Coagulation: Basics Flashcards

1
Q

what are the main steps of primary hemostasis?

A
  • initial vessel spasm
  • platelet aggregation
  • fibrin formation
  • initiation phase of cell model
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2
Q

how long does primary hemostasis take?

A

seconds

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3
Q

what does primary hemostasis culminate in?

A

platelet plug

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4
Q

what are the main steps of secondary hemostasis?

A
  • process of clot formation
  • protease cascades of the clotting factors
  • amplification and propagation phase of the cell model
  • intrinsic and common pathways
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5
Q

what does secondary hemostasis culminate in?

A

fibrin clot formation

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6
Q

how long does secondary hemostasis take?

A

several minutes

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7
Q

what is “Initiation”?

A

the initiation of hemostasis, when TF and VII (extrinsic pathway) –> produce small amounts of thrombin –> thrombin then activates platelets

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8
Q

what factors start “Initiation”?

A

TF and VIIa

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9
Q

What are the 3 major steps of platelet plug formation?

A
  • adhesion
  • aggregation
  • activation
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10
Q

what initiates platelet plug formation?

A

exposure of platelets to TF and basal lamina components like collagen

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11
Q

what is “Adhesion”?

A

platelet adhesion to the surface collagen via VWF as well as directly

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12
Q

what is “Aggregation”?

A

platelet to platelet attachment, mediated by fibrin and VWF

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13
Q

what is “Activation” of platelets?

A
  • degranulation –> releases vasoactive and platelet-activating mediators
  • shape change –> from discs to flattened star shaped with cellular projections
  • phosphatidylserine exposure on platelet surface –> essential for clotting factor binding
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14
Q

what does “Amplification” mean?

A
  • thrombin and other platelet granule content activates the intrinsic pathway –> thrombin burst
  • activated platelet’s surfaces act as site for attachment for VIII and V
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15
Q

what is propagation

A

activation of large amounts of thrombin –> “thrombin burst” –> large amounts of fibrinogen becoming fibrin

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16
Q

what are the two common models of hemostasis?

A
  • cascade model with extrinsic/intrinsic/common pathways

- cell model with primary and secondary hemostasis

17
Q

name factor I and Ia

A

fibrinogen and fibrin

18
Q

name factor II and IIa

A

prothrombin and thrombin

19
Q

name factor III

A

thromboplastin

20
Q

name factor IV

21
Q

name factor V

A

proaccelerin

22
Q

name factor VII

A

proconvertin

23
Q

name factor VIII

A

antihemophilic factor

24
Q

name factor IX

A

plasma thromboplastin component

25
name factor X
Stuart-Prower factor
26
name factor XI
plasma thromboplastin antecendent
27
name factor XII
Hageman's factor
28
which factors require Vit K for synthesis
factors II, VII, IX, and X
29
what factor can be synthesized outside the liver
factor VIII, but also mainly synthesized in the liver, also produced by endothelial cells
30
what factor is required in the largest quantities for coagulation
fibrinogen (around 2-4 g/L in blood is normal)
31
under what level does hypofibrinogenemia affect coagulation
levels below < 1.0 g/L