Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SP 16 - Path Test 2 > Coagulation and Bleeding Disorders > Flashcards

Coagulation and Bleeding Disorders Flashcards

1
Q

What are the 3 major components of the hemostatic system?

A

Vascular wall
Platelets
Coagulation Proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 phases of primary hemostasis?

A

Adhesion
Activation
Aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Adhesion

A

Adhesion of platelets to the damaged endothelial wall

Adhesion activates surface membrane receptors and adhesive proteins (vWF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

von Willebrand Factor

A

Mediates the adherence of platelets to the subendothelial colalgen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Activation

A

In order to effectively form a hemostatic plug, additional platelets are recruited to the local site
As platelets are activated by binding to vWF, there is release of second messenger molecules within the platelet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does platelet activation lead to?

A

Shape change of platelet from discoid to spheroid
Secretion of cytoplasmic ADP
Activation of the glycoprotein IIb/IIIa receptor
Contraction of the platelet mediated through actin fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Activation

A

Platelets interact with other platelets
The release of cytoplasmic ADP causes the activation of adjacent platelets, and platelet-platelet binding through fibrinogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Secondary Hemostasis / Fibrin clot formation

A

Soluble coagulation proteins within the plasma are activated to generate thrombin in an amplification reaction
Thrombin converts fibrinogen to fibrin, which adds stability to the clot after fibrin monomers are cross-linked by Factor XII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Intrinsic Pathway

A

Sequence of activation of Factor XII
XII –> XIIa (via kallikrein)
XI –> XIa (via XIIa)
IX –> IXa (via XIa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Extrinsic Pathway

A

Sequence of activation of Factor VII by TF:

VII –> VIIa (via TF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The Common Pathway

A

X –> Xa
Prothrombin –> Thrombin (via Xa)
Fibrinogen –> Fibrin (via thrombin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What proteins are responsible for regulating hemostasis?

A

Antithrombin
Protein C
Plasminogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does Antithrombin regulate hemostasis

A

Inhibits the activity of thrombin and other serine proteases of the coagulation cascade, but forming an inactive enzyme-inhibitor complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most well known Antithrombin and how does it work?

A

Antithrombin III
In the presence of heparin, it becomes activated so that it can form a complex with thrombin, thus destroying the ability of thrombin to participate in the coagulation cascade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Protein C

A

Regulates major cofactors of the coagulation cascade (Va and VIIIa)
Activated Protein C (APC) plus Protein S (its cofactor) together inactivate factors Va and VIIIa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Plasminogen

A

Gets activated by tissue plasminogen activator from the endothelium (tPA) into Plasmin
Plasmin trims fibrin, thus controlling the degree of secondary coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Prothrombin time (PT)

A

Time needed for plasma to form a clot in the presence of added tissue thromboplastin
Screens for the activity of proteins in the extrinsic pathway
Used to measure anticoagulation of pts using oral anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Partial Thromboplastin Time (PTT)

A

A measurement of the time needed for plasma to form a clot in the presence of added ground glass or kaolin (these activate Factor XII)
Screens for activity within the Intrinsic Pathwys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Platelet count

A

A measurement of platelet number in anticoagulated blood

Normal: 150,000-400,000/uL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Thrombocytopenia

A

Decrease in platelet number

21
Q

Thrombocytosis

A

Increase in platelet number

22
Q

Thrombocythemia

A

Increase in platelet number

23
Q

Mixing Studies

A

Measures platelet function
If pt has prolonged PT or PTT, you mix their blood with normal blood in a 1:1 ratio
If the problem is corrected - a deficiency exists
If the problem persists - there is an inhibitor present

24
Q

von Willebrand disease symptoms

A 
Mucocutanous bleeding is the predominant clinical manigestation:
Nosebleeds
Ecchymosis (bruising)
Bleeding with trauma or surgery
Excessive menstrual flow
25
Q

von Willebrand Disease

A

Autosomal dominant abnormal vWF
Most common inherited bleeding disorder
Symptoms often improve after adolescence

26
Q

Type I vWF disase

A

Most common form

Decreased production in the amounts of vWF

27
Q

Type II wWF disease

A

Qualitatively abnormal vWF

28
Q

Type III vWF disease

A

Complete lack of vWF

This form is autosomal recessive

29
Q

What are the laboratory manifestations of vWF disease?

A

Prolonged PT

Prolonged PTT

30
Q

What are the therapeutic options for vWF disease?

A

Desmopressin
Antifibrinolytic agents in mild cases
Factor VII concentrates containing vWF and cryoprecipitate in severe cases

31
Q

What is the cause of Hemophilia A?

A

X-Linked Recessive
Decreased Production of Factor VIII
It’s the most common cause for serious bleeding

32
Q

Clinical Manifestations of Hemophilia A?

A 
Recurrent soft tissue bleeding
Hemarthrosis
Bleeding with trauma
Intramuscular hematomas
Intracranial hematomas
Bleeding into other tissues
33
Q

Laboratory features of Hemophilia A

A

Normal PT
Prolonged PTT
Decreased Factor VIII

34
Q

Severe Hemophilia A

A

Factor VIII level of

35
Q

Moderate Hemophilia A

A

1-5% Factor VIII

Bleeding with minor trauma

36
Q

Mild Hemophilia A

A

> 5% Factor VIII

Bleeding with major trauma

37
Q

How does Hemophilia B compare to A?

A

Clinical and lab presentation is similar to the deficiency of Factor VIII in Hemophilia A

38
Q

What causes Hemophilia B?

A

X-linked Recessive

Deficiency in Factor IX

39
Q

What three diseases cause Thrombocytopenia

A

ITP
TTP
DIC

40
Q

Bleeding due to Thrombocytopenia looks like what?

A

Petechial hemorrhages in the skin an mucous membrane

41
Q

Immune Thrombocytopenia Purpura

A

Immune-mediated destruction of platelets
Platelets are coated with antibodies and sequestered in the spleen
High mortality rate if left untreated

42
Q

Acute/Childhood Immune Thrombocytopenia Purpura (ITP)

A 
Occurs in childhood
Sudden onset
Severe thrombocytopenia
Often self-limited and resolves in 2-6 weeks
Males and females are effected equally
43
Q

Chronic/Adult Immune Thrombocytopenia Purpura (ITP)

A 
More typical in adults
Gradual onset
Moderate thrombocytopenia (much less than acute form)
Doesn't resolve w/o treatment
More common in females
44
Q

Clinical Features of ITP

A

Petechial hemorrhages
Ecchymoses
Bleeding with trauma or surgery

45
Q

Pathophysiology of ITP

A

Autoantibodies directed at the platelet membrane antigens
GP Ib/IX and IIb/IIIa are common targets
Increased IgG bound to the platelet surface promotes increased destruction by the reticuloendothelial system

46
Q

Thrombotic Thrombocytopenic Purpura cause

A

Intravascular platelet activation with formation of platelet-rich microthrombi throughout circulation
Due to deficiency of ADAMTS 13 - which normally degrades very high molecular weight vWF

47
Q

Disseminate Intravascular Coagulation

A

Unregulated, widespread intravascular activation of the hemostatic system and systemic formation of thrombi and plasmin with simultaneous microthrombi formation and consumption of clotting factors

48
Q

DIC clinical manifestations

A 
Bleeding from multiple sites
Thrombotic problems
Hypotension and shock
Respiratory dysfunction
Hepatic and renal dysfunction
CNS dysfunciton
49
Q

What clinical situations predispose a person to DIC?

A

Infections (gram- sepsis)
Tissue injury (trauma, burn, surgery)
Obstetrical complications
Certain malignancies

SP 16 - Path Test 2 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions