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coagulation Flashcards

1
Q

first line of defense against bleeding

A

vasoconstriction

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2
Q

key mediator of vasoconstriction in response to endothelial damage

A

endothelins (proteins released by endothelial cells)

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3
Q

coagulation factors are synthelized in the

A

liver

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4
Q

coagulation factors form

A

fibrin

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5
Q

coagulation factors circulate as

A

zymogens

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6
Q

many coagulation factors active to become

A

serine proteases

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7
Q

center of coagulation cascade is activation of

A

X to Xa

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8
Q

Xa converts

A

prothrombin to thrombin

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9
Q

thrombin converts

A

fibrinogen to fibrin

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10
Q

Xa inhibitors

A

rivaroxaban
apixaban

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11
Q

direct thrombin inhibitors

A

hirudin
lepirudin
bivalirudin
desirudin
argatroban
dabigatran

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12
Q

major activator of coagulation system

A

tissue factor

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13
Q

primary event causes

A

exposure of tissue factor

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14
Q

tissue factor interacts with

A

VII and activates it

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15
Q

tissue factor and VIIa activate

A

X to Xa

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16
Q

thrombin makes more

A

thrombin and acts as positive feedback for the cascade

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17
Q

defects in factors IX and VIII cause

A

hemophilia (cant amply clotting cascade which causes bleeding)

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18
Q

factor VIII circulates bound to

A

von Willebrand factor (which increases half life)

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19
Q

factor VIII is produced in

A

endothelial cells

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20
Q

multicomponent complexes are three components bound together including

A
  1. active clotting factor
  2. co factor
  3. substrate
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21
Q

multicomponent complexes require

A

phospholipids and calcium

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22
Q

extrinsic Xase (multicomponent complex) enzyme

A

VIIa

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23
Q

intrinsic Xase enzyme

A

IXa

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24
Q

calcium is required for

A

clot formation

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25
Q

role of factor XIII

A

crosslinks fibrin stabilizing the plug

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26
Q

factor XIII requires what as a cofactor

A

calcium

27
Q

XII is activated by

A

contact with negative charges (silica)

28
Q

basis for partial thromboplastin time

A

factor XII

29
Q

intrinsic pathway requires

A

kinins

30
Q

kinins link

A

coagulation with inflammation

31
Q

bradykinin

A

vasodilator

32
Q

bradykinin is degraded by

A

ACE & C1 inhibitor

33
Q

C1 inhibitor deficiency causes

A

hereditary angioedema

34
Q

factor XII activates

A

clotting and produces bradykinin

35
Q

prekallikrein deficiency results in

A

markedly prolonged PTT

36
Q

in prekallikrein deficiency __ cannot activate the clotting cascade normally

A

XII

37
Q

kinin system activated by

A

factor XII

38
Q

imp deactivators of coagulation

A

antithrombin III
protein C and S
tissue factor pathway inhibitor

39
Q

antithrombin III is a

A

serpin (inhibitor of sarin proteases)

40
Q

antithrombin III inhibits

A

II, VII, IX, X, XI, XII

41
Q

antithrombin III is the basis for

A

heparin drug therapy

42
Q

deficiency antithrombin III causes

A

hypercoagulable state

43
Q

protein C and S are

A

glycoproteins synthesized in liver

44
Q

activated protein C inactivates factors

A

Va and VIIIa

45
Q

protein C activated by

A

thrombomodulin

46
Q

thrombomodulin binds

A

thrombin and then activates protein C

47
Q

activated protein C requires

A

protein S as a co factor

48
Q

tissue factor pathway inhibitor inactivates

A

Xa

49
Q

tissue factor pathway plasma levels increased with

A

heparin administration

50
Q

plasminogen is synthelized by

A

liver

51
Q

plasminogen is converted to

A

active enzyme plasmin

52
Q

main role of plasmin

A

breakdown fibrin

53
Q

plasminogen activators

A

tissue plasminogen activator & urokinase

54
Q

fibrin is broken down into

A

fibrin degradation products & D dimer

55
Q

presence of D dimer indicates

A

clot breakdown

56
Q

fibrinogen degradation products indicate

A

plasmin activity only

57
Q

primary fibrinolysis is a rare phenomena in which

A

plasmin is overactive

58
Q

primary fibrinolysis causes

A

increased fibrin degradation products with normal D dimer

59
Q

plasmin can deplete

A

clotting factors

60
Q

clot breakdown causes

A

fibrinogen degradation products and dimers

61
Q

hyperfibrinolysis causes

A

fibrinogen degradation products and normal dimers

62
Q

vitamin K is required for

A

syntheisis of clotting factors II, VII, IX, X, C, S

63
Q

warfarin is a

A

vit k antagonist

64
Q

erythrocyte sedimentation rate is increased in

A

inflammatory conditions

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