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cardiovascular > Coagulation > Flashcards

Coagulation Flashcards

1
Q

What is involved in primary haemostasis?

A

vasoconstriction, platelet adhesion, platelet aggregation

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2
Q

How long does primary haemostasis take?

A

second to minutes

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3
Q

What is involved in secondary haemostasis?

A

activation of coagulation factors and formation of fibrin

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4
Q

How long does secondary haemostasis take?

A

minutes

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5
Q

What is involved in fibrinolysis?

A

lysis of the clot

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6
Q

When does fibrinolysis occur?

A

minutes to hours

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7
Q

What are the three abnormalities that influence thrombosis (virchow’s triad)?

A

abnormalities of the vessel wall, abnormalities of blood flow, abnormalities of blood composition

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8
Q

Is it possible to clinically test the integrity of the vessel wall?

A

No

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9
Q

Is the coagulation system redundant?

A

Yes - if one part of the system is functioning another part may be able to compensate

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10
Q

What is the key enzyme in coagulation?

A

thrombin

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11
Q

What is the initiating protein in coagulation?

A

tissue facctor

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12
Q

Do the extrinsic and intrinsic pathways explain the physiological process?

A

No

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13
Q

What are the three phases of coagulation?

A

Initiation phase, amplification phase, propagation phase

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14
Q

What occurs in initation phase?

A

Tissue factor is exposed and starts off the whole cascade

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15
Q

What occurs in the amplification phase?

A

thrombin starts to be generated - this gives positive feedback and amplifies the amount of thrombin generated

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16
Q

What happens in the propagation phase?

A

thrombin burst leads to the formation of fibrin - the clot that plugs the hole

17
Q

What is the action of thrombin?

A

converts fibrinogen to fibrin, cross links fibrin, positive feedback, bind thrombomodulin, activates TAFI, activates platelets

18
Q

How is thrombin inactivated?

A

Binding to thrombomodulin

19
Q

What types of haemostatic tests can be done?

A

Can measure the number, function and appearance of platelets or can measure coagulation system

20
Q

What are the different types of coagulation system tests?

A

global, specific or genotyping

21
Q

What are the key principles of coagulation tests?

A

sample integrity is crucial, need a standard curve to compare to controls, duplicate testing needs to be done and an abnormal test doesn’t mean abnormality - test needs to be repeated and to match history

22
Q

What are the global tests for bleeding?

A

ACT, APTT, PT/INR, thrombin generation

23
Q

What are the specific tests for bleeding?

A

factor assays, von willebrand factor, collagen binding assays, fibrinogen

24
Q

What is a functional clot based assay?

A

A test which measure clotting time but is difficult technically

25
Q

What is a chromagenic assay?

A

A test which measures light to represent protein functions - doesn’t reflect physiology but is easily reproducible

26
Q

What is an immunological assay?

A

A test which measures the amount of protein - this test does not tell you anything about function - can have patients with a normal amount and low function

27
Q

What is a PT test?

A

Test which measures clotting time via the extrinsic system

28
Q

What is a PT ratio?

A

To normalise results in a PT test

29
Q

What is an INR test?

A

An international normalised ratio - a PT ratio raised to the power of the international sensitivity index - gives the same result world wide - a normal result is around 1

30
Q

What is an APTT test?

A

A test which measures clotting time via the intrinsic system - results are specific for the lab that you are in

31
Q

Which test would you use if the patient is on warfirin?

A

INR

32
Q

Which test would you use if the patient was on heparin or lupus anticoagulant?

A

APTT

33
Q

What factors does Warfirin inhibit?

A

Vitamin K dependent factors - II, VII, IX, X

cardiovascular (36 decks)

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