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Heme > Blood clotting + Drugs > Flashcards

Blood clotting + Drugs Flashcards

1
Q

Primary Hemostatsis

A
  1. Collagen exposed
  2. calls in uncoild VWF”
  3. bind to collagen domain A3 and A1 (on VWF) to prep for platelets
  4. Chef VWF lasagna - col, VWF,Plat, VWF, Plat

“TTP cant break down VWF

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2
Q

Secondary Hemostatsis

A
  1. sauce added - clotting factors 7, 9, 11, 10 and spicy - 8, 5
  2. creates sticky cross link of everything
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3
Q

Intrinsic clotting pathway

A

the side bars are the tests to see what is deficent
DRVVT- test for ani-phosplipid syndrom or lupus anti-coag

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4
Q

Platelet Bleeding problems

A

VWF or Platelets
1. mucosal
2. skin - bruising

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5
Q

Clotting bleeding problems

A
  1. joints
  2. muscles
  3. spotaneous
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6
Q

Virchow Triad

A

Reason: Thrombotic disorder
Symptoms:
1. trubulant and abnormal blood flow
2. think or inflammed vessel walls
3. abnormal coag, fibrinolytic, platelet
Findings:
Labs:

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7
Q

Which clotting is more abundant in which for Arterial vs. Venous

A

Arterial - Platelet rich bc high flow to so cure = antiplatelet
Venous - lower flow and so fibrin-rich so use antifibrinolytics

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8
Q

Platelet functions

A
  1. hemeostasis
  2. Inflammation
  3. immunity and immune system building
  4. atherosclerosis
  5. cancer
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9
Q

Platelet maturation

A
  1. Thrombopoietin (Liver 90% 10% kidney)
  2. megakaryoblast
  3. Megakaryocte
  4. then becomes platelets and dont have a nucleous
  5. first action to a bleed
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10
Q

Platelet stats

A
  1. 7-10 lifespan
  2. 150-450 normal
  3. STIM BY TPO
  4. 1/3 held in spleen and all destryoed in the spleen
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11
Q

Thrombocytopenia

A

Reason: Low Platelets < 150
Symptoms: Petechiae/purpura (blood dotted skin), Spontaneous mucosal bleeding, prolonged bleeding, easy brusing
Findings: Decrease productions, increased destruction, splenic sequestration (blood staying in spleen)
Labs:

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12
Q

Thrombocytosis

A

Reason: increased platelets > 450
Symptoms: increased arterial and venous thrombosis
Findings: Inflammation, infection, splenectomy, neoplasm
Labs:

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13
Q

Von WilleBrand Factor Characteristics

VWF

A
  1. made by endo cell
  2. floats with VIII to protect inactivation
  3. helps platelets adhere (GP- Ib)
  4. largest and most effective multimers
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14
Q

Platelets adherence to Endo

A

4 receptors 2 top and 2 bottom
1. bottom binds to VWF (GP-Ib) and collagen
2. top binds to collagen and fibrinogen
once intial contact TXA and ADP strengthen the adhesion and stim growth for 2nd layer

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15
Q

Glanzmann Thrombasthenia

A

lack of GP2b/3a and cant bind to fibrogen

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16
Q

Bernard-Soulier Syndrome

A

lack of G1b no platelet to VWF

17
Q

Von Willebrand disease

A

unable to do Platelet to endo

18
Q

Thrombin Burst/ feedback loop

A

aThrobin goes and actives factor 5a, 8a, 11a

19
Q

What are the prothrombic Co-Factors

A
  1. 7a binds with TF
  2. Tenase complex - 9a + 8a
  3. Protrombinase complex 10a + 5a
20
Q

Fibrogen

A

dimeric head to head and has 3 chains alpah, beta and gamma
made in the liver 200-400
bind to gp2b/3a

21
Q

Factor 13 and 13a position and role

A

13a convalently links the fibirn polymers Alpha to gamm
activated by thrombin
made in liver and stored in platelets
HL - 19 days

22
Q

Fibrinoolysis and inhibition of it

A
  1. TPA gets relased by endo and bind to PLG -> Plasmin
  2. Plasmin cleaves fibrin and the Lysine accelerates tpa PLG binding
  3. INHIBITORS
    TAFI - binds the lysine
    Alpha2-antiplasmin - binds plasmin
    PAI-1- bind TPA (both come from endo cells)
23
Q

IIa coag function

A

it is Thrombin and starts the postitve feedback loop

24
Q

IIa anti coag function

A
  1. IIa binds to Endo protien C - R = APC
  2. APC inactivates F8a and F5a (s is a confactor)
    synthesised in liver
25
Q

What are the natural anticoag

A
  1. IIa (8a and 5a)
  2. TFPI ( blocks TF + 7a, made in endo)
  3. Antithrombin (binds heprin to eno walls, enhanced by heprin and made in liver)
26
Q

Contact activation system

A

Players - F12, F11 and Prekallikrein wl HMWK as cofactor
1. 12a actives intrisic pathway (HMWK cofactor)
2. 12a cleaves prekallikerin to kallikerin to autoactivate 12a

27
Q

aPTT test

A

intrisic pathway with kaolin/silica 30-35 sec

28
Q

PT test

A

Direct factors with TF - 10-12 seconds

29
Q

Reptilase time

A

marker for thrombin problems as it is the same time

30
Q

TEG or Rotem

A

Test Clot formation via oscillation

Heme (6 decks)

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