chapter 4-2

Question 1

secondary hemostasis s/s

Answer 1

deep tissue bleeding into muscles/joint- after sx-circumcision/wisdom teeth
LAB= PT/PTT effected

Question 2

coagulation cascade generates thrombin which does?

Answer 2

converts plt plug’s fibrinogen to fibrin = stable plt fibrin thrombus

Question 3

activation of secondary hemostasis-coagulation cascade factors from liver inactived and floating around-

Answer 3

factor 7- exposure to Tissue tromboplastin=TT
factor 12- exposure to Subendothelial collagen activator =SEC
phospholipid on plt surgace
Ca from plt dense granules

Question 4

clotting cascade

Answer 4

goal is to get to 10
12-11-9-8 - 10 -5-2-1 =PTT and SEC
7-10-5-2-1=PT and TT

Question 5

Hemophilia A

Answer 5

A=8 X linked R or new mutation
8 (12-11-9-8 think PTT) PTT increase not PT
normal PLT count and BT
recombinant F-8
mixing study- resolves issue

Question 6

hemophilia B

Answer 6

B=9
9 (12-11-9-8 think PTT) PTT increase no PT
normal PLT count and BT

Question 7

Coagulation factor inhibitor

Answer 7

Antibodies against F-8 most common
no 8 (12-11-9-8 increase in PTT not PT)
Mixing of normal plasma does not help!

Question 8

von Willebrand dz

Answer 8

most common inherited coagulation d/o
AD- dec in vWF- needed for plt plug adhesion and stabilizing F8
INCREASE BT and PTT normal PT- no deep bleeding.
ABNORMAL RISTOCETIN TEST

Question 9

von Willebrand Dz test

Answer 9

Ristocetin test- induce plt aggregation by making vWF bind plt GP1B- but if + no vWF from weibel palade bodies of endo cells

Question 10

Vit K activation

Answer 10

Vit K uptaken in gut by microbe go to liver activated by epoxide reductase. Activated K gamma carboxylates 2, 7, 9,10 C&S so they can function.