Clotting Flashcards
1
Q
vit k is an essential _____ for _____ enzyme involved in the production of ______ and _____
A
coenzyme
carboxylase
prothrombin and blood clotting factors
2
Q
Carboxylase enzyme requires carboxylation of the _______ at _____ carbon of the factors
A
glutamic acid
gamma
3
Q
carboxylated prothrombin contains —— carboxylate groups
A
2
4
Q
coagulation system in humans is normally in a (static or dynamic?) state
A
Dynamic
5
Q
COAGULATION
-is the process by which blood looses its ____ and becomes a ____
A
fluidity
jelly like mass
6
Q
TYPES OF THROMBUS
White thrombus=
-_____+____+_____
-common in places where blood flow is _____(_____)
A
platelet + fibrin + low rbc
rapid
7
Q
TYPES OF THROMBUS
Red thrombus
- ____+____
- resembles clot formed in a ____
- common in ____
A
red blood cells + fibrin
testube
8
Q
TYPES OF THROMBUS
Fibrin deposits
-common in ____
A
capillaries
9
Q
NATURAL BODY MECHANISM
-secretion of ____ and ____
A
prostacyclin
nitric oxide
10
Q
heparin sulfate in the blood binds to _____ to _______ clotting factors ____,___,__,___,___ (covers ___% of antithrombin activity)
A
antithrombin3
inhibit or degenerate
7,9,10,11 and 12
75
11
Q
________ contributes most of the rest of the antithrombin activity
A
2-macroglobulin
12
Q
_______ and _______ are minor inhibitors under physiologic conditions
A
heparin cofactor 2 and 1-antitrypsin
13
Q
thrombomodulin binds to _____ to activate ______ that would inhibit clotting factors ___ and ___
A
thrombin
protein C
5 and 8
14
Q
HEPARIN
- produced by the ____
- an (acidic or alkaline?) ____ that _____ ———
- Destroyed by ____
- binds to a specific _____ site of _____
- induces a conformational change to promote its binding to —— and other substrates
A
liver
acidic
proteoglycan
sulfates glycosaminoglycans
heparinase
cationic
antithrombin 3
thrombin
15
Q
strongly cationic polypeptides such as ______ can be used to antagonize heparin by binding to it and not letting it bind to the other guy;works almost _____
A
protamine
instantaneously
16
Q
THROMBIN
-thrombin helps to activate ____
A
protein C
17
Q
protein _+ protein _ helps to degrade clotting factors ___ and ____
A
C
S
5 and 8
18
Q
those who are genetically deficient in protein C or S can have _____ ———
A
venous thrombosis
19
Q
thrombin (inhibits or activates?) factor 5 by (positive or negative?)?feedback mechanism
A
Activates
Positive
20
Q
VASCULAR SPASM
- your blood vessels are trying to ___
- vaso____
- _____ produced by the blood vessels initiates contraction of the blood vessels
- direct trauma to the smooth muscles after the blood vessels leads to a _____ response that initiates _____
- direct trauma to the pain receptors (noiceoreceptors) or inflammation in that area also leads to the production of things like ______,_____ etc and these stimulate the pain receptors to cause pain that would lead to ____ of the blood vessels
A
contract
constriction
endothelin
myogenic; contraction
histamine, prostaglandins,
contraction
21
Q
PLATELET PLUG FORMATION
- your blood vessels produce _____ at the needed site
- platelets love it and attach to it
- the secretion of ____,____,_____ etc by the platelets makes the vwf more attractive to the other platelets
A
vonwildebrand factor
ADP,thromboxane,serotonin,
22
Q
the receptor that lets the platelet bind to the von wildebrand factor is ____________
A
glp1b-9-5
23
Q
the receptor that lets the platelet bind to other platelet is _____,___, and ___
A
glp2b , 3a and fibrinogen
24
Q
platelet aggregating factor is accelerated by platelet ______ factor
A
activating
25
CLOTTING GAN GAN
-the _____ compound found on the membrane of the platelets (plug?) form a ____ charge to initiate (intrinsic or extrinsic ?) factor
phosphatidylserine
negative
intrinsic
26
liver produces few clotting factors
T/F
F
Plenty clotting favo
27
INTRINSIC
- the process of coagulation done by _____
- takes ____
