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Hematology > Ch24 Hemostasis > Flashcards

Ch24 Hemostasis Flashcards

0
Q

What is the major role of the hemostatic system?

A

Maintaining a complete balance of the body’s tendency toward clotting and bleeding

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1
Q

What is the complex process by which the body spontaneously stops bleeding and maintains blood in the fluid state within the vascular compartment?

A

Hemostasis

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2
Q

When do the clinical signs and symptoms of hemorrhage occur?

A

When the vascular injury exceeds the capacity of the platelets

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3
Q

What stage of hemostasis refers to the response to vascular injury that produced a platelet plug at the site of damage

A

Primary

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4
Q

Which stage of hemostasis involves the enzymatic activation of the coagulation proteins to produce fibrin from fibrinogen?

A

Secondary

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5
Q

How is secondary hemostasis activated?

A

By the release of tissue factor from epithelial cells that are exposed to the circulation site of the vascular injury

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6
Q

What involves the proteolytic digestion of fibrinogen and fibrin by the enzyme plasmin?

A

Fibrinolysis

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7
Q

What are the 2 main types of bleeding?

A

Mucocutaneous hemorrhage

Joint bleeding

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8
Q

It takes about 1 week for maturity from _______ to produce platelets?

A

Megakaryblast

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9
Q

Platelets survive _____ days in circulation

A

7-10

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10
Q

What is the normal platelet count?

A

150,000-400,000/uL

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11
Q

Platelet activation includes:

A

Change of shape
Adhesion
Aggregation
Secretion

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12
Q

Platelets are involved in the nurturing of endothelial cells lining which system?

A

Vascular

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13
Q

Platelet receptors bind to the vascular endothelium in a(n) _______ process

A

Adhesion

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14
Q

Platelets undergo a ______ which is a sensitive parameter of platelet activation.

A

Shape change

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15
Q

Platelet to platelet interaction is known as:

A

Aggregation

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16
Q

When does aggregation of platelets occur?

A

10-20 seconds after vascular injury

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17
Q

What is required to activate the second phase of aggregation?

A

ADP from dense granules

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18
Q

What is the last stage involved in arresting bleeding after vessel damage?

A

Stabilization

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19
Q

What is achieved through the activation of coagulation cascades and formation and deposition of fibrin?

A

Stabilization

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20
Q

What is the end product of coagulation?

A

Fibrin

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21
Q

What is simultaneously activated during the process of clot formation?

A

Fibrinolysis

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22
Q

When is fibrinolytic activated?

A

The final stage of clot formation

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23
Q

What is a widely used antithrombotic agent for the clinical treatment of arterial thrombi?

A

Aspirin

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24
Q

Aspirin inhibits:

A

The action of specific enzymes

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25
Q

What is the purpose of fibrin clot formation?

A

To reinforce the platelet plug (primary hemostasis)

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26
Q

How is secondary hemostasis started?

A

By the release of tissue factors from epithelial or endothelial cells exposed to a vascular injury

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27
Q

What does a defect in the secondary hemostasis cause?

A

Decrease fibrin production and reduce the stability of the formed clot

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28
Q

Where are all coagulation proteins produced?

29
Q

What are the 3 main categories of hemostatic function?

A

Substrate
Cofactors
Enzyme category

30
Q

What is the main substrate of the blood coagulation system?

A

Factor I, fibrinogen

31
Q

Proteins that accelerate the enzymatic reaction involving the coagulation process is known as what?

32
Q

What are the 3 groups of physical properties of the classification of coagulation?

A

Contact proteins
Prothrombin proteins
Fibrinogen or thrombin-sensitive proteins

33
Q

What proteins are involved in the initial phage of intrinsic system activation?

A

Contact proteins

34
Q

What group contains a unique amino acid necessary for calcium binding and attraction of coagulation factors?

