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Physiology > Blood coagulation > Flashcards

Blood coagulation Flashcards

1
Q

describe the blood clotting process

A
  1. severed or injured blood vessel contract, restrict blood flow
  2. platelets aggregate form hemostatic plug
  3. activation of platelets initiates clotting cascade (fibrin appears)
  4. fibrin clot forms (secondary hemostatic plug)
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2
Q

what causes platelet activation?

A

circulating platelet binds to subendothelial collagen and vWF exposed during injury

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3
Q

T/F platelets do not have a structural change during activation

A

false

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4
Q

What recruits more platelet activation?

A

TxA2 and ADP

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5
Q

aspirin

A

inhibit platelet activation

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6
Q

thrombocyte

A

platelet

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7
Q

thrombocytopenia

A

lack of platelets

more bleeding

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8
Q

thrombocytosis

A

too many platelets

blockage of blood vessels

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9
Q

Draw the coagulation cascade

A

Coagulation PPT Slide 6

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10
Q

What are some coagulation factors?

A

phospholipids, Calcium and Gla proteins

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11
Q

Where are coagluation factors produced?

A

liver, released as zymogens

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12
Q

What do Gla proteins depend on?

A

Vitamin K

due to vitamin K dependent carboxylase

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13
Q

platelet count

A

measures # of platelets in serum

routine in CBC

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14
Q

what is a normal platelet count?

A

150,000-400,000 cells/microL

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15
Q

prothrombin time (PT)

A

rate of clotting by extrinsic and common pathways (usually amount of prothrombin in plasma)

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16
Q

what is normal PT?

A

10-14 seconds

normal INR 1.1

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17
Q

What medication usage should you always order a PT for?

A

warfarin

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18
Q

partial thromboplastin time (PTT)

A

rate of clotting time by intrinsic and common pathways

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19
Q

What is normal PTT?

A

30-42 seconds

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20
Q

activated clotting time

A

bedside test of entire clotting process

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21
Q

hemophilia A

A

factor VIII deficiency

22
Q

afibrinogenemia

A

lack of fibrinogen

23
Q

vonWillebrand Disease (vWF deficiency)

A

missing or defective vWF

24
Q

vWF

A

bind to Factor VIII in serum and stabilizes it

25
Q

Vitamin K deficiency

A

lack of vitamin K

26
Q

What factors does thrombin activate?

A

V, VII, VIII, XI

27
Q

what causes feedback amplification?

A

thrombin

28
Q

Describe the feedback inhibition of clotting

A

thrombin binds thrombomodulin and activates protein C which binds protein S (and Ca).
C-S complex cleaves V, and VIII

29
Q

serpin

A

serine protease inhibitors

regulate cascade by inhibiting coagulation or fibrinolysis

30
Q

antithrombin III

A

irreversibly inactivates thrombin

binds heparin then thrombin, heparin dissociates

31
Q

heparin

A

enhances antithrombin IIIs affinity for thrombin and is used as an anticoagulant

32
Q

fibrinolysis

A

dissolving of the clot

33
Q

plasminogen

A

plasma protein that is incorporated into clot during coagulation

34
Q

what causes proteolysis of plasminogen (creates plasmin)?

A

tissue plasminogen activator (tPA)

urokinase (U-PA)

35
Q

plasmin

A

protease that cleaves fibrin and clotting factors

36
Q

where is tPA synthesized?

A

vascular endothelial cells

37
Q

where is urokinase produced?

A

most tissues

38
Q

what increase the synthesis and release of tPA and UPA?

A

stress

hypoxia

39
Q

What two things can you treat a MI or stroke?

A

tPA

streptokinase

40
Q

hemostatic balance

A

the balance of coagulation and fibrinolysis

41
Q

hypercoagulation

A

stroke, MI, thrombosis

42
Q

hypocoagulation (too much fibrinolysis)

A

trauma, major surgery, hemophilia

43
Q

Deficiency in Factor VIII

A

hypocoagulation

44
Q

advanced liver disease

A

hypocoagulation

45
Q

deficiency in protein C

A

hypercoagulation

46
Q

vitamin K deficiency

A

hypocoagulation

47
Q

mutation in factor V at protein C cleavage site

A

hypercoagulation

Factor V Leiden

48
Q

platelet deficiency

A

hypocoagulation

thrombocytopenia

49
Q

Deficiency in Factor IX

A

hypocoagulation

hemophilia B

50
Q

What are the 5 types of common coagulation disorders?

A

1- diffuse intravascular coagulation (DIC)
2- thrombocytopenias
3- clotting factor deficiencies
4- drug induced hypocoagulation
5- effects of surgery on coagulation (hypercoagulative effects)

51
Q

What are the three drugs that cause hypocoagulation?

A

asprin and antiplatelet
warfarin
heparin

Physiology (13 decks)

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