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2nd Semester Final > Clotting and Bleeding Disorders Lecture Powerpoint > Flashcards

Clotting and Bleeding Disorders Lecture Powerpoint Flashcards

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1
Q

Bleeding disorders are also sometimes known as….

A

….coagulopathies

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2
Q

Phases of clot formation and a brief explanation according to Pam (4)

A

1) vascular injury and spasm - constriction of injured vessel
2) platelet plug formation - von Willebrand factor needed to bridge platelets and collagen
3) Coagulation cascade - intrinsic or extrinsic fibrin formation
4) dissolution of clot

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3
Q

Tunica media compliance

A

Decreases as we age causing greater shear from blood flow such as with atherosclerosis

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4
Q

What 2 cells synthesize vonWillebrand factor?

A

Platelets

Endothelial cells

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5
Q

In a resting state, an endothelial cell is a vaso____ and ____ platelet adhesion

A

dilator, inhibits

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6
Q

Serotonin is a vaso____, although we often only think of its psychological properties

A

constrictor

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7
Q

What 3 organs produce thrombopoietin?

A

Liver
Bone marrow
Kidney

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8
Q

ASA causes ___ binding of a platelet acting for ___ to ___ days

A

irreversible, 7-10 or the life of the thrombocyte

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9
Q

4 major functions of platelets

A

1) adhesion/activation
2) aggregation
3) secretion
4) procoagulant activation

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10
Q

4 steps of platelet action mech of action

A
  • platelet binds to subendothelial matrix von willebrand factor activating glycoprotein iib/iiia surface receptors
  • Platelets cohere and aggregate and fibrinogen binds activated glycoprotein 2b/3a becoming fibrin
  • Platelet granule proteins such as ADO, serotonin, factor V, and thromboxane are released
  • Fibrin activates thrombin via the clotting cascade
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11
Q

Von Willebrand factor

A

An adherent glycoprotein on the sub endothelial matrix that allows for activation of glycoprotein IIb/IIIa surface receptors on thrombocytes to begin adhering to the surface

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12
Q

The most common herreditary bleeding disorder is….

A

…von wilibrand factor deficiency

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13
Q

Role of Ca2+ in clotting cascade

A

It acts as factor 4 in allowing fibrin to polymerize

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14
Q

Factor X

A

The convergent point between the extrinsic and intrinsic pathway that functions to convert prothrombin (factor II) to thrombin (factor IIa)

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15
Q

D dimer test function and why is it not sufficient?

A

Looks for breakdown of collagen chains indicating a clot has occurred in the body, but not specific as to where

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16
Q

The intrinsic clotting pathway is ___ than the extrinsic, the intrinsic involves ___ while extrinsic involves _____

A

Faster, factors in blood itself, tissue factor released from damaged vessels

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17
Q

Amplification cascade

A

Tendency for the clotting cascade to amplify its response from a small amount of starting factors

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18
Q

Where do the majority of clotting factors come from?

A

The liver

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19
Q

Intrinsic clotting cascade pathway

A

Surface contact activates factor XII to XIIa, which activates factor XI to XIa, which activates IX to IXa, which activates VIII and Ca2+ (factor IV) to convert factor X to Xa

20
Q

Extrinsic clotting cascade pathway

A

Tissue damage activates Tissue factor (VII), which activates factor X to Xa

21
Q

List the vit K dependent procoagulants

A

Factor II, VII, IX, and X

22
Q

Protein C and S action

A

Inactivate factor Va and VIIIa acting as a natural anticoagulant

23
Q

Protein C and S deficiency results in…

A

Spontaneous thrombosis, suspected genetic inheritance in young with DVT or stroke

24
Q

Factor V leidan definition

A

Mutation in factor V that allows it to resist protein C, resulting in increased venous thromboembolism

25
Q

tPA function

A

Convert plasminogen to plasmin which will then degrade fibrin clots

26
Q

More deaths occur from ___ disorders than ___ disorders

A

Clotting, bleeding

27
Q

Common forms of (4) endothelial injury

A
  • atherosclerosis
  • mechanical trauma
  • hypoxia
  • autimmune disorders
28
Q

1 cause of inherited thrombophilia

A

Activated protein C resistance

29
Q

Common forms of hypercoaguable states (3)

A
  • OCP’s
  • pregnancy
  • surgery
30
Q

Name 3 thrombolytic agents

A
  • streptokinase
  • urokinase
  • tPA activators
31
Q

Dabigatran (pradaxa) acts by directly inhibiting ___

A

thrombin

32
Q

Disseminated intravascular coagulatoin (DIC) definition and some common causes (3)

A

Clotting cascade gone wild, with many small clots forming and affecting microcirculation leaving larger chance of bleeding excessively

  • infection
  • OB complication
  • snake venom
33
Q

Lab work for DIC will show ___ thrombocytes, ___ PT/INR, ___ PTT

A

low, prolonged, prolonged

34
Q

Purpura definition

A

Large areas of skin discoloration due to blood leakage from a vessel in that spot

35
Q

Petechiae definition

A

Small broken blood vessels on skin

36
Q

What’s included on a CBC

A

Hgb
Hct
WBC
Platelets

37
Q

What’s included on a basic metabolic panel (BMP) (8)

A 
Na+
K+
Cl-
CO2
BUN
Creatinine
Glucose
Ca2+
38
Q

What’s included on a chem7 panel vs a BMP

A

No Ca2+

39
Q

How does ASA affect platelet function?

A

Binds COX irreversibly affecting thromboxane A2 preventing aggregation of platelets

40
Q

The most common hypercoaguable disorder is…

A

…factor V leidan

41
Q

Hemophilia A vs B vs C

A

Hemophilia A and B are the same presentation of deep tissue bleeding but B is due to christmas factor (IX), C is much less severe and just has prolonged bleeding

42
Q

Protein S functions to activate….

A

….protein C

43
Q

Venom induced consumption coagulopathy definition

A

A clotting disorder due to the consumptionor bite of venom that has a procoagulant effect

44
Q

Ehler’s Danlos syndrome characteristics

A

Hyper elasticity in skin and easy bruisibility

45
Q

Hemolytic Uremic syndrome characteristics

A

Fever, purpura, severe CNS signs and involving kidneys

46
Q

Thrombotic thrombocytopenic purpura characteristics

A

Fever, purpura, and severe cns signs

2nd Semester Final (207 decks)

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