Coagulation Review Flashcards
________________ hemostasis involves the platelets clumping and adhering to the vessel and the vascular response to injury
Secondary
_________________ effect is the physical effect of the surrounding tissues which seals the vessel
Extravascular
__________ effect involves plasma factors
Intravascular
Vascular effects take effect when _______ from the endothelial membrane is exposed to platelets and they begin to aggregate
Collagen
Anti-thrombin Heparin complex neutralizes _______
Thrombin, factors IXa, Xa, XIa and XIIa
Based on their unique properties the coagulation factors are separated into 3 groups
- Fibrinogen Group
- Prothrombin group
- Contact factors
The coagulation factors are proteins except
Factor IV (Calcium)
What factor is found in the common pathway, is synthesized in the liver, is a heat labile factor, yet is not affected by vitamin K deficiencies?
Factor V
This factor is converted by thrombin to its activated form and it stabilizes the fibrin clot in the common pathway.
Factor XIII
What factor is also known as the Fletcher Factor?
Prekallikrein
Hemophiliac will show a deficiency of what factor
Factor XIII
Factors XII’s activation starts ___________ pathway
Intrinsic
Factor VII is exclusive to the _____________ pathway
Extrinsic
Plasminogen activates to _____________ and is responsible for fibrinolysis or digesting fibrin
Plasmin
___________ is the cessation of blood
Hemostasis
The_________ assures that clots in the body are formed only formed only when needed
Hemostatic mechanism
The body’s complex Hemostatic mechanism can respond in 2 ways. Name the 2 responses and briefly describe each
.
__________ is when a damaged blood vessel contracts to decrease blood flow
Vado constriction
Factor 1 = Sun/gun
Fibrinogen
Factor 2 - Shoe
PT (prothrombin)
Factor 3 - Tree
Tissue Thromboplastin (TT)
Factor 4 - door
Calcium
Factor 5- knive
Proaccerlerin/ Labile factor
LAY-bile ( body laying there stabbed)
Factor 7 Heaven
Proconvertin / STABLE factor
Factor 8- great
Anti hemophiliac factor A is great
Factor 9 - dime
Plasma thromboplastin component (Christmas)
Factor 3 is a type of thromboplastin, 3 is a factor of 9 plus dime for Christmas
Factor 10- pen
Stuart proper factor
Stuart little stabbed by a pen
Factor 11-
PTA (plasma thromboplastin antecedent)
Think GTA 11
Factor 12 - shelf
Hageman factors
Hanging on the shelf
Factor 13 -Freddy
Fibrin Stabilizing factor
Principle of PT is the time required for plasma to clot after an excess of ______ and an optimal amount of _______ have been mixed with that patient’s plasma
Thromboplastin and Ca
If PT level is decreased, _______ may occur
Embolism
If PT level is increased, _________ may occur
Hemmorhage
The INR, devised by the ____, standardized the way PT results were reported internationally
WHO
The ISI is specific to each lot of _____
Thromboplastin
The APTT test monitors the ____ pathway coagulation factors
Intrinsic and Common pathway
The common pathway begins with the activation of factor:
Factor X
Which of the following is the best test to monitor heparin therapy?
APTT
What factors are Vitamin K dependent?
II, VII, IX and X
What factors are synthesized in the liver?
I, II, V, IX, X, XI and XII
Deficiency of this factor causes Hemophilia A
Factor VIII
This Disease is a deficiency of factor IX and is sex linked coagulation disorder
Hemophilia B
Which factors are increased due to inflammation pregnancy and oral contraception use
Plasma coagulation factors I, V, VIII and XIII
What is the anticoagulant of choice for routine coagulation assays
Heparin
The prothrombin assay requires that patients citrated plasma maybe combine with what
Thromboplastin
Why are plastic or siliconized tubes used for blood specimens for coagulation essays
So the the blood won’t clot because of hageman factor
Plasma coagulation Factors can be divided into 3 components, list each one
- Cofactor group
- Fibrinogen group
- Prothrombin group
_______ is when platelets move to site, stick together, and help inhibit bleeding
Primary Hemostasis
If you have a pt that is factor VIII deficient, the pts platelets are not adhering properly and have an abnormal bleeding time. what disease is most likely causing this?
