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Biochemistry > Blood Coagulation and Wound Healing Pt. 2 > Flashcards

Blood Coagulation and Wound Healing Pt. 2 Flashcards

1
Q

What is the source of the growth factor TNF-alpha?

A

macrophages, T-lymphocytes

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2
Q

What is the source of the growth factor TGF-alpha?

A

activates macrophages, platelets, epithelial cells, injured cells

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3
Q

_____ are found during the inflammatory phase.

A

macrophages, neutrophils

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4
Q

Can disease states interfere with wound healing and progression?

A

absolutely (diabetes, venous/arterial disease, old age, infection)

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5
Q

The ____ takes citrated plasma and then adds calcium and thromboplastin to the test tube to evaluate the presence of clotting factors in the blood sample.

A

prothrombin test

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6
Q

What is ACD anticoagulant?

A

Acid Citrate Dextrose Solution is a solution of citric acid, sodium citrate, and dextrose in water

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7
Q

Drugs that prevent blood coagulation are:

A

Warfarin, Pradaxa, Xarelto, Eliquis, Plavix

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8
Q

Does plasma contain clotting factors?

A

YES

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9
Q

What is the source of the growth factor IL-1?

A

macrophages

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10
Q

What are the functions of IL-1?

A

fibroblast proliferation

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11
Q

Patients with a _____ deficiency (Glanzmann’s thrombasthenia) may experience hematoma, prolonged or excessive bleeding, nosebleeds, and petechiae.

A

GPIIb/IIIa

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12
Q

What is the source of the growth factor EGF?

A

plasma, platelets, macrophages, epithelial cells

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13
Q

Which growth factors inhibit fibroblast proliferation?

A

IFNs

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14
Q

The prothrombin time is a measure of the integrity of the _______ and ______ pathways of the coagulation cascade.

A

extrinsic; common

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15
Q

What is the source of the growth factor IFNs?

A

lymphocytes, fibroblasts

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16
Q

What are the functions of IGF-1?

A

synthesis of sulfated proteoglycans and collagen, fibroblast proliferation

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17
Q

_____ are found during the remodeling phase.

A

collagen fibers

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18
Q

What does the prothrombin test evaluate the presence of?

A

prothrombin (II), fibrinogen, factors X, V, and VII (components of the extrinsic and common pathway)

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19
Q

What are the functions of EGF?

A

epithelial cell proliferation, granulation tissue formation

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20
Q

Which growth factors induce fibroblast proliferation?

A

PDGF, TGF-beta, IL-1, FGF, TNF-alpha, IGF-1

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21
Q

When the INR is higher than the recommended range, it means your blood clots ____, and a lower INR means your blood clots ____.

A

slowly; quickly

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22
Q

Which blood thinning drugs have rapid onset and rapid wear off?

A

Pradaxa, Xarelto, Eliquis

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23
Q

What are the functions of TGF-beta?

A

induces fibroblast proliferation, chemotaxis, collagen metabolism

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24
Q

How important is it that these wound healing steps are made in a sequential order?

A

VERY important

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25
Q

How does Warfarin reduce the synthesis of active clotting factors and induce blood thinning?

A

by depleting the functional vitamin K reserves

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26
Q

Patients with a _____ deficiency (Bernard Soulier) may have increased nosebleeds, spontaneous bleeding, petechiae and heavy periods.

A

GPIb

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27
Q

What are the functions of TNF-alpha?

A

fibroblast proliferation

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28
Q

The extrinsic pathway can compensate for the impaired intrinsic coagulation pathway seen in patients with a _____ mutation because either pathway can activate the needed proteins.

A

kallikrein

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29
Q

What are the functions of KGF?

A

epithelial cell proliferation

30
Q

_____ are found during the proliferation phase.

A

fibroblasts, myofibroblasts, granulation tissue, keratinocytes, endothelial cells

31
Q

What happens during the inflammatory phase?

A

bacteria and debris are phagocytosed by WBCs; factors are released that cause migration and division of cells

32
Q

What happens during the remodeling phase?

A

collagen is remodeled along along tension force lines and some cells are removed via apoptosis

33
Q

_____ syndrome isa bleeding disorder caused by defective scrambling of membrane phospholipids such as the exposure of phosphatidylserine (PS) on the outer surface.

A

Scott

34
Q

How does ACD work?

A

citrate disrupts the coagulation cascade by binding the citrate compounds to the calcium in the blood; reducing calcium in the blood inhibits the start and regulation of the clotting cascade

35
Q

Hemophilia is an _____ disease.