- can be initiated by ____tively charged surface in _ like glass
the blood itself
minutes
nega
28
Intrinsic Clotting
```
___ gets activated to __(_____,____)
__gets activated by __ to ___(___)
__ gets activated by __ to __(____)
__combines with __,__,__ to give us __
___+ __ + ___ +__ =______
```
12; 12a ; kalikrein,Kinogen
11; 12a ; 11a; kinogen
9; 11a; 9a; calcium
9a; 8,pf3,Ca; Xa
Xa; 5; pf3; ca; prothrombin activator
29
Intrinsic clotting part 2
Prothrombin activator + 2 = ___(___)
2a converts soluble fibrinogen to _____
2a also activates ___ to ___ to turn ___ into _____(____)
2a; thrombin
insoluble fibrin
13 to 13a
fibrin
fibrin mesh ; calcium
30
EXTRINSIC
- the _____ are the ones that start this route
- occurs in _____
- 3 activated ___ to ___
- __ can activate __to___
- ___ can also convert __ to ___
damage tissues
seconds
7 to 7a
7a
9 to 9a
7a; x to Xa
31
fibrinogen becomes fibrin by the (loss or gain ?) of ____ sets of _____ from fibrinogen
loss
2
polypeptides
32
CLOT RETRACTION AND REPAIR
- the platelets ____ so as to bring the two sides of the damaged _____ together
- they also secrete _______ to stimulate mitosis or proliferation in damaged smooth muscles, etc
- also stimulate _________ to regenerate the damages endothelial lining
- _____ oozes out of the clot during this
- it’s the action of contractile protein like ___,___,____
contract ; endothelial lining
platelet derived growth factor
vascular endothelial growth factor
serum
actin, myosin, and thrombosthetin
33
FIBRINOLYSIS
- _______ activates ____ to plasmin
- plasmin ______ the ___ and releases some ___,____ etc
tissue plasminogen activator
plasminogen
degrades/eats up; thrombus
fibrinogen, D-dimer,
34
tissue plasminogen activator(a _____ ——)
plasminogen(________ Da)
plasmin (a _________ )
serine protease
90k
serine protease
35
D-dimer is important for _____ to know if someone has had a ____
diagnosis
clotting Kini
36
under normal conditions, plasmin is inactivated by ______ called _________
plasmin inhibitor
ã2-antiplasmin
37
so, plasmin binds to ___ as the __ is being formed to protect itself from ____
fibrin
clot
Antiplasmin
38
tissue plasmin activator is inhibited by ____ and ____
factor 5 and factor 8
39
Heparin: it would enhance the function of ______
antithrombin3
40
Heparin drug works in vivo or in vitro?
Both
in vivo and in vitro
41
_________,________,______ inhibits ADP
Aspirin(a ____ inhibitor) inhibits _____ and ____
clopielogrel, prasugrel, ticagrelor
cox1; thromboxane A2 and prostacyclin
42
Abciximab inhibits _________
pradaxa inhibits ____
glp2b and 3a
factor 2
43
warafarin: prevents some proteins like _____ and ____, and clotting factors like ________ that need vitamin __, from getting vitamin ___
protein C and S
2,7,9, and 10
K
K.
44
Warfarin is an oral anticouagulant
Warfarin is used in vitro only
T/F
T
F
It’s in vivo
45
EDTA- removes ____ from blood
8) Oxalates-removes ____ from blood
9) citrates-removes ____
calcium
calcium
calcium
46
EDTA is used in vivo or in vitro?
Oxalates is used in vivo or in vitro?
Citrates is used in vivo or in vitro?
Both ; in vivo and in vitro
In vitro
in vitro
47
________ form of anti coagulants is used in a blood bank
Citrates
48
peptone,C-type lectin from _______
dabigatran inhibits ____
snake’s venom
thrombin
49
hirudin from ___________ ————-
rivaroxaban,apixaban, etc inhibits ____
hirudinaria manillensis
50
protein C contain Gla(gamma-carboxyglutamate) residue but protein S doesn’t
T/F
F
They both do
51
tissue plasminogen activator is (active or inactive?) until it’s ______
Inactive
bound to fibrin
52
kallikrein can’t activate urokinase
| T/F
F
It can
53
factors ____ and ____ can activate plasmin
12 and 11
54
urokinase and thrombin are from the _____
tpA is from the _______
blood
endothelium
55
Is kininogen from bradykinin
Or
Kalikrein is from bradykinin
Or
bradykinin is from kininogen
Or bradykinin is from kalikrein?
