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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
Q

What does tissue factor activate?

A

Factor VII

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26
Q

Factor IV is

A

Calcium ion

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27
Q

Factor V is

A

Proaccelerin/ labile factor

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28
Q

2 actions of factor V

A

activates factor VII, combines with factor X to form prothrombin activator

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29
Q

Factor VII is also known as (2)

A

stable factor, serum prothrombin conversion accelerator

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30
Q

action of factor VII

A

activates factor X - EXTRINSIC PATHWAY

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31
Q

Factor VIII also known as

A

antihaemophilic factor

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32
Q

activity of factor VIII

A

activates factor X - INTRINSIC PATHWAY

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33
Q

Factor IX action

A

activates factor VIII

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34
Q

Factor X action

A

combines with factor V to form prothrombin activator

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35
Q

Factor XI action

A

activates factor IX

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36
Q

Factor XII action (3)

A

activates factorXI and plasmin, converts prekallikrein to kallikrein

37
Q

Factor XIII also known as

A

fibrin-stabilising factor

38
Q

Factor XIII action

A

cross linking of fibrin fillaments –> fibrin polymer = stabilises clot

39
Q

role of platelet factor 1 (3)

A

activates factor VII, combines with factor X to form prothrombin activator, accelerates platelet activation

40
Q

role of platelet factor 2

A

accelerates thrombin formation

41
Q

role of platelet factor 3 (2)

A

aids in activation of factor VIII and prothrombin activator

42
Q

role of platelet factor 4

A

bind heparin during clotting –> inhibit anticoagulant effect

43
Q

3 pathways of blood clotting

A

extrinsic, intrinsic, common

44
Q

3 lab tests for coagulation

A

thrombin time, prothrombin time, activated partial thromboplastin time (APTT)

45
Q

Intrinsic pathway only uses clotting factors found in

A

blood

46
Q

Which lab test is used to test intrinsic pathway

A

APTT (activated partial thromboplastin time)

47
Q

Intrinsic pathway of coagulation

A

Platelets degranulate > release factor XII > Factor XI activated > Factor IX activated > calcium ion, PF3 and Factor IX activate Factor VIII > Factor X

48
Q

Extrinsic pathway initiated by clotting factors from sources other than blood released by

A

damaged blood vessels and perivascular tissues

49
Q

Extrinsic pathway of coagulation

A

tissue factor > combines with factor VII and calcium ion > activates factors IX and X > greatly accelerates coagulation

50
Q

tissue factor is expressed in all cells other than

A

endothelial cells

51
Q

clinical test for extrinsic pathway of coagulation

A

prothrombin time (PT)

52
Q

damaged blood vessels and perivascular tissues release

A

tissue factor

53
Q

final common pathway of coagulation is tested for by

A

Thrombin time (TT)

54
Q

final common pathway of coagulation

A

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
Q

fibrin polymer forms structural framework of

A

blood clot

56
Q

in common pathway, thrombin works with factor V to accelerate production of

A

prothrombin activator

57
Q

tissue repair is achieved by (2)

A

clot retraction and damage repair

58
Q

process of clot retraction

A

after clot formation, platelets adhere to strands of fibrin > fibrin threads pulled > edges of broken vessel pulled together > clot compacts

59
Q

process of damage repair

A

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
Q

kallikrein action

A

converts plasminogen to plasmin (a fibrin dissolving enzyme)

61
Q

factor XII catalyses formation of

A

kallikrein

62
Q

thrombin activates

A

plasmin

63
Q

most common hereditary clotting disorder

A

factor V leiden

64
Q

deep vein thrombosis is part of group of problems together known as

A

venous thromboembolism

65
Q

DVT affects how many /1000 people in UK every year

A

1/1000

66
Q

3 symptoms of DVT

A

pain/tenderness of calf, swelling of calf, colour/temperature change of calf

67
Q

risk factors /causes of DVT(12)

A

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
Q

way of calculating likelihood of DVT (and PE)

A

Well’s score

69
Q

NICE recommended Well’s scale is how many levels

A

2

70
Q

Well’s scale for DVT from …. to ….

A

-2 to 9

71
Q

score on Well’s scale meaning unlikely DVT

A

less that 2

72
Q

score on Well’s scale meaning likely DVT

A

2 or more

73
Q

Well’s scale for PE from … to …

A

0 to 12.5

74
Q

Score on Well’s scale meaning unlikely PE

A

4 or less

75
Q

Score on Well’s scale meaning likely PE

A

more than 4

76
Q

D-Dimer test detects

A

pieces of blood clot that have been broken down and lost in bloodstream

77
Q

D Dimer test isn’t always reliable as can increase after (4)

A

operation, injury, inflammation, pregnancy

78
Q

additional tests to Well’s scale assessment needed to confirm DVT such as (2)

A

ultrasound, venogram

79
Q

4 treatments for DVT

A

anticoagulation, compressive stockings, regular walking, raising leg when resting

80
Q

2 causes of PE

A

DVT, embolus which is not clot

81
Q

symptoms of PE (6)

A

breathlessness, coughing up blood, fever, tachycardia, chest pain, feeling faint

82
Q

treatment for PE (6)

A

anticoagulants, oxygen, IV fluids, surgery, filters, thrombolysis

83
Q

vitamin K has two types

A

vitamin K1, vitamin K2

84
Q

vitamin K1 is found in

A

leafy green vegetables

85
Q

vitamin K2

A

main storage form in animals

86
Q

what is vitamin K required for? (4)

A

post-translational modification of certain proteins required for blood coagulation, metabolic pathways, bone, other tissues.

87
Q

what in colon convert vitamin K1 > vitamin K2

A

bacteria

88
Q

risk factors of blood clot formation (11)

A

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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