Coag Test and Fibrinolysis - Lect Flashcards
tilt tube method is the principle behind?
APTT and PT
this method requires gentle tilting of the tube back and forth at the rate of about once per second until a fibrin web is formed.
tilt tube method
wire loop technique is the principle behind?
clot retraction method
wire loop technique uses __ materia
nichrome
wire loop technique employs the use of a wire loop that is passed through the mixture at the ___ until a formed clot adheres to the loop.
rate of two sweeps per second
enumerate the manual techniques
tilt tube method and wire loop technique
enumerate the automated techniques
moving probe and optical density
this technique is immersed in the mixture that is triggered by clot formation
moving probe
this technique detects clot when it is formed in the mixture.
optical density
most common technique in automated devices and the one being measured in a turbid mixture to detect the rate of the formed clot.
optical density
enumerate the tests under secondary hemostasis
lee and white clotting time and slide method
lee and white clotting time screen secondary hemostasis, the ___ pathway
extrinsic and intrinsic pathway
principle of lee and white method
Expose blood to a negatively charged surface (glass)
normal value of lee and white
5-15 mins
normal value of slide method
4-10 mins
sensitivity of slide method clotting time
intrinsic pathway factors
this method is the surface of the glass tube initiates the clotting process. Fibrin string presence indicates clot formation.
clotting time - slide method
PT measures the __
extrinsic and common pathway
APTT measures the __ and common pathway except ___ and __
intrinsic and common pathway except factor XIII and platelets
PT monitors?
coumadin therapy
sample used for PT
citrated plasma - platelet poor plasma
sample used for APTT
citrated plasma - platelet poor plasma
nv of PT
10-15 secs
reagent used in PT
Tissue Thromboplastin, 0.025 M CaCl Solution
APTT monitors the?
heparin therapy
reagent used in APTT
Partial Thromboplastin (substitute for platelet),
CaCl, Activators
activators used in APTTT
Kaolin, Ellagic acid, Celite, Silica
Abnormal results from both indicates problem in the __
common pathway
the one that binds with calcium to form insoluble complexes—inhibits calcium since the rest of the cascade requires calcium
sodium citrate
calcium chloride substitutes calcium
that is being ___ .
inhibited or precipitated by the anticoagulant
substitute for collagen
activators
Thrombin time measures functional fibrinogen availability or decreased amount of _____ (75-100 mg/dL).
Fibrinogenemia or Dysfribrinogenemia
drawback of TT
prolonged in patients undergoing Heparin Therapy
measured thrombin is added to plasma and time for fibrin clot formation is recorded
thrombin time
nv of TT
10-14 secs (brown)
same as thrombin but not affected by heparin
reptilase time
an enzyme found in the Bothrops atrox Snake venom that can convert Fibrinogen to
Fibrin.
reptilase (atroxin)
reagent for RT
atroxin
nv of RT
10-15 secs
sytpven time is also known as __
russell’s viper venom time
stypven time used to detect common pathway deficiencies in the Factors ___
X, V, II, and I
Stypven is a thromboplastin-like substance that
activates __
factor X
principle: Stypven is a thromboplastin-like substance that activates factor X. When this substance is added to plasma together with ____, coagulation will activate and time is recorded until clot is formed.
platelin (platelet substitute) and CaCl
nv of stypven time
6-10 secs
ducker’s test is also known as
5m urea solubility test
ducker’s test detects ___ deficiency
factor XIII
principle of ducker’s test
clot formed after coagulation is added with 5M urea.
reagent used in ducker’s test
5M Urea or 1% monochloroacetic Acid and 2% acetic acid
nv of ducker’s test
Insoluble clot formation after 24 hours
substitute for 5m urea in ducker’s test
1% monocholoacetic acid and 2%
acetic acid
last step of coagulation cascade
fibrinolysis
a protein that breakdowns the clots
plasmin
it is the systemic, accelerating fibrin hydrolysis by plasmin.
fibrinolysis
Plasminogen is the inactivated form of plasmin by ___ / ___.
Tissue Plasminogen Activator (t-PA) / Urokinase Plasminogen Activator (u-PA)
regulates the balance of plasminogen activation so that not all plasminogen
will be converted to plasmin.
Plasminogen Activator Inhibitor-1 (PAI-1)
regulates the balance of plasminogen activation so that not all plasminogen
will be converted to plasmin.
Plasminogen Activator Inhibitor-1 (PAI-1)
Plasmin degrades __, remodels ___ and promotes cell migration which is actually for the purpose of
healing the injured area.
fibrin, remodels extracellular matrix (ECM),
enuemerate the proteins necessary in the fibrinolysis
- plasminogen
- tissue plasminogen activator
- urokinase
- plasminogen activator inhibitor - 1
- a2-antiplamsin
- thrombin activatable fibrinolysis inhibitor
inactive form of plasmin
serine protease zygomen
PLASMINOGEN
Serine Protease Zymogen: plasmin is the active form
which digests __ and __.
fibrin and Fibrinogen
a protein secreted by the endothelium and activates
plasminogen
tissue plasminogen activator
protein secreted by kidneys and activates plasminogen
urokinase
protein/s that activates plasminogen
tissue plasminogen activator and urokinase
a protein from endothelium and inhibits TPA
plasminogen activator inhibitor-1
a protein that inhibits plasmin
a2-antiplasmin
a protein that suppresses fibrinolysis
thrombin activatable fibrinolysis inhibitor
fibrinolysis process
The fibrin formed is composed of 2 domains: D and E
2. Plasminogen in plasma is activaed by TPA and urokinase into active enzyme called plasmin.
3. Plasmin, then cleaves the peptide bonds on the
arginine and lysine amino acid that connects the two
domains.
4. The digested fibrin will then form the fibrin degradation products (FDPS) namely:
a. Fragment X (D-E-D)
b. Fragment Y (D-E)
c. Fragment D, E
d. fragment D-D
the one measured and
test that correspond to active fibrinolysis such as in patients with DIC where __ are elevated.
D-dimer
