albumin, fibrinogen, A1, A2, B)
Y globulins are produced by lymphoid tissue.
30
how does the shape of the proteins differ
albumin: small, oval
globulins: heterogeneous group
fibrinogen: elongated fiber
31
how does the molecular weight of proteins differ?
albumin: 69
globulins: 90-800
fibrinogen: 35
32
which is the most prominent protein in the plasma?
albumin
33
what is the primary function of plasma proteins?
-determines the distribution of fluids between the plasma and ISF compartments by controlling transcapillary dynamics
34
what is the cell membrane relatively impermeable to?
ions
35
what can freely pass through the capillary wall?
H20 and Ions
36
what is needed for their to be a net flow of water between compartments
a difference in osmotic pressure
37
what type of solutes contribute to the effective osmotic pressure of a solution
non diffusible solutes
38
are plasma proteins considered to be diffusible of non-diffusible?
non diffusible
39
what is the term used to describe plasma protein osmotic pressure
COP
| colloidal osmotic pressure
40
what happens if COP increases in the plasma
more water will flow into the plasma
41
what happens if cop decreases
water will flow into ISF hence ISF volume will increase
42
what are the major forms of fluid transport across the capillary walls?
- COP of plasma which determines the net flow (in/out) of the capillaries (osmotic flow caused by the plasma proteins)
- bulk flow: the poreous membrane where the pressure difference will cause for plasma to move across, except for its proteins which are too large to cross.
43
what are the starling forces?
the opposing forces between filtration and Osmotic flow which will determine the net flow (force) between the plasma and ISF
44
generally how does the circulatory system function?
blood leaves the heart through the artery and enters arterioles which then pass through the capillaries which branch off into the veins and back into the heart
45
what is the capillary bed?
site where exchanges between the plasma and ISF occur
46
how does starling transcapillary dynamiscs function?
opposing forces between the pressing from the artery and COP and Vein Pressur vs COP cause for a net filtration and net absorption pressure.
47
how are nutrients, waste O2 and CO2 exchanged through the capillaries?
they are exchanged through simple diffusion
48
what do the startling’s transcapillary dymanics determine?
the distribution of the ECF volume between the plasma and ISF
49
through the process of filtration in transcapillary dynamics, what tends to occur?
the process of filtration tends to push the fluid out from the inside of the capillaries
50
through the process of osmotic flow in transcapillary dynamics, what tends to occur?
the osmotic flow tends to pull in or retain the fluid inside the capillaries
51
in starling’s transcapillary dynamics, where do the exchanges (absorption/filtration) tends to occur?
along the whole length of the capillary
52
what % of fluid being filtered out gets reabsorbed back into the capillary?
what happens to the rest?
90% is taken back into capillaries
| the other 10% is drained by the lynmphatic vessels
53
what is the lymphatic system? (quick summary)
network of blind ended terminal tubules which coalesce to form larges lymphatic vessels and then converge into lymphatic ducts which then drain into veins in the chest.
54
what is the total blood flow in our body during a day?
6000L
55
How much of the blood volume is filtered into the ISF per day?
20L
56
Of the amount of blood filtered through the ISF daily gets returned by absorption?
around 17L
57
What volume of the blood filtered through the ISF passes through lymphatic drainage daily?
around 3L
58
in starling’s transcapillary dynamics what does the COP of plasma determine?
how much water flows into or out of the Capillaries
59
what is the osmotic pressure dependent of?
the number of osmotically active particles/unit volume
60
proteins fractions will exert an osmotic pressure which is directly related to?
their concentration in the plasma
61
proteins fractions will exert an osmotic pressure which is inversely related to?
the molecular weight of that protein
62
which protein will therefore contribute most to the COP
Albumin as it has the highest concentration and the lowest molecular weight, hence the Greatest COP
63
what are some factors that affect transcapillary dynamics?
- hydrostatic pressure
- cop
- capillary permeability
- lymphatic drainage
64
what is edema?
its is the accumulation of excess fluid in interstitial spaces
65
gives examples of how edema can develop
- increase in hydrostatic pressure
- decrease in the levels of plasma proteins, hence a decrease in COP
- increase of capillary permeability
- obstruction of the lymphatic drainage
66
how can an increase in hydrostatic pressure cause for edema?
say that the hydrostatic pressure in both the veins and arteries increases while keeping the COP constant, the net Filtration and Net absorption will change causing an imbalance. (pressure of filtration > pressure of Absorption)
67
how can decreasing the COP cause edema?
by decreasing the COP the net filtration and absorption pressures are once again altered (causing for net filtration > net absorption causing for fluid to accumulate)
68
what may cause for a decrease of COP?
