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Sem 2 > Blood clotting > Flashcards

Blood clotting Flashcards

1
Q

normal intact endothelium is what kind of surface

A

antithrombotic

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2
Q

two potent vasodilators and inhibitors of platelet function produced by endothelium

A

prostacyclin, nitric oxide

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3
Q

after vascular injury there is vaso-

A

constriction

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4
Q

vasoconstriction after vascular injury is partly mediated by which two platelet activation products

A

serotonin and thromboxane A2

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5
Q

after vascular injury, blood flow is exposed to (2)

A

subendothelial collagen and tissue factor

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6
Q

subendothelial collagen activates

A

intrinsic pathway of blood coagulation

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7
Q

tissue factor activates

A

extrinsic pathway of blood coagulation

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8
Q

exposure to collagen activates intrinsic pathway and stimulates

A

platelet activation

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9
Q

platelets bind to collagen via

A

von willebrand factor (vWF)

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10
Q

von willebrand factor is released from

A

endothelial cells

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11
Q

von willebrand factor binds to collagen fibres and platelets via

A

platelet membrane glycoprotein receptor (GPIb-IX)

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12
Q

platelets can be activated in haemostasis by

A

platelet activating factor (PAF)

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13
Q

what forms initial haemostatic plug in small vessels and initial thrombus in arteries and veins

A

platelets

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14
Q

6 things that activate platelets

A

ADP, adrenaline, collagen, thrombin, PAF, high BP

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15
Q

In platelet activation, most chemicals bind and cause a change in shape from disc to

A

sphere

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16
Q

In platelet activation, change in shape to sphere causes

A

release of compounds involved in haemostasis from granules

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17
Q

Two receptors involved in platelet activation

A

GPIb-IX (von Willebrand Factor) and GPIIa-IIIb (fibrinogen)

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18
Q

In small vessels, blood coagulation factors interact to form secondary fibrin-rich…

A

haemostatic plug

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19
Q

In arteries and veins, blood coagulation factors interact to form secondary fibrin..

A

thrombus

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20
Q

fibrinogen is a precursor of

A

fibrin

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21
Q

Factor I is

A

fibrinogen

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22
Q

prothrombin is a precursor of

A

thrombin

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23
Q

Factor II is

A

Prothrombin

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24
Q

Factor III is (2)

A

Tissue factor (thromboplastin)