bradykinin is from kininogen
56
PROCOAGULANTS
- _____
- ______(ikr, pick a side)
- extracts of ______; they have ____
- sodium or calcium alginate act by activating ____
- oxidized cellulose, act by ___
thrombin
snake venom
lungs and thymus
thromboplastin
hageman
hageman
57
So,
aPTT is used for (intrinsic or extrinsic ?) and ____
PT is used for (intrinsic or extrinsic?) and ____
Intrinsic ; heparin
Extrinsic; warfarin
58
Things that Need Vk
???
Factor 2,7,9,10
| Protein C and S
59
Antithrombin 3 inhibits ___,__,___,___,__
7,9,10,11,12
60
Protein C and S inhibits ???
5 and 8
61
Coumarin inhibits ???
2,7,9,10,C,S
62
Thrombin inhibits ??
5,8,7,13,1,11
63
The extrinsic and intrinsic pathway of clotting are independent
T/F
They aren’t
64
The extrinsic pathway is initiated at the site of tissue injury with the exposure of ________ , located in the ___ and on activated ____.
tissue factor
subendothelium; monocytes
65
In extrinsic pathway
TF interacts with and activates factor __ , synthesized in the liver.
VII
66
in the Gla-containing zymogens (factors __,__,__,__), the Gla residues in the ____ terminal regions of the molecules serve as ______ binding sites for Ca2+.
II, VII, IX, and X
amino
high-affinity
67
In extrinsic pathway
TF acts as a cofactor for factor ____, enhancing its enzymatic activity to activate factor __ .
The reaction by which factor X is activated requires the assembly of the extrinsic tenase complex (___-___-____) formed on a cell membrane surface exposing the procoagulant (anionic or cationic?) aminophospholipid phosphatidylserine.
VIIa
X
Ca2+; TF; factor VIIa
Anionic
68
TF and factor VIIa also activate factor IX in the intrinsic pathway.
T/F
T
69
Indeed, the formation of complexes between membranebound ____ and ____ is now considered to be the key process involved in initiation of blood coagulation in vivo.
TF and factor VIIa
70
_______________ (TFPI) is a minor physiologic inhibitor of coagulation.
T/F
F
Tissue factor pathway inhibitor
Major
71
TFPI is a protein that circulates in the blood where it directly inhibits factor ___ by binding to the enzyme ___ its ___ site.
This factor ______ complex then inhibits the factor ____ complex.
Xa
near its active
Xa-TFPI
VIIa-TF
72
The formation of factor ___ is the major site where the intrinsic and extrinsic pathways converge
Xa
73
Kaolin, a highly negatively charged hydrated _______, can be used for in (vivo or vitro?) tests as an initiator of the intrinsic pathway.
Kaolin
aluminum silicate
Vitro
74
When the components of the contact phase assemble on the activating surface, factor XII is activated to factor XIIa upon ____ by _____.
proteolysis
kallikrein
75
factor XIIa, generated by kallikrein, attacks ____ to generate (more or less?) kallikrein, setting up a ____ feedback activation loop.
Factor XIIa, once formed, activates factor XI to XIa and also releases bradykinin (a peptide with potent vasov—- action) from _____
prekallikrein
More
positive
dilator
HMW kininogen.
76
phosphatidylserine.
Pro or anti coagulant?
Pro
77
Upon binding to the complex of factors ______ on the platelet membrane , prothrombin is cleaved by factor Xa at two sites to generate the active, two-chain thrombin molecule, which is then released from the ____ surface.
Va and Xa
platelet
78
Factor XIIIa is a highly specific _____ that covalently cross-links__–chains and, more (slowly or rapidly?) , __-chains of fibrin molecules
transglutaminase
γ
Slowly
α
79
The endogenous activity of antithrombin is greatly potentiated by the presence of ______ (_____)
sulfated glycosaminoglycans
heparans
80
Which is better to use
Low-molecular-weight heparins (LMWHs) or Unfractionated?
Low-molecular-weight heparins (LMWHs),
81
Which acts faster??
