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AU17: Gen Pathology > Coagulation > Flashcards

Coagulation Flashcards

1
Q

What are the procoagulant aspects of hemostasis?

A
  1. Platelets: adhesion -> activation -> aggregation

2. Coagulation: Activation -> thrombin formation -> fibrin formation, polymerization, stabilization

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2
Q

__________ hemostasis involves the platelet plug, __________ hemostasis involves the fibrin clot.

A

Primary; secondary

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3
Q

What is the membrane receptor for platelet response?

A

Glycoproteins 1b

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4
Q

Describe the process of platelet plug formation

A

vWF binds platelet (via GP 1b) to subendothelial matrix

Platelets release alpha-granules and dense bodies which activate GP IIb/IIIa receptors on other platelets and cause release of ADP

Fibrinogen connects GP IIb/IIIa receptors of each platelet and flattens the platelets

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5
Q

Crosslinking of fibrin monomers is done via factor ______.

A

XIIIa

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6
Q

_________ starts the coagulation cascade in most cases.

A

Tissue factor

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7
Q

What are the regulators of primary hemostasis?

A
  1. NO
  2. PGl2
  3. ADPase
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8
Q

What are the regulators for secondary hemostasis?

A
  1. Serine protease inhibitors (antithrombin)
  2. Protein C (controls Va and VIIIa)
  3. Fibrinolytic system
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9
Q

What could be a result of protein C or protein S deficiencies?

A

Hypercoaguability

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10
Q

___________ promotes coagulation by causing resistance to enzymatic inactivation by the Protein C/S complex.

A

Factor V Leiden mutation

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11
Q

How is the plasminogen activated?

A

tPA + plasminogen = active plasmin

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12
Q

Prothrombin Time screens for the activity of the __________.

A

Extrinsic coagulation pathway

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13
Q

Prothrombin time forms the basis of ______.

A

International Normalized Ratio (INR)

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14
Q

A patient has a PT done and is recorded as a 3 on the INR. What medication might he be on?

A

Warfarin (anticoagulant)

Longer clot time than normal

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15
Q

Partial thromboplastin time screens for the activity of the ___________.

A

Intrinsic pathway

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16
Q

Which takes longer to activate (extrinsic or intrinsic)?

A

Intrinsic

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17
Q

What medication might a patient be on if he is being monitored via PTT?

A

Heparin

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18
Q

What are some clinical manifestations of a primary hemostasis disorder?

A
  1. Mucocutaneous bleeding, petechia

2. Excessive bleeding with trauma

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19
Q

What are some clinical manifestations of secondary hemostasis disorders?

A
  1. Soft tissue bleeding

2. Excessive bleeding with trauma

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20
Q

A patient with a prolonged PT and PTT is likely to have a (primary or secondary) hemostasis disorder?

A

Secondary

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21
Q

A patient arrives with small petechia on the skin. What type of hemostasis disorder might this be?

A

Platelet (primary)

22
Q

If a patient has normal bleeding time, PT, and PTT, but experiences excessive bleeding what might you suspect?

A

Regulatory Hemostasis Disorder

23
Q

T/F: PT screens for platelets, while PTT screens for Coagulation pathway.

A

FALSE

Both are for coagulation.
PT = extrinsic
PTT = intrinsic

24
Q

What is the dominant clinical manifestation of vWD?

A

Mucocutaneous bleeding

25
Q

What are the three types of vWD?

A

Type 1: Quantitative deficiency (partial)
Type 2: Qualitative deficiency
Type 3: Quantitative deficiency (total)

26
Q

Why would PTT be slightly prolongued with vWD?

A

Factor VIII is slightly effected because it uses vWF to transport

27
Q

Hemophilia A is a deficiency in factor _____.

A

VIII

28
Q

What are the major laboratory features of hemophilia A?

A

Prolonged PTT and decreased Factor VIII

29
Q

What is the major treatment option for Hemophilia A?

A

Factor VIII concentrates

30
Q

A young child has spontaneous intracranial bleeding and a high PTT number. What might be the diagnosis?

A

Hemophilia A

31
Q

T/F: Hemophilia A is more likely to affect men.

A

TRue

32
Q

Hemophilia B involves a deficiency in factor ____.

A

IX

33
Q

What is the major treatment option for Hemophilia B?

A

Factor IX concentrates

34
Q

T/F: Platelet disorders will show with an increased bleeding time.

A

TRUE

35
Q

What is thrombocytopenia?

A

Having a lack of platelets

36
Q

T/F: Adults are likely to have acute ITP.

A

FALSE

Children = Acute
Adult = Chronic
37
Q

Describe the pathophysiology of ITP?

A

Autoantibodies attack the platelet membrane antigens

38
Q

How would you treat ITP?

A

Corticosteroids and intravenous immunoglobulin

39
Q

ITP may cost someone there ________, while TTP may cost someone there _________.

A

Spleen; kidney

40
Q

What are the two major clinical manifestations of DIC?

A

Bleeding from multiple sites and thromboembolic problems

41
Q

What is the most imperative early issue with DIC?

A

Stop the bleeding

42
Q

What is the sequence of clotting factors activated via the intrinsic pathway?

A

Factor XII -> Factor XI -> Factor IX

43
Q

In the extrinsic pathway, tissue factor activates factor ___.

A

VII

44
Q

What changes occur through the common pathway of blood clotting?

A
  1. Activation of Factor X
  2. Prothrombin -> thrombin
  3. Fibrinogen to fibrin molecules
45
Q

PTT would be measured in patients taking __________. While PT would be measured in patients taking ___________.

A

Heparin; Caumadin/Warfarin

46
Q

Thrombocytopenia is a ___________ in platelet count. Thrombocytosis and thrombocythemia denote an ________ in platelet number.

A

Decrease; increase

47
Q

Does bleeding time measure for primary or secondary hemostasis?

A

Primary (platelets)

48
Q

What are the characteristics of a primary hemostasis disorder?

A
  1. Muccocutaneous bleeding or bleeding with trauma

2. Prolonged bleed time and thrombocytopenia

49
Q

What are characteristics of a secondary hemostasis disorder?

A
  1. Soft tissue bleeding and bleeding with trauma

2. Long PT and/or PTT

50
Q

What molecule acts as a carrier protein for Factor VIII until endothelial damage is seen?

A

vWF

AU17: Gen Pathology (22 decks)

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