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Apex Review > Coagulation 3 > Flashcards

Coagulation 3 Flashcards

1
Q

What is the FIRST coagulation factor activated in the extrinsic pathway?
a. fibrinogen
b. Stuart-Prower factor
c. Tissue factor
d. labile factor

A

c. tissue factor

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2
Q

The extrinsic pathway is activated by

A

vascular injury or when the vessel wall comes into contact with blood

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3
Q

The extrinsic pathway includes factors

A

3 & 7

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4
Q

The extrinsic pathway is _______________- than the intrinsic pathway

A

faster

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5
Q

The extrinsic pathway is measured by the

A

PT & INR

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6
Q

The extrinsic pathway is inhibited by

A

warfarin

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7
Q

_____________ activates the extrinsic pathway

A

Tissue factor

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8
Q

Tissue factor activates factor

A

7

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9
Q

Factor 7 activates _ in the presence of _

A

10; 4 (Ca+)

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10
Q

What is the mnemonic for the extrinsic pathway?

A

For 37 cents, you can purchase the extrinsic pathway

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11
Q

What factor will be the first factor to become deficient in patients with liver failure, vitamin K deficiency, and those on warfarin?

A

factor 7 (has the shortest half-life)

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12
Q

How fast can a clot form via the extrinsic pathway of the coagulation cascade?

A

~15 seconds

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13
Q

What factors are specific to the classical intrinsic pathway? (select 3)
a. 4
b. 6
c. 7
d. 8
e. 9
f. 11

A

8, 9 & 11

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14
Q

The intrinsic pathway is activated by

A

blood trauma

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15
Q

The intrinsic pathway includes factors

A

12, 11, 9 & 8

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16
Q

The intrinsic pathway is _______ than the extrinsic pathway

A

slower

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17
Q

The intrinsic pathway is measured by

A

PTT & ACT

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18
Q

The intrinsic pathway is inhibited by

A

heparin

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19
Q

The classical intrinsic pathway is also called the

A

contact activation pathway

20
Q

What is the mnemonic for the intrinsic pathway?

A

If you can’t buy the intrinsic pathway for $12, you can buy it for $11.98

21
Q

What factor is missing with hemophilia A?

A

factor 8

22
Q

______ are missing with thrombocytopenia

A

Platelets

23
Q

What are the five steps of the intrinsic pathway?

A
  1. blood trauma exposure to collagen–> activates factor 12
  2. factor 11 activation
  3. factor 9 activation
  4. factor 10 activation (via factor 9a & 8)
  5. Prothrombin activator activates thrombin (factor 2a)
24
Q

How long does it take to form a clot via the intrinsic pathway of the coagulation cascade?

A

~6 minutes

25
Q

What factors make up the intrinsic pathway?

A

12, 11, 9, & 8

26
Q

Place the events of the final common pathway in the correct sequence:
thrombin activates fibrin monomer
prothrombin activator activates thrombin
activated fibrin stabilizing factor crosslinks fibrin

A

1st. Prothrombin activator activates thrombin
2nd. Activated fibrin stabilizing factor crosslinks fibrin
3rd. Thrombin activates fibrin monomer

27
Q

The primary goal of both the intrinsic and extrinsic pathways are to

A

produce prothrombin activator

28
Q

The final common pathway begins where

A

prothrombin activator changes prothrombin (2) to thrombin (2a)

29
Q

Thrombin (2a) is a proteolytic enzyme that changes

A

fibrinogen to fibrinogen monomer

30
Q

After the platelets aggregate, _______ is incorporated into the platelet plug

A

fibrin

31
Q

The clot will stay in place until the

A

underlying vascular tissue has repaired itself

32
Q

Prothrombinase is a complex of

A

complex of 10a + 5a + 4

33
Q

What is the mnemonic for the final common pathway?

A

The final common pathway can be purchased at the five and dime for 1 or 2 dollars on the 13th of the month.

34
Q

What is the role of thrombin?

A

it converts fibrinogen to fibrinogen monomer

35
Q

What must be present to convert fibrinogen monomer to fibrin fibers?

A

Calcium (factor 4)

36
Q

Identify the true statements regarding fibrinolysis. (select 2)
a. D-dimer measures fibrin split products
b. plasminogen is synthesized in the endothelium
c. tPA inhibitor inhibits the conversion of fibrinogen to fibrin
d. alpha-2 antiplasmin inhibits the action of plasmin on fibrin

A

a. D-dimer measures fibrin split products
d. alpha-2 antiplasmin inhibits the action of plasmin on fibrin

37
Q

Since the clot is only a temporary fix while the vessel repairs itself, the body needs a way to breakdown the clot after it is no longer needed. This process is called

A

fibrinolysis

38
Q

________ is a proteolytic enzyme that degrades fibrin into fibrin degradation products

A

Plasmin

39
Q

Plasminogen is incorporated into the clot as it’s being formed, but it lays dormant until a

A

plasmin activator activates it (e.g. tPA, urokinase)

40
Q

The body has a mechanism to stop the clot from increasing indefinitely. These processes include:

A

vasodilation & washout of ADP & TxA2
tissue factor pathway inhibitor neutralizes tissue factor
protein C & S, inhibiting factors 5a & 8a
antithrombin inactivates thrombin (2a) as well as factors 9a, 10a, 11a, and 12a

41
Q

Fibrin degradation products are measured by

A

D-dimer

42
Q

Plasmin activation is the result of:

A

injured tissue releasing tissue plasminogen activator (tPA) (major)
urokinase produced by the kidneys and released into the circulation (minor)

43
Q

Plasmin activators are used therapeutically to

A

dissolve thrombi and restore blood flow

44
Q

Once the clot is degraded, the body needs a way to turn off the fibrinolytic process:

A

tPA inhibitor (TPAI) inhibits the conversion of plasminogen to plasmin
Alpha-2 antiplasmin inhibits the action of plasmin on fibrin

45
Q

What 2 enzyme inhibitors turn-off the fibrinolytic process?

A

tPA inhibitor (TPAI)
alpha-2 antiplasmin

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