Heparin or warfarin
Heparin
82
The most common hereditary bleeding disorder is deficiency of factor ___, causing hemophilia A
Hemophilia B, also X chromosome-linked, is due to a deficiency of factor __
VIII
IX
83
The most common hereditary bleeding disorder is ______ disease, with a prevalence of up to _% of the population.
von Willebrand
1
84
Urokinase can activate plasminogen
T/F
T
85
ADPase _____ ADP
Degrades
86
Nitric oxide (NO) Inhibits ______ and ______ by elevating levels of ____
Prostacyclin Inhibits platelet aggregation by increasing levels of ——
platelet adhesion and aggregation
cGMP
cAMP
87
______ time (aPTT or PTT)
______ time (PT)
_____ time (TT)
activated partial thromboplastin
prothrombin
Thrombin
88
Oya, factors and names
I
II
III
IV
Fibrinogen
Prothrombin
Tissue factor
Calcium
89
Oya, factors and names
V
VIIa
VIII
IX
Proaccelerin
Proconvertin
Antihemophilic factor A
Antihemophilic factor B
90
Proaccelerin aka ____
Antihemophilic factor B aka ______
Labile factor
Christmas factor
91
Oya, factors and name
X
XI
XII
XIII
Stuart-Prower factor
Plasma thromboplastin antecedent (PTA)
Hageman factor
Fibrin stabilizing factor (FSF)
92
List the cofactors in clotting
Factors 8,5,3
93
_____ falls under Thiol-Dependent Transglutaminase
_____ falls under fibrinogen
Factor 13
Factor 1
94
Zymogens of Serine Proteases includes ????
Factor 12,11,9,10,2,7
95
The external blood clot is also called ____. It adheres to the opening of damaged blood vessel and prevents ____
scab
blood loss.
96
thrombomodulin is secreted by the endothelium of all the blood vessels, except the minute vessels of ___.
brain
97
Heparin is a naturally produced anticoagulant in the body.
| T/F
T
98
It is produced by ___ cells which are the wandering cells present immediately (inside or outside?) the capillaries in many tissues or organs that contain more connective tissue.
These cells are abundant in ____ and _____. ___phils also secrete heparin.
mast
Outside
liver and lungs
Basophils
99
Heparin is a conjugated polysaccharide.
| T/F
T
100
Commercial heparin is prepared from the liver and other organs of animals. Commercial preparation is available in ___ form or ___ form as ___,___,____,____
Liquid
Dry
sodium, calcium, ammonium or lithium salts.
101
Heparin is destroyed by ____ in the body
Heparinase
102
_____ is the most expensive anticoagulant.
Heparin
103
commonly used oral anticoagulants are ____ and ___
Warfarin
| Dicoumarol
104
Oxalate is poisonous
T/F
T
105
Increasing the temperature postpones the coagulation of blood.
T/F
F
Reducing
106
Collecting the blood in a container with smooth surface like a ____-coated container ____ clotting. The smooth surface inhibits the activation of factor ___ and platelets. So, the formation of prothrombin activator is prevented.
silicon
prevent
XII
107
Factors 12 is ?????, aka ___
Hageman
Contact
108
Hemophilia C or factor ___ deficiency
XI
109
Most common hemophilia is ???
Followed by ????
Then ????
A
B
C
110
Purpura is a disorder characterized by prolonged ____ time. However, the ____ time is normal.
bleeding
clotting
111
Hemophilia is characterized by prolonged ____ time. However, the ____ time is normal
clotting
bleeding
112
von Willebrand is also responsible for the survival and maintenance of factor ___ in plasma.
VIII
113
During thrombosis, lumen of blood vessels is ____. The solid mass of platelets, red cells and/or clot, which obstructs the blood vessel, is called_____ .
The thrombus formed due to agglutination of RBC is called _____
.
occluded
thrombus
agglutinative thrombus
114
Embolism is the process in which the _____ or _____ is detached and carried in _____ and occludes the small blood vessels, resulting in arrests of blood flow to any organ or region of the body.
thrombus
a part of it
Bloodstream
115
Embolus is the _____ or _____, which arrests the blood flow.
The obstruction of blood flow by embolism is common in ____ , ______ or _____
thrombus or part of it
lungs
Brain
Heart
116
Death of body tissue is called ____.
necrosis