- the failure to synthesize plasma proteins in cases of liver diseases
- severe protein malnutrition such as in kwashiorkor (big bellies in undernourished children)
69
what happens if permeability of the capillary wall increases?
generally, there is very little protein in the ISF (what distinguishes it from the plasma) however, if the permeability increases, some of the plasma proteins will escape and move into the ISF where they can exert and oncotic effect. causing for a decrease of COP overall.
70
what may be cause when lymphatic drainage is obstructed?
elephantis cause by a parasite infection (filaria nematode) which causes for lymphatic drainage to be blocked.
71
what do the plasma proteins contribute to?
1- distribution between ISF and plasma by controlling transcapillary dynamics
2- contribute to the viscosity of plasma
3- contribute to the buffering power of plasma
72
viscosity is a contributing factor to the maintenance of what?
blood pressure
73
what is the normal pH range of the blood(plasma)?
it is genrally kept constant at around 7.4
74
what proteins are essential in blood clotting?
fibrinogen and some globulins
75
what proteins provide specific resistance to infection?
Y-globulins (immunoglobulins)
76
which protein(s) act as a carrier for lipids, minerals and hormones?
Albumin and some globulins
77
what is the life span of RBC (erythrocytes?)
120 days
78
what is the life span of platelets?
7-8 days
79
what is the life span of WBC (leucocytes)
varies can range from hours to years
80
in termes of concentration, which is the most abundant blood cell?
- RBC 5x10^6/ uL
- platelets 2.5-4 x 10^4/ uL
- WBC: 0.8-1 x 10^4/ uL
81
what is erythropoiesis?
its the production of RBCs
82
what is thrombopoiesis?
its the production of platelets
83
what term is used to describe the production of WBCs?
Leukopoiesis
84
how does hematopoiesis general patteren function ?
cytokines (an inducer) stimulates the production of pleuripotent stem cells which undergo a process of self replication. a stimulus allows for the committed stem cells to be converted to their respective parties; leukocytes, platelates and erythrocytes to division and cell differentiation
85
what are cytokines?
substances (proteins or peptides) whcih are released by one cell and affect the growth, development and activity of another cell.
86
what is the name of the cytokines responsible for differentiation and proliferation of blood cell precursors?
Hemtopoietic GFs
87
what are the 2 big cell branches in which pluripotent hematopoietic stem cells can be made into?
- lymphoid stem cell
| - myeloid stem cell
88
if we inject bone marrow stem cells can all hematopoietic cells be reconstituated
yes
89
what are the sites of hemotopoiesis during prenatal stages?
yolk sac
- liver and spleen
- distal bones
90
as we age, what happens to the sites of hematopoiesis?
not all bones continue to produce cells.
91
what bones continue to produce blood cells?
proximal epiphysis of long bones, flat bones of the fkull, shoulder blades, pelvis, vertebrae, sternum and ribs
92
what is the main fct of RBC?
facilitate the transport of respiratory gases between lungs and cells
93
how are RBC shaped?
as biconcave disks
94
what are the advantages of the shape of RBC?
1. maximum surface area and minimum diffusion distance for volume allows to increase the efficiency of O2 and CO2 diffusion
2. high degree of flexibility allows it to squeeze through the narrow capillaries
95
do RBC contain any nucleus or relative organelles?
no, they have no subcellular organelles
96
which gender has more RBC and why?
- males
| - testosterone favours the production of RBC as opposed to estrogen which does the opposite
97
what is the composition of RBC?
mostly water
33% hemoglobin
a slight faction of lipids, proteins and ions
98
why are the glycolytic enzymes important for RBC’s?
they generate energy
99
why are the carbonic are the carbonic anhydrase
will help transport co2
100
What is the general structure of hemoglobin
contains 4 AA chains (2 Alpha and 2 beta chains)
| has MW of 64K
101
how much Hb is present per RBC?
200-300 x10^6 Molecules/ RBC
102
what happens when blood appears bright red?
in the lungs, Hb molecules are saturated with O2
103
what happens when blood appears dark red?
in tissues, O2 is dissociating from Hb.
104
what is a primary function of hemoglobin?
it increases the solubility of O2 in plasma.
| from 0.3ml O2/100 ml plasma to 20 ml O2/100 ml
105
what are the general functions of hemoglobin?
- transport of 02
- transport of CO2
- acts as a buffer
106
why is Hb found inside the cell rather than dissolved within the plasma?