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25
What does tissue factor activate?
Factor VII
26
Factor IV is
Calcium ion
27
Factor V is
Proaccelerin/ labile factor
28
2 actions of factor V
activates factor VII, combines with factor X to form prothrombin activator
29
Factor VII is also known as (2)
stable factor, serum prothrombin conversion accelerator
30
action of factor VII
activates factor X - EXTRINSIC PATHWAY
31
Factor VIII also known as
antihaemophilic factor
32
activity of factor VIII
activates factor X - INTRINSIC PATHWAY
33
Factor IX action
activates factor VIII
34
Factor X action
combines with factor V to form prothrombin activator
35
Factor XI action
activates factor IX
36
Factor XII action (3)
activates factorXI and plasmin, converts prekallikrein to kallikrein
37
Factor XIII also known as
fibrin-stabilising factor
38
Factor XIII action
cross linking of fibrin fillaments --> fibrin polymer = stabilises clot
39
role of platelet factor 1 (3)
activates factor VII, combines with factor X to form prothrombin activator, accelerates platelet activation
40
role of platelet factor 2
accelerates thrombin formation
41
role of platelet factor 3 (2)
aids in activation of factor VIII and prothrombin activator
42
role of platelet factor 4
bind heparin during clotting --> inhibit anticoagulant effect
43
3 pathways of blood clotting
extrinsic, intrinsic, common
44
3 lab tests for coagulation
thrombin time, prothrombin time, activated partial thromboplastin time (APTT)
45
Intrinsic pathway only uses clotting factors found in
blood
46
Which lab test is used to test intrinsic pathway
APTT (activated partial thromboplastin time)
47
Intrinsic pathway of coagulation
Platelets degranulate > release factor XII > Factor XI activated > Factor IX activated > calcium ion, PF3 and Factor IX activate Factor VIII > Factor X
48
Extrinsic pathway initiated by clotting factors from sources other than blood released by
damaged blood vessels and perivascular tissues
49
Extrinsic pathway of coagulation
tissue factor > combines with factor VII and calcium ion > activates factors IX and X > greatly accelerates coagulation
50
tissue factor is expressed in all cells other than
endothelial cells
51
clinical test for extrinsic pathway of coagulation
prothrombin time (PT)
52
damaged blood vessels and perivascular tissues release
tissue factor
53
final common pathway of coagulation is tested for by
Thrombin time (TT)
54
final common pathway of coagulation
Factor Xa (from extrinsic or intrinsic) combines with Factor III and V in presence of calcium ion and PF3 > prothrombin activator > acts of factor II > converts to thrombin > chops factor I (fibrinogen) to fibrin > combines with Factor XIII (fibrin stabilising factor) and calcium ion > fibrin polymer
55
fibrin polymer forms structural framework of
blood clot
56
in common pathway, thrombin works with factor V to accelerate production of
prothrombin activator
57
tissue repair is achieved by (2)
clot retraction and damage repair
58
process of clot retraction
after clot formation, platelets adhere to strands of fibrin > fibrin threads pulled > edges of broken vessel pulled together > clot compacts
59
process of damage repair
platelets and endothelial cells secrete platelet derived growth factor (PDGF) > stimulates fibroblasts and smooth muscle cells to multiply > repair damaged blood vessel > fibroblasts invade clot > produce fibrous connective tissue > helps strengthen and seal vessel whilst repair takes place
60
kallikrein action
converts plasminogen to plasmin (a fibrin dissolving enzyme)
61
factor XII catalyses formation of
kallikrein
62
thrombin activates
plasmin
63
most common hereditary clotting disorder
factor V leiden
64
deep vein thrombosis is part of group of problems together known as
venous thromboembolism
65
DVT affects how many /1000 people in UK every year
1/1000
66
3 symptoms of DVT
pain/tenderness of calf, swelling of calf, colour/temperature change of calf
67
risk factors /causes of DVT(12)
dehydration (sticky blood), male, obesity, pregnancy, over 60yrs old, contraceptive pill/ HRT, cancer, heart failure, conditions that cause thrombophilia, damage to inside lining of vein, immobility, spontaneous DVT
68
way of calculating likelihood of DVT (and PE)
Well's score
69
NICE recommended Well's scale is how many levels
2
70
Well's scale for DVT from .... to ....
-2 to 9
71
score on Well's scale meaning unlikely DVT
less that 2
72
score on Well's scale meaning likely DVT
2 or more
73
Well's scale for PE from ... to ...
0 to 12.5
74
Score on Well's scale meaning unlikely PE
4 or less
75
Score on Well's scale meaning likely PE
more than 4
76
D-Dimer test detects
pieces of blood clot that have been broken down and lost in bloodstream
77
D Dimer test isn't always reliable as can increase after (4)
operation, injury, inflammation, pregnancy
78
additional tests to Well's scale assessment needed to confirm DVT such as (2)
ultrasound, venogram
79
4 treatments for DVT
anticoagulation, compressive stockings, regular walking, raising leg when resting
80
2 causes of PE
DVT, embolus which is not clot
81
symptoms of PE (6)
breathlessness, coughing up blood, fever, tachycardia, chest pain, feeling faint
82
treatment for PE (6)
anticoagulants, oxygen, IV fluids, surgery, filters, thrombolysis
83
vitamin K has two types
vitamin K1, vitamin K2
84
vitamin K1 is found in
leafy green vegetables
85
vitamin K2
main storage form in animals
86
what is vitamin K required for? (4)
post-translational modification of certain proteins required for blood coagulation, metabolic pathways, bone, other tissues.
87
what in colon convert vitamin K1 > vitamin K2
bacteria
88
risk factors of blood clot formation (11)
obesity, pregnancy, immobility, smoking, over 60 yrs, diabetes, high BP, high cholesterol, trauma, oral contraceptives, inherited clotting disorders

Sem 2 (11 decks)

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