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Clotting cascade etc Flashcards

1
Q

This is a protein that catalyses plasminogen –> plasmin conversion

A

Tissue plasminogen activator tPA

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2
Q

Antidote for tissue plasminogen activator toxicity?

A

aminocaproic acid

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3
Q

This serine protease dissolves fibrin blood clots

A

Plasmin

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4
Q

Proteins that inhibit plasmin?

A

alpha2-macroglobulin

alpha2-antiplasmin

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5
Q

What effect does heparin have on antithrombin?

A

Heparin increases AT binding of factor II and X

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6
Q

Produced by activated platelets and has prothrombotic effects by increasing expression of GPIIb/IIIa on platelets

A

Thromboxane A2

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7
Q

This enzyme is important for platelet aggregation and is irreversibly inhibited by aspirin.

A

Cyclooxygenase

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8
Q

It works by irreversibly inactivating Factor Va and VIII. It is activated itself by thrombomodulin.

A

Protein C

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9
Q

What is the other name for Prostaglandin-endoperoxide synthase 2?

A

Cyclooxygenase-2

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10
Q

BM - increased megakaryocytes on a background of fluctuating history of easy bruising, epistaxis and menorrhagia.

A

Immune thrombocytopenic purpura

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11
Q

Which components of the coagulation cascade are dependent on Vitamin K?

A

Factors II, VII, IX and X

Protein C, S and Z

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12
Q

Vascular endothelium or subendothelium … which one synthesises tissue factor, vWF, prostacyclin, plasminogen activator, antithrombin III and thrombomodulin?

A

Endothelium

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13
Q

Pain, tenderness, indurated cord along a palpable superficial vein. Skin is warm and erythematous.

A

Superficial venous thrombosis

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14
Q

Peripheral oedema, tachycardia, supine hypotensive syndrome.

A

IVC syndrome

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15
Q

Shortness of breath
Facial and arm swelling
Distended veins in the upper chest/arms

A

SVC syndrome (obstruction)

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16
Q

Past medical history of DVT
Brownish discolouration of skin
Ulcer
Worsens after walking or standing for a long time

A

Post-thrombotic syndrome

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17
Q

Antithrombin potentiator
Administered IV
Can be reversed quickly

A

Unfractionated heparin

18
Q

Potentiates antithrombin III
Usually subcut.
Risk of osteoporosis/hyperkalaemia

A

Dalteparin (LMWH)

19
Q

This is used to monitor warfarin therapy

A

INR (the patient’s PT divided by a normal PT)

20
Q

This prodrug goes on to inhibit P2Y receptors found on platelets - inhibiting their function
Primary prevention of stroke in aspirin allergic patients
Used in acute MI along with aspirin

A

Clopidogrel

21
Q

In patients with metallic heart valves, this drug is the most effective anticoagulant

A

Warfarin

22
Q

In patients with cancer and acute venous thromboembolism, the most effective drug at reducing the risk of recurrent VTE is __?

A

Dalteparin (LMWH)

23
Q

This drug when given alone initially increases the clotting risk

A

Warfarin

24
Q

Side effects include cutaneous necrosis

A

Warfarin

25
Q

The drug most likely to cause thrombocytopaenia with paradoxical thrombosis

A

Unfractionated heparin (UFH)

26
Q

Heparin mechanism of action?

A

Activates Antithrombin III –> inactivates Thrombin and FXa

27
Q

When is streptokinase contraindicated?

A

Contra-indicated if recent sore throat, if ever used before, or in the presence of proliferative retinopathy.

28
Q

Peripheral cytopenia

Greater than 20% blast cells in bone marrow

A

AML

29
Q

Macrocytic anaemia
Megakaryocyte hyperplasia with nuclear hypolobation
Moderate thrombocytosis

A

5q syndrome

30
Q

Pelger-Huet anomaly

A

Hyposegmented neutrophils

31
Q

A myelodysplastic syndrome with a marrow blast percentage of 5 to 19%

A

Refractory anaemia with excess of blasts

32
Q

A myelodysplastic syndrome in which two of the three blood cell types are abnormal and less than 1% of peripheral cells are blasts

A

Refractory cytopenia with multilineage dysplasia

33
Q

A myelodysplastic syndrome with low red cells and ringed sideroblasts

A

Refractory anaemia with ringed sideroblasts

34
Q

Imatinib used for what?

A

Treatment of CML - it’s a tyrosine kinase inhibitor

35
Q

Two conditions in which you might see dacrocytes (teardrop cell)

A

Beta thalassemia major

Myelofibrosis

36
Q

Patient with CLL

Biopsy shows anaplastic, large cell lymphoma

A

Richter’s syndrome

CLL or hairy cell leukaemia –> diffuse large B cell lymphoma (a type of NHL)

37
Q

Patient with ALL has bone marrow infiltration of blasts or lymphocytes?

A

Blasts

38
Q

The commonest adult leukaemia

A

CLL

‘C’ for common!

39
Q

Neutrophil alkaline phosphatase is low

A

CML

40
Q

Neutrophil alkaline phosphatase is raised

A

myeloproliferative disorders

Infections

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