- plasma viscosity would change due to the increase in proteins
- the plasma COP would also differ (increase)
- hemoglobin would potentially be lost through the kidneys, due to its similar size to albumin which also is the first protein to get lost through the kidney's
107
when Hb is fully saturated with O2, how much o2 does each gram of Hb hold?
1.34 ml O2
108
what are some factors affecting Hb to bind and release O2
```
temperature
ionic composition
pH
pCO2
Intracellular enzyme concentration
```
109
how long does the bone marrow stem cell division and differentiation last?
3-5 days
110
what happens to the reticulocyte during the first 24h when its in circulation?
it is recognizable, due to its ribosomal matter which makes it appear bumpy. however, after that 24H window, it becomes a RBC like any other and cannot be distinguished.
111
what is the normal reticulocyte count?
<1%
112
what does the reticulocyte count reflect?
it reflects the amount of erythropoiesis bone marrow
113
what determines the number of RBCs
- the requirement for O2
| - the availability of O2
114
what happens to RBC count as we increase in altitude?
the number of RBC increases as altitude increases. this is caused by the fact that the pressure of O2 decreases with altitude
115
what is erythropoietin?
a glycoprotein hormone/cytokine produced largely by the kidney
116
what is the function of erythropoietin?
it gets released in hypoxic conditions which may result from
- decreased RBC count
- decreased O2 availability
- increased tissue demand for O2
117
how is erythropoiesis regulated through negative feedback?
a decrease in 02 supply will increase the release of erythropoetin which then increases the concentration of plasma, it reaches the bones and acts as a precursor of the rbc causing them to divide and differentiate further and produce more RBC and carry more O2
118
what happens to erythropoietin if O2 supply is already high?
its release is decreased
119
what is the overall function of erythropoietin?
it gets released by kidneys in the presence of hypoxia and stimulates the bone marrow to produce more RBCs thereby maintaining Homeostasis
120
in the case that someone undergoes severe accidental hemorrage what would happen?
-less Hb availible for O2 transport
-reduce supply of O2 for kidney and liver
-increase production and release of erythropoietin
-increase production of erythrocyte precursors in bone marrow
-increase discharge of young erythrocytes in blood
= more Hb for O2 transport
121
how does testosterone act upon erythropoietin?
- increases the release of erythropoietin
| - increases sensitivity of RBC precurosrs to erythropoietin
122
can the lifespan of RBC be prolonged?
no
123
what are the cells that remove RBCs from circulation?
Macrophages
124
what does the macrophage do to the RBC?
the macrophage allows the old RBC to be digested through phagocytosis, its contents get released
125
what part of the RBC is recycled what component is lost?
from hemoglobin the globin component is returned to the AA pool
Ferrous iron is picked up by transferrin and stored with ferritin and brought back to bone marrow to produce new RBC where as Heme is not recycled and instead is converted to biliverdin and then bilirubin which then gets picked up by liver and is lost in the intestinal tract
126
how can jaudice be caused?
1. excessive hemolysis (too much RBC as digested by the macrophage causing for too much bilirubin in the liver)
2. hepatic damage where the liver can not adequately filter all the bilirubin it is receiving.
3. bile duct obstruction causing it impossible for the liver to get rid of the bile (containing the bilirubin)
127
what does the normal dynamic for RBC look like?
production = destruction
128
what happens if RBC production > destruction?
polycythemia
129
what happens if RBC production < destruction?
anemia
130
in a clinical setting how can we evaluate RBC dynamics?
- number of RBCs
- amount of Hb
- Hematocrit
131
what must we be careful to if using the hematocrit to determine RBC dynamics?
the Hematocrit may be extremely high, however it may not be cause by the over production of RBC but rather someone who is in a state of dehydration
132
what is relative polycythemia?
it is due to the decrease in plasma volume
133
what is the normal g% of RBC and what is the usual concentration of RBC?
- 16g%
| - 5-5.5 x 10^6 RBC/uL
134
what values represent a state of polycythemia?
- > 18g%
| - >6x 10^6 RBC/uL
135
what is physiological Polycythemia?
it is a secondary effect caused by an increased need for O2 or a decreased availability of O2
136
give examples of when physiological polycythemia may occur?
- at high elevations
- during increased physical activity
- in cases of chronic lung diseases
- in heavy smokers
137
what is pathological polycythemia?
excess creating of RBC without a known or specific cause
138
how may pathological polycythemia occur?
- tumours present on cells producing EPO causing for accelerated production of RBC
- unregulated production of bone marrow which will over produce RBC
139
under polycythemis vera (pathological) what is the Ht value and what is the concentration of RBC?