A

Prothrombin group

35
Q

During coagulation, generated thrombin acts on all the factors in the _________ group

A

Fibrinogen

36
Q

The process of blood coagulation requires:

A

Plasma proteins
Phospholipids
Calcium

37
Q

What 3 coagulation pathways can lead to fibrin formation?

A

Extrinsic
Intrinsic
Common

38
Q

According to the ________ theory, each coagulation factor is converted to its active form by the preceding factor in a series of biochemical chain reactions

39
Q

What are the consequence elf factor deficiency?

A

Coagulation can’t proceed at normal rate
Initiation of next reaction is delayed
Time required for clot to form is prolonged
Bleeding continues for a longer time

40
Q

What term is used to describe a pathways that is initiated when tissue factor enters the vascular system

41
Q

What term is used to describe a pathways in which all factors necessary for clot formation are found within the circulating blood

42
Q

In the extrinsic pathway, factor VII is activated to factor VIIA in the presence of:

A

Calcium and tissue factor

43
Q

The activation of what factor initiates clotting through the intrinsic pathway?

A

Factor XII

44
Q

What factor converts factor XII to XIa in the intrinsic pathway?

A

Factor XIIa

45
Q

What testis used to evaluate the intrinsic pathway?

A

Activated partial thromboplastin time (APTT) test

46
Q

What is the major protein in the factor VIII complex?

A

The carrier protein von willebrand factor

47
Q

What does vWF have the ability to do?

A

Bind to the platelet membrane receptors

Role in anchoring the platelet plug to the vessel breach

48
Q

How does the common pathways begin?

A

By the activation of factor X

49
Q

What test(s) can be used to identify defects and deficiencies occurring in the pathways?

50
Q

Thrombin acts of fibrinogen to form:

A

Fibrin monomers

51
Q

Fibrinogen is composed of 3 pairs of polypeptide chains

A

2 alpha
2 beta chains
2 gamma chains

52
Q

What is the process of removing unwanted fibrin deposits called?

A

Fibrinolysis

53
Q

Plasmin acts mainly on fibrin to produce:

A

Lysis of the clot

54
Q

What system is important for inflammation, vascular permeability and chemotaxis?

A

Kinen system

55
Q

The activation of factor ____ acts as th common link between many of th hemostatic mechanisms

56
Q

What system is composed of approx 22 serum proteins, working together with antibodies and clotting factors, playing an important Rolf as mediators of both immune and allergic reactions?

A

Complement system

57
Q

What is the most important biological role of the complement system?

A

The production of cell membrane lysis of antibody coated target cells

58
Q

What are some common lab tests used for screening for hemostatic disorders

A 
Platelet count
Peripheral blood smear
IBT
PT
APTT
59
Q

What tests measure plasma recalcification times accelerated by that’d diction of a thromboplastic substance?

60
Q

What test measured factors of the extrinsic and the common pathways of coagulation

61
Q

What is the method of choice for PT reporting?

A

International normalized radio (INR)

62
Q

A PT test will detect:

A

Vitamin K defect
Liver disease
Presence of inhibitors

63
Q

What activities are involved in the normal formation of a platelet plug?

A

Activation
Adhesion
Aggression
Release reaction

64
Q

What product is responsible for stabilization of the hemostatic plug?

65
Q

What factors are unique to the extrinsic system?

A

Factors III, VII

66
Q

What factors are unique to the intrinsic pathways?

A

XII
XI
IX
VIII

67
Q

What are the common pathways factors?

A

X, V, III, thrombin and I-fibrinogen

68
Q

What is a function of thrombin?

A

Conversion of fibrinogen to fibrin

69
Q

What is a function of plasmin?

A

Destruction of fibrin

70
Q

What is the purpose of the PT test in monitoring hemostasis?

A

Measures factors of the extrinsic pathway

71
Q

What is the purpose of the APTT test in monitoring hemostasis?

A

Monitoring heparin anticoagulation

Hematology (10 decks)

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