A

X-linked recessive

36
Q

Why would someone get a prothrombin test?

A

it is often used for people who take blood thinning medications

37
Q

What is the source of the growth factor PDGF?

A

platelets, macrophages, endothelial cells, injured cells

38
Q

What are the functions of FGF?

A

fibroblast proliferation, matrix deposition, wound contraction angiogenesis

39
Q

A mutation in the ____ gene causes bleeding of the gums and blood in the urine. It can cause factor X deficiency (type I) or impair factor X protein function (type II).

A

F10

40
Q

If the INR is greater than 5, the person ___ clot.

A

cannot

41
Q

How could a clinical neutralize the effects of Warfarin?

A

by administering a massive dose of vitamin K to the patient

42
Q

What is the source of the growth factor IGF-1?

A

plasma, liver, fibroblasts

43
Q

Why is the Internationalized Normalized Ratio (INR) used for the prothrombin test?

A

because the reagents used are different for each lab and change over time

44
Q

What are the functions of PDGF?

A

induces chemotaxis, fibroblast proliferation, collagenase production

45
Q

A decrease in the blood concentration of calcium will ____ the clotting cascade.

A

halt

46
Q

Which blood thinning drug requires frequent monitoring?

A

Warfarin

47
Q

_____ induce the sequential phases of wound healing.

A

Released growth factors

48
Q

A _____ is a test used to help detect and diagnose a bleeding disorder or excessive clotting disorder.

A

prothrombin time (PT)

49
Q

Why does Warfarin have interactions with food?

A

because the amount of vitamin K in the diet can have an effect on the INR

50
Q

The mutation of factor ____ leads to an overproduction of prothrombin, which leads to more thrombin, which promotes the formation of blood clots.

A

II

51
Q

What is the source of the growth factor TGF-beta?

A

macrophages, platelets, neutrophils, lymphocytes, fibroblasts, epithelial and endothelial cells, injured cells

52
Q

The most common mutation in people with severe hemophilia A is a rearrangement of genetic material called ______.

A

inversion

53
Q

What are the functions of IFNs?

A

inhibition of fibroblast proliferation and collagen synthesis

54
Q

An INR of ___ or below is considered normal.

A

1.1

55
Q

How does the drug Pradaxa work?

A

It is a direct thrombin inhibitor (IIa)

56
Q

_____ are found during the hemostatic phase.

A

red blood cells, platelets

57
Q

What part of the clotting cascade do the drugs Xarelto and Eliquis inhibit?

A

Factor Xa

58
Q

Does serum contain clotting factors?

A

NO

59
Q

Hemophilia ___ is the decreased synthesis of factor IX (9) and is treated with recombinant factor IX.

A

B

60
Q

What is the source of the growth factor KGF?

A

fibroblasts

61
Q

Why does depleting the vitamin K reserves prevent blood clotting?

A

because the synthesis of coagulation factors II, VII, IX, and X, as well as protein C and S require the presence of vitamin K to function (Vitamin K is an ESSENTIAL cofactor)

62
Q

S-warfarin is the most active isomer of warfarin. How does it control the production of vitamin K?

A

by inhibiting vitamin K reductase, thereby preventing the reduction and activation of oxidized vitamin K

63
Q

What happens during the proliferative phase?

A

angiogenesis, collagen deposition, granulation tissue formation, epithelialization, wound contraction

64
Q

The stem cell niche, where the classic model of would healing begins, is located in the ______.

A

bone marrow

65
Q

A shortage of coagulation factor VII can be caused by a mutation of the F7 gene and can cause episodes of ____ bleeding.

A

abnormal

66
Q

Even though both are clot busters, TPA works ____ in the blood, while plasmin works ____.

A

systemically; locally/regionally

67
Q

What is the classic model of wound healing?

A

hemostasis > inflammatory > proliferative > remodeling

68
Q

Warfarin competitively inhibits the _______ complex, which is an essential enzyme for activating the ____ available in the body.

A

vitamin K epoxide reductase (VKORC1); vitamin K

69
Q

What happens during the hemostasis/coagulation phase?

A

platelets aggregate at the injury site and prompt the formation of a fibrin clot

70
Q

Hemophilia ___ is the decreased synthesis of factor VIII (8) and is treated with recombinant factor VIII.

A

A (“A”ight)

71
Q

What is the source of the growth factor FGF?

A

pituitary, macrophages, fibroblasts, endothelial cells

72
Q

What are the functions of TGF-alpha?

A

epithelial cell proliferation, granulation tissue formation

Biochemistry (17 decks)

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