Coagulation Cascade

Question 1

two main components of blood

Answer 1

plasma (55%) and formed elements (45%)

Question 2

composition of plasma

Answer 2

proteins, water, other solutes
- 92% water
- electrolytes

Question 3

composition of formed elements

Answer 3

platelets, WBC, RBC
- majority is RBC

Question 4

plasma proteins

Answer 4

• albumin and globulins (albumin 57%)
• clotting proteins (fibrinogen most plentiful clotting factor)

Question 5

function of albumin in blood

Answer 5

regulates how much water is in cellular vs vascular space
regulates oncotic pressure

Question 6

serum

Answer 6

plasma without the clotting factors

Question 7

erythrocyte

Answer 7

RBC, most abundant cell in the blood
- transports O2 to and from the lungs and tissue cells

Question 8

leukocytes

Answer 8

WBC whose main role is defense

Question 9

neutrophils

Answer 9

type of WBC who is the first responder to site of injury
- also plays a role in phagocytosis

Question 10

eosinophils

Answer 10

WBC who plays a role in allergic rxn and parasitic infections

Question 11

basophil

Answer 11

type of WBC who plays a smaller role in allergic rxn

Question 12

monoyte/macrophages

Answer 12

type of WBC whose role is phagocytosis
- eats debris and waste

Question 13

lymphocyte

Answer 13

types of WBC who is responsible for defending and remembering pathogens
- b and t immunity cells

Question 14

natural killer cells

Answer 14

type of WBC whose is the primary defense against tumors and viruses

Question 15

platelet

Answer 15

irregularly shaped, anuclear cell w cytoplasmic properties that are essential for clotting
- contain cytoplasmic granules that can release adhesive proteins, coagulation, and growth factors when they sense vessel injury

Question 16

normal platelet count

Answer 16

150,000-400,000

Question 17

thrombocytopenia

Answer 17

less than 100,000 platelets
high risk for bleeding bc you cant clot

Question 18

where are additional platelets stored

Answer 18

spleen

Question 19

platelets circulate in a [blank] state

Answer 19

unactivated

Question 20

what happens to platelets when bv is damaged

Answer 20

1) inc platelet adhesion (become sticky/dendritic)
2) activation leads to platelet aggregation
3) platelet/platelet and platelet-vascular wall adhesion inc
4) activation of clotting system forming immobilizing meshwork

Question 21

clotting cascade

Answer 21

group of proteins that will form blood clot when activated

Question 22

blood clot

Answer 22

meshwork of fibrin strands and platelets
- protein strands stabilize platelet plug and trap other cells

Question 23

primary activator of clotting cascade

Answer 23

platelet

Question 24

hemostasis

Answer 24

the stopping of blood flow
- clot plugs damage vessel to stop the bleeding

Question 25

fibrin is made up of

Answer 25

protein strands

Question 26

ways to stop the clot

Answer 26

anti thrombin and tissue factor pathway inhibitor

Question 27

antithrombin

Answer 27

inhibits thrombin to stop clotting process

Question 28

tissue factor pathway inhibitor

Answer 28

inhibits factor Xa

Question 29

natural removal of clot

Answer 29

breakdown carried out by fibrinlytic system - tissue plasminogen activator turns plasminogen into plasmin - plasmin degrades fibrin to breakdown clot

Question 30

coagulation therapy goals

Answer 30

- prevent clot formation - break apart existing clots - can help inc circulation and perfusion - dec pain - prevent further tissue damage

Question 31

drugs that inhibit coag

Answer 31

- heparin, low wt molecular heparin - warfarin - apixaban - aspirin - clopidogrel

Question 32

biggest concern for anti coags

Answer 32

bleeding - internal or external - know why pt is taking, and area of most risk for bleeding - monitor h&h and vs

Question 33

what happens to vs if pt is bleeding

Answer 33

HR inc RR inc inc pallor BP dec

Question 34

types of drugs used for clotting

Answer 34

anticoagulants anti-platelet

Question 35

anticoagulants

Answer 35

inhibit the action or formation of clotting factors PREVENT CLOTS

Question 36

anti platelet

Answer 36

prevent platelet plugs form forming by inhibiting platelet aggregation (dec sticky platelets) - best for prevent stroke/heart attacks

Question 37

thrombus

Answer 37

blood clot that remains attached to bv - most common in veins due to flow and pressure

Question 38

thromboembolism

Answer 38

detached blood clot

Question 39

deep vein thrombosis

Answer 39

thrombus occurring in the lower extremity - typically veins and more specifically around valves

Question 40

triad of virchow

Answer 40

there are three factors that promote the formation of a clot 1) venous stasis 2) venous endothelial damage 3) hyper coagulation

Question 41

high risk of triad of virchow

Answer 41

- ortho surgeries - spinal cord injuries - obstetric/gynecologic conditions

Question 42

venous stasis

Answer 42

slow flow of the venous system - typical in older adults, dec mobility, heart failure

Question 43

venous endothelial damage

Answer 43

injury typically related to trauma, surgery or some types of IV meds

Question 44

hyper coagulable states

Answer 44

high clotting state - caused by malignancy, pregnancy, oral contraceptives, genetics

Question 45

thrombus typically occur near

Answer 45

venous valves

Question 46

patho of DVT/VTE

Answer 46

inflammation around the thrombus promotes inappropriate platelet aggregation and thrombus grows - cause pain and redness but also no symptoms

Question 47

thrombus can cause

Answer 47

significant obstruction to venous blood flow and can cause pressure buildup and cause edema of extremity

Question 48

risk of DVT/VTE

Answer 48

- clotting disorders - immobility - injury/surgery - pregnancy - oral contraceptive/hormone replacement therapy - overwt/obese - smoking - cancer/chemo - heart failure - inflammatory bowel diseases - hx of DVT or fam hx - over age 60 - varicose veins/spider veins

Question 49

serious complication of DVT/VTE

Answer 49

- PE (prevents gas exchange in the lungs) - chronic thromboembolic pulmonary HTN (caused by repeated clots, inc pressure in lungs, rare) - post thrombotic syndrome (related to chronic te pulm HTN, pain, achy, fatigue, nerve issue, spider veins, inc pigmentation) - phlegmesia cerula dolens (rlly rare, clots in major veins causing total occlusion, deep pain, intense cyanosis, can lead to gangrene and amputation)

Question 50

treatment for DVT/VTE

Answer 50

- anti coag - prevention of risk factors - IVC filters - embolectomy