Ht is around 70%
| concentration is between 7-8 x 10^6 RBC/uL
140
what are some issues caused by polycythemia?
increased blood viscosity causes for sluggish blood flow which may lead to blood clotting
141
what does anemia lead to?
decrease in the oxygen carrying capacity of the blood.
142
what factors may be affected in people who suffer with anemia?
```
1. RBC count may decrease
males < 4x 10^6/uL
females < 3.2 x10^6/uL
2. Hemoglobine content decreases
males: <11g%
females <9g%
```
143
what is the term used to describe someone who is anemic and has large RBCs? what is the volume of the cell?
macrocytic
| > 94u^3
144
what is the term used to describe someone who is anemic and has normal RBCs? what is the volume of the cell?
normocytic
| 80-94 u^3
145
what is the term used to describe someone who is anemic and has normal Hb count?
normochromic
| around 33% Hb
146
what is the term used to describe someone who is anemic and has small RBCs? what is the volume of the cell?
Microcytic
| <80u^3
147
what is the term used to describe someone who is anemic and has less Hb count?
hypochromic
<33%
the blood cells will appear a lighter red color
148
what are the main causes to anemia?
1. diminished production
2. ineffective malnutrition
3. increased destruction
149
give an example of a type of anemia where production is decreased due to abnormal site production?
aplastic (hypoplastic) anemia
| maybe caused by various factors such as an exposure to radiation, drugs or chemicals
150
how can we classify Aplastic Anemia?
normocytic, normochromic
151
give an example as to why anemia may be produced by stimulation failure? how can such be classified?
renal diseases may yield for normocytic, normochromic
152
iron deficency anemia is a result of what? how can it be caused?
inadequate obtention of raw materials
it can be caused due to an increase of requirements such as during pregnancy, as infants or adolescents
or inadequate supplies due to
-loss of Fe in hemorage
-dietary deficencies (vegan diets especially)
-failure to absorb iron
153
how can we decribe the anemia in iron deficency anemia
microcytic, hypochromic
154
what is special about iron in the body?
we need about 25 mg daily
we have about 4g in our bodies
our daily intake is of about 15-20mg and from that only 1-2mg are absorbed from the guy (more in females)
155
why do we only need so little of iron absorbed daily?
because the amount we need is simply to cover for the amount that was lost, that is to say that the rest was recycled.
156
how is the 2mg of iron lost per day in women calculated?
it is assumed that 1gHb contains 3.5mg Fe
and that for 100mL of blood we have 15g Hb and hence around 50mg Fe. thus in a month we lose approximately 50mL of blood (25 mg Fe) and our 1g/day summing up to 2mg/day
157
what may be a cause of ineffective maturation leading to maturation failure anemia?
deficencies in Vit B12 and folic acid which are both needed for normal DNA synthesis
158
what are vitamin B12 deficencies generaly caused by?
failure to absorb it or in a strictly vegan diet
159
what are folic acid deficiencies generally caused by?
usually caused by dietary absences, overcooking vegetables.
160
what is pernicious anemia?
it is an iron deficency anemia that is caused by intrinsic factor deficency causing for Vit B12 to not be taken up into the intestines.
161
Generally what is the pressure exerted bu COP?
25 mm Hg
162
Generally what is the normal BP in the arteries?
35 mmHg
163
Generally what is the normal BP in the veins?
15 mm Hg
164
What is the approximate COP exerted by the different protein fractions?
Albumin: ~20 mm Hg
Globulines: 5
Fibrinogen: <1
165
what is hemostasis?
the arrest of bleeding following a vascular injury
166
what are the stages of hemostasis?
primary hemostasis involves the vascular response and the platelet response
where as secondary hemostasis involves the clot formation
167
what happens during the vascular response
nervous reflex causes the cells to stick together
myogenic response will cause the smooth muscle cells in larger vessels to contract together
or chemical vasoconstrictors such as cytokines will cause for sticking of the cells
168
what is white thrombus?
it is another name given to the temporary clot (platelet plug) formed during the platelet response
169
do platelets have a nucleus?
no
170
what are some important features of platelets
diameter: 2-4 um
lacks nucleus
contains many granules
between 250, 000-400, 000/uL
171
what are some of the contents of the granules
```
factors for vasoconstriction
platelet aggregation
clotting
filaments
microtubules
mitochondria
sER
```
172
what is the life span of a platelet
7-10 days
173
how is the platelet produced?
