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<3 > Clotting Cascade > Flashcards

Clotting Cascade Flashcards

1
Q

What will activate the extrinsic pathway in the clotting cascade?

A

Via external trauma - blood escape from vasc. System

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2
Q

Is the extrinsic or intrinsic pathway quicker in the clotting cascade?

A

Extrinsic = quicker

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3
Q

What is the extrinsic pathway?

A

3 (tissue factor) —> 7 —> 10

10–> 2 (thrombin) —> 1 (fibrin)

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4
Q

What will thrombin go back and activate in the extrinsic pathway?

A

Will feedback to activate:

5, 7, 8, 11

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5
Q

What stimulates the production of anti-thrombin? What will it impede?

A

Thrombin stimulates it

Impedes thrombin and factor 10

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6
Q

What is the intrinsic pathway?

A

12 —> 11 —> (9+8) tenase complex —> (10+5) prothrombinase complex
—> 2a (active thrombin)

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7
Q

How is fibrin cross linked?

A

Via factor 13

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8
Q

What is primary hemostasis?

A

Platelets in blood aggregate at injury site and form a platelet plug to block hole

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9
Q

What is secondary hemostasis?

A

Platelet plug is further reinforced by a fibrin mesh produced thru proteolytic coagulation cascade

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10
Q

What is the KEY difference b/w primary and secondary hemostasis?

A

Primary = weaker plug

Secondary - strong plug bc fibrin mesh is on it

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11
Q

Is primary or secondary hemostasis longer?

A

Secondary

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12
Q

What is thrombin, generally?

A

PROTEASE that cuts proteins

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13
Q

What proteins will thrombin act on?

A

Fibrinogen
Factor 8
Factor 5
Factor 13

Will activate platelets

Prothrombin

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14
Q

What form do we ingest Vit. K in?

How do we make it active?

A

Ingest in quinone form

Activate via quinol form in liver

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15
Q

What is the mechanism for activation of Vitamin K?

A

Step 1:
Vit. K 2,3, epoxide reductase + NADH —> quinone form

Step 2:
Quinone reductase —> active v. K. Quinol from

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16
Q

What are 2 examples of anticoagulants?

A

Hydroxycoumarins

Indanediones

17
Q

What is an example of hydroxycoumarins?

A

Warfarin

18
Q

How do blood clots form?

So how does warfarin prevent the formation of blood clots?

A

Thru a series of Vit. K dependent rxns in liver

Warfarin decreases activity of Vit. K. Epoxide reductase

19
Q

Which enantiomer of Warfarin is more potent? (R or S)

A

S-warfarin - 2-5x more potent

20
Q

When is warfarin pharmacologically active?

A

When it is FREE

21
Q

Why is Vit. K. Important in the clotting cascade?

A

Cofactors in synthesizing factors 2, 7, 9, 10, protein s and protein c

22
Q

What does protein c do?

A

Inactivates t-Pa = no active plasmin

23
Q

Which factor has the longest half life?

A

Factor 2

24
Q

What are the roles of Protein S and C?

A

Anti-coagulation action by maintaining permeability of blood vessel walls

25
Q

What will protein S and C proteolytically inactivate?

A

Factors 5 and 8

26
Q

What is associated with a protein C deficiency?

A

Increased risk for venous thrombosis

27
Q

what is the MOA of warfarin?

A

Inhibits Vit. K epoxide reductase

Limits available Vit. K. Quinone

Therefore, blocking the gamma carboxylation of several glutamate residues in prothrombin

28
Q

What is the deficient factor in Hemophilia A?

A

Factor 8

29
Q

What is the inheritance pattern of Hemophilia A?

A

Genetic disorder passed down from parent to child

1/3 can be from spont. Mutation

30
Q

Is hemophilia a or b more common?

A

Hemo A

31
Q

What deficiency causes Hemophilia B?

A

Factor 9 deficiency

32
Q

What does Prothrombin time measure?

A

Extrinsic coagulation

33
Q

What does Partial thromboplastin time (PTT) measure?

A

Measure Intrinsic system and common clotting pathway

34
Q

What can be indicated if Prothrombin time (extrinsic) is prolonged?

A

Liver disease

<3 (26 decks)

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