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B&R Final > Blood Coagulation Cascade and Reg Factors > Flashcards

Blood Coagulation Cascade and Reg Factors Flashcards

1
Q

Define hemostasis

A

Prevent blood loss

  • Damage? Stop bleeding
  • Normal conditions? Maintain fluidity
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2
Q

Define thrombosis

A

Form a clot or thrombus inside an intact blood vessel

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3
Q

Hemostasis and thrombosis involved what components?

A

Vascular endothelium
Platelets
Coag system
Fibrinolytic system

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4
Q

Coagulation cascade has what pathways involved?

A

Extrinsic
Intrinsic
Common

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5
Q

Vitamin K depedent factors are?

A

2, 7, 9 and 10

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6
Q

Contact activated factors are?

A

12, prekallikrien, high molecular weight kininogen

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7
Q

Thrombin sensitive factor

A

1, 5, 8, 11, 13

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8
Q

Hematostasis events

A

Localized vascular spasms
Primary hemostasis (loose plug)
Secondary hemostasis
Clot dissolution

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9
Q

Localized Vasoconstriction

A

Mediated by reflex neurogenic mechanisms –> increase Ca within SMC

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10
Q

Primary Hemostasis

A

Platelet adhesion
Platelet activation
Platelet aggregation
Form primary platelet plug

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11
Q

Platelet Adhesion

A

via von Willebrand Factor binds to GPIb (bridge between platelet and collagen)

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12
Q

Platelet Activation

A

release TxA2 which leads to platelet aggregation and activating vasoconstrictors

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13
Q

Platelet Aggregation

A

TxA2, PAF, ADP call other platelets to aggregate via fibrinogen

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14
Q

Secondary Hemostasis

A 
Extrinsic Pathway (rapid response via initial coag)
Inhibited by TFPI but the thrombin activates the intrinsic pathway
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15
Q

Intrinsic pathway does what?

A

Activates Thrombin-sensitive factors 5, 8 and 11 which boost thrombin production

  • Promotes platelet activation
  • Converts fibrinogen into fibrin
  • Activated Factor 8
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16
Q

What does Thrombin do?

A

Promotes platelet activation and aggregation via proteases activated receptors
Catalyze fibrinogen to fibrin
Activates factor 8 which stabilizes platelet aggregation

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17
Q

OVERALL Secondary hemostatis is to do what?

A

Stabilize the initial soft clot

Takes longer than primary

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18
Q

Platelet Function

A

CONTAIN ONLY COX1
Bind exposed collagen
Increased Ca and PKC activation = more platelets
TxA2 stimulates new platelets and more aggregation

19
Q

Dense granules are?

A

ADP and ATP, ionized calcium

Released first

20
Q

Alpha granules are?

A

von Willebrand factor
Fibrinogen
Factor V and VIII

21
Q

ADP does what?

A

Activates P2Y1 which activate phospholipase C –> increase Ca
P2Y12 inhibits adenylyl cyclase –> bind fibrogen

22
Q

Pro-coagulant Properties

A

Promote adhension (VWF)
Anti-fibronlytic
Release of tissue factors (trigger entrinsic)

23
Q

Anticoagulant properties are?

A

Inhibit activation and aggregation (ADP, NO)
Release anticoagulants (TFPI)
Fibrinolytic properties

24
Q

Extrinsic Pathway MOA?

A

TF forms complex with VII which activates X which creates thrombin

25
Q

Intrinsic Pathway MOA?

A

Form HMWK, PK and Factor XII

XII –> XI –> IX + VIII (tenase) + Ca –> X

26
Q

Common Pathway

A

X + V = prothrombinase complex –> prothrombin –> thrombin

Thrombin: fibrinogen –> fibrin & Factor XIII –> crosslinking

27
Q

PAR1 and PAR4 activation leads to

A

platelet activation

28
Q

Pro-Thrombin effects are?

A 
Activated PAR 1 and PAR4
Factor V, VIII, XI
Fibrinogen to fibrin
Factor XIII
Activation of TAFI
29
Q

Anti-Thrombin effects are?

A

Activated Protein C

APC degrades factor Va/Viii

30
Q

Mutation in Factor V does what?

A

Prevents breakdown via APC –> thrombophilia

31
Q

Antithrombin

A

Targets intrinsic pathway factors (X and II)

Heparin increases catalytic activity

32
Q

TFPI

A

Inhibits Factor X which inhibits vWF –> No more X

33
Q

Tissue Plasminogen Activator

A

Cleaves fibrin from plasmin and degrades fibrin

34
Q

Vitamin K

A

Required to activate Factors II, VII, IX, X + protein S/C

35
Q

Calcium and phospholipids required for

A

Tenase (VIII + IX) and prothrombinase complexes

aka clotting

36
Q

Blood test for extrinsic pathway?

A

Prothrombin time

37
Q

Blood test for intrinsic pathway?

A

Activated partial Thromboplastin Time

38
Q

Prothrombin Time Test

A

Blood sample + calcium chelator
TF + phospholipids are added
Finally calcium to initiate the test
Range is 12-14 seconds (>20 = deficiency)

39
Q

Activated Partial Thromboplastin TIme

A

Negative phospholipids + particulate is added to citrated plasma
Add Ca and test is initiated
Clot formation time is measured
Range is 26-33 sec

40
Q

If you have prolonged aPTT and PT you have a defect in?

A

Common coagulation pathway

41
Q

Hemophilia A

A

Fact VIII deficent

42
Q

Hemophilia B

A

Fact IX

43
Q

Hemophilia C

A

Fact XI

B&R Final (9 decks)

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