Von Willebrands Disease
The hemostatic mechanism can be divided into 3 components, list each one
Intravascular
Extravascular
Vascular
What component of the hemostatic mechanism is occurring when blood vessel endothelial membranes release collagen, platelets come in contact with collagen, platelet aggregation occurs and a clot begins to form?
Vascular component
What do platelets release during vasoconstriction?
Serotonin
What component of the Hemostatic Mechanism is described when a platelet plug is being formed and the intrinsic pathway plasma coag factors are being activated?
intravascular factor
_________ react to injury of vessels to form a platelet plug
Platelets
How many plasma coag factors are there?
14
What are the plasma coag factors made of?
protein
which factor is not a protein?
Calcium Factor IV
________ is the mechanism whereby, there is injury to a blood vessel, plasma proteins and calcium work together on the surface platelets to form a fibrin clot
Hemostatic Mechanism
_________ is the activated enzyme responsible for digesting fibrin
Plasmin
Waste products of fibrinolysis are removed from the body by what?
RES
Factors involved in extrinsic
III (+Ca) & VIII
Factors involved in the intrinsic pathway
HMWK, PK, 12,11,9 & 7
What anti-coag therapy is APTT used to help monitor?
Heparin
What anti-coag therapy is PT used to monitor?
coumadin
What factors does heparin inhibit?
XII, XI, X, IX and II
_______ must be present for heparin to work
heparin
T/F Heparin is naturally present in the body in low concentrations
True
_____ and ____ are drugs to prevent thrombosis and pulmonary embolism
Coumadin and Warfarin
If PT level is decreased, _____ can occur. If PT level is increased, fatal _____ can occur.
embolism for decreased, fatal hemorrhage is increased
What is ISI?
International Sensitivity Index
What factors doe Coumadin inhibit?
II,VII, IX and X
T/F Coumadin is administered orally?
True
T/F Controls are run in duplicated and must agree within specific limits est. for the test. Controls limits vary with brand use
True
____ used to report standardized results for PT assays for pts who are receiving oral anticoag therapy
INR
What plasma factor is found in the liver, required for the formation of a fibrin clot; without it clotting is prolonged or may even fail
fibrinogen
The _____ devised a standard reference thromboplastin that is assigned a reference value of 1.0
WHO
____ the principle of this is an activator is mixed with a platelet substitute (thromboplastin) before the addition of the plasma being tested; only a partial component of thromboplastin is used
APTT
_____ is the best procedure for detection of deficiencies in the intrinsic and common pathways, Used to manage pts on heparin anticoag therapy
APTT
T?F D Dimer is a fibrin split product that is formed when fibrin strands degrade
True
What is a POS result for a qualitative d dimer test?
Agglutination
What antibody is used to bind and D Dimer present in pt plasma?
anti d dimer
________ is a rare inherited recessive trait characterized by lack of fibrinogen and can cause profuse bleeding after slight trauma
Afibrinogenemia
_________ is a inherited condition where fibrinogen levels are decreased and hemorrhage after trauma is uncommon
hypofibrinogenemia
_________ inherited defect or can be acquired with liver disease, normal interaction of fibrinogen with its enzymes is disrupted, causing defective fibrin formation
dysfibrinogenemia
The principle of the quant. method of fibrinogen test is the comparison of pt plasma______ to that of a known fibrinogen __________
clotting time and standard
What is the normal range for fibrinogen test?
200-400 mg/dl
T/F Abnormality of deficiency of coag factors affects bleeding time
False
T/F ingestion of aspirin can affect platelet function for up to 8 days
true
Simplate method, what are measurements of cut
5mm long and 1mm deep
For a bleeding time inflate blood pressure cuff to ______
40 mm Hg
T/F Hemophilia A pts have a prolonged PT/PTT
False
What is associated with thrombocytopenic purpura
petechiae and hemorrhage
T/F Von Willebrands disease affects platelets
True
_____ measures the rate of change of light absorbance
optical density
T/F the fibrometer sample and reagent wells incubate 37C
True
T/F the sample and reagents are mechanically pipetted in the semi-automated fibrometer
false
How does the semi automated fibrometer detect clots
moving electrodes
T/F POC testing can be performed in a surgery suite, physicians office or pts home because its very reliable and low cost
false
