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Block 6 > Coagulation > Flashcards

Coagulation Flashcards

1
Q

Plasminogen can be proteolytically activated to _________ .

A

Plasmin

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2
Q

Which form of this protein, plasminogen or plasmin, is freely circulating when you are NOT clotting?

A

Plasminogen

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3
Q

Which form of this protein is the active, protein plug (clot) forming form? Fibrinogen or fibrin

A

Fibrin. Aggregates to form a fiber plug.

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4
Q

What kicks off the clotting cascade?

A

Cells that do not normally come into contact with RBC and other blood products, now come into contact with these and release signals to alert other cells that there is a problem. Signals for vasoconstriction and clotting.

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5
Q

What is the role of TXs in mitigating bleeding?

A

Assist platelet aggregation

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6
Q

How does our body prevent coagulation downstream of original injury to the endothelium?

A

The endothelial cells downstream of the cut display anti-coag proteins, bind anti-coag proteins, and destroy the accelerators of the coagulation reaction.
Endothelial cells also produce Prostacyclins that dilate vessels downstream to inhibit platelet aggregation.

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7
Q

Thrombin plays an important role in forming a platelet plug and in activating the enzyme Factor XIIIa (fibrin stapler) to _________ fibrin.

A

Cross-link

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8
Q

Does Thrombin activate platelets

A

Yes

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9
Q

What protein is responsible for making Fibrinogen insoluble so that its active form, Fibrin, will begin to polymerize?

A

Thrombin

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10
Q

What protein cross-links Fibrin, making it a rigid & strong mesh for helping platelets form clots to plug holes in endothelium?

A

Factor XIIIa

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11
Q

What protein activates Factor XIII to Factor XIIIa?

A

Thrombin

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12
Q

What protein activates platelets to change surface receptors and initiate shape change?

A

Thrombin

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13
Q

Upon injury, subendothelial cells at the site of injury release _________ that binds to Factor VIIa.

A

Tissue Factor

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14
Q

When the Tissue factor/Factor VIIa complex binds to Factor X, Factor X is activated forming Factor Xa which then activates small quantities of _________ .

A

Thrombin

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15
Q

Factors XI, V and VIII have a +ive feedback loop that increases the activation of ___________ x10,000

A

Prothrombin

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16
Q

The complex of Factors _____ & _______ activate Prothrombin to Thrombin x10,000 faster than Xa alone.

A

Xa & Va

17
Q

Accelerators of coagulation are found on the cell surface of _________ .

A

Platelets

18
Q

List the 3 steps in clot formation and maintenance

A
  1. Initiation
  2. Amplification
  3. Propagation & Stabilization
19
Q

What keeps the clot localized, preventing clots from over-propagating or causing emboli?

A
  1. Limiting initiation: LACI (lipoprotein associated coag factor)
  2. Limit amplification: anti-thrombin/heparin
  3. Limit propagation: protein C-S destroys accelerators
  4. Dissolve/digest clots with plasmin
20
Q

LACI does what to limit initiation of clot formation?

A

inactivates TF-VIIa-Xa to limit and terminate initiation

21
Q

What keeps the coag localized?

A

Platelet adhesion to the site

22
Q

What is the action of Antithrombin III in limiting amplification of clotting?

A

inactivates Thrombin, Factor Xa and IXa if they flow away from the injured site

23
Q

Plasmin digests clots by digesting which protein aggregate?

A

Fibrin

24
Q

Plasmin is activated by activated protein ____ and ________ _________ .

A

Protein C; plasminogen activator

25
Q

Endothelial cells express ____________ , a transmembrane protein that binds to thrombin and protein C. Activated C-S complexes inactivate the coag amplifiers Va and VIIIa.

A

thrombomodulin

26
Q

What protein and proteoglycan bind to Thrombin, Xa and IXa, inactivating them?

A

Anti-thrombin III & Heparin

27
Q

What protein inhibits the Tissue Factor-VIIa complex from activating factor Xa?

A

LACI

28
Q

What complex on endothelial cell surfaces binds Factors Va and VIIIa and digests them as well as releasing plasmin to digest the clot?

A

C-S complex. (proteins C & S)

29
Q

Do all the protein-protein interactions occur freely in the plasma?

A

No, they all occur on the extracellular surface of subendothelial cells, endothelial cells or platelets.

Block 6 (19 decks)

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