thrombopoietin produced mainly in the liver will stimulate the committed stem cell and stimulate multiple rounds of mitosis causing for the production of a megakaryocte which will extend its pseudopods into the blood stream and release its contents ( between 2-3 thousand platelets)
174
how is the platelet plug formed (general steps)
1. adhesion
2. activation and release of cytokines
3. aggregation
4. consolidation
175
what roles do prostacyclin and nitric oxide have on the platelet plug formation?
prostacyclin pushes the platelets away with NO which leads to vasodilatation
176
what is the role of collagen in platelet plug formation?
collagen will bind and activate the platelets causing them to stick together
177
what is PF3 secreted by?
| what is its role in the platelet plug formation?
it is secreted by damaged endothelial cells
| they get release and will attract more platelets to coagulate together promoting the coagulation scheme
178
how is aggregation and consolidation of the platelet plug achieved?
TA2 acts as a vasoconstrictor and will enable for the white thrombus to aggregate and consolidate into the platelet plug
179
what is the role of serotonin in the platelet plug formation?
it acts as a vasoconstrictor
180
adhesion of the platelets is facilitated by what?
by the von willebrand factor
181
what are the main functions of platelets?
- release of vasoconstriction agents
- formation of the platelet plug
- release of clotting factors
- participate in clot retraction once healed
- promotes maintenance of the endothelial integrity
182
what condition occurs if there is insufficent platelets?
petechiae
183
what happens if the primary hemostatic response is abnormal?
it will lead to prolonged bleeding
184
what factors may cause for the primary hemostatic response to be abnormal?
1. failure of blood vessel to constrict
2. platelet deficency
< 75 000 platelets/uL (thrombocytopenia
may occur due to congenital conditions or due to drugs toxins and antibodies
185
how does Asprin interfere with blood clotting?
in small doses asprin will inhibit the synthesis and the release of TXA2 hence leading to functional platelet deficiency
186
what is a thrombus?
blood clot
187
what is responsible for clot formation, plasma or RBC?
plasma, hence RBC are nor required for the process
188
what may initiate blood clotting?
injury to a blood vessel
189
what does clotting result in?
activation of numerous groups of plasma proteins or clotting factors, in the presence of Ca2+ and phospholipid agents
190
what pathways can be taken in order to achieve blood clotting
- intrinsic pathway
| - extrinsic pathway
191
what are the important features of the intrinsic pathway
- 3-6 minutes
- acts upon damage to blood vessels
- can be increase by the activation of the extrinsic pathway
192
how does the intrinsic pathway function?
requires multiple plasma factors that can act with Ca2+ and PF3 to produce prothrombinase which can then convert prothrombin to thrombin which will act to convert fibrinogen to fibrin which leads to blood clotting
193
what are some important features of the extrinsic pathway?
- 15-20 seconds
- produces in small amounts
- activated by damage to tissue outside of vessel
- requires interacting plasma factors, ca2+ and tissue phospholipids
194
how does the extrinsic pathway function?
tissue factors released from dammaged cells along with plasma factors and Ca2+ rapidly form prothombinase which can then help convert prothombin into thrombin which works with fibrinogen to produce fibrin needed for blood clot formation
195
how does the extrinsic scheme work with the instrinsic scheme?
through the process of positive feedback, the small amounts of thrombin produced by the extrinsic scheme trigger the intrinsic scheme to produce greater quantities of thrombin
196
what are some factors involved in coagulation?
Ca 2+
Phospholipid
Protein plasma factors
197
give an example of a congenital factor deficency?
| normall is it a single or multiple factors that will be affected by congenital deficency?
hemophilia
| single factor, in this case VIII
198
in acquired clotting factor deficiency is it a single or multiple factors that are affected?
multifactor
199
what may cause for acquired clotting factor deficency?
- liver diseases
| - vit K. deficency which is an essential factor for the synthesis of prothrombin, VII, IX, X
200
what does clot retraction depend on?
it depends on the presence of contractile protein (thrombosthenin) which gets released by platelets
201
what is fribrinolysis?
the lysis of a cloth
202
how does fibrinolysis occur?
plasminogen along with some activators (intrinsic and extrinsic) will produce plasmin which will act upon fibrin and reduce it to fragments
203
what common drug acts as an inhibitor for platelet adhesion?
asprin
204
what are some common anticoagulant drugs?
- coumadin
| - heparin
205
identify the following anticoagulant drug
| promotes inhibition of thrombin activation and action
heparin
206
identify the following anticoagulant drug
| blocks synthesis of functional prothrombin, VII, IX, X
coumadin
207
what type of drugs will promote clot lysis
| give exampled
```
thrombolytic drugs
such as
tissue plasminogen activator
and
streptokinase
```
