Coagulation Details Flashcards
Glanzmann Thrombasthenia is a deficiency of…?
GP IIb/IIIa
Bernard Soulier Syndrome is a deficiency of…?
GP Ib
Activated protein C mediates what?
Degradation of Factor 5a and 8a
What signals upregulate GP IIb/IIIa to cause platelet aggregation?
ADP
Factors 2, 7, 9, 10 are all produced where? What enzyme is required for their synthesis?
Liver
Epoxide reductase
Fletcher factor is AKA…
Prekallikrein
Fitzgerald Factor is AKA…
HMW Kininogen
Virchow’s Triad
Hypercoagulable State
Abnormal Blood Flow
Endothelial Injury
Describe basic mechanism of heparin induced thrombocytopenia
Heparin is administered IV and binds with platelet factor 4 in the bloodstream. Antibodies are generated against this substance, which also have activity against platelets. This causes thrombocytopenia
What is the major adverse consequence of heparin induced thrombocytopenia?
Venous limb gangrene
Describe the basic mechanism of ITP
Immune Thrombocytopenic Purpura
IgG antibodies against platelets are generated, leading to thrombotic disorders and excess clotting
Describe the basic mechanism of TTP
Thrombotic Thrombocytopenic Purpura
Deficiency of an enzyme (ADAMST13) that cleaves vWF multimers leads to excess vWF in the bloodstream. Causes aggregation of platelets without endothelial injury. Aggregates will block the microvasculature, causing microangiopathic hemolytic anemia.
What is poikocytosis?
Heterogeneity in cell structure due to the high force by which blood cells are forced through occluded vessels in microangiopathic syndromes
What conversion does TFPI specifically inhibit?
Conversion of Factor X to Factor Xa
Describe the basic mechanism of Factor V Leiden disease
Mutation leading to Factor V resistance to Protein C degradation. Protein C cannot degrade Factor 5, so these patients have hypercoagulability
What does thrombomodulin do?
Activates Protein C to break down Factors 5a and 8a. Therefore, thrombomodulin promotes a hypocoagulable state.
Hemophilia A is a deficiency of…?
Factor 8
Hemophilia B is a deficiency of…?
Factor 9
Describe how you might test for von Willebrand disease
Add ristocetin, which should complex with vWF to cause coagulation. If there is no vWF, the ristocetin will not promote coagulation.
Describe the 3 different types of von Willebrand disease
Type 1 and Type 3 = decreased circulating level of vWF (quantitative)
Type 2 = qualitative defect in vWF protein
Describe some clinical findings in Hemophilias
Prolonged APTT
Platelet function is normal
Bleeding time is normal
Describe some clinical findings in von Willebrand Disease
Impaired adhesion of platelets in vivo.
Bleeding time elevated
APTT slightly elevated
What si the main difference between primary and secondary fibrinolysis?
Primary fibrinolysis involves plasmin degrading only fibrinogen.
Secondary fibrinolysis involves plasmin degrading fibrinogen and fibrin.
Hyperhomocysteinemia can lead to…
Excess thrombosis
