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Health Assessment (Spring 2023) > Exam 3 Hemostasis & Coags > Flashcards

Exam 3 Hemostasis & Coags Flashcards

1
Q

The blood vessel endothelial layer contains?

A
  • vWF
  • tissue factor
  • prostacyclin
  • NO
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2
Q

The blood vessel media layer contains?

A

Collagen & Fibronectin

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3
Q

Endothelial cells synthesize & secrete (5)?

A
  • Procoaculants
  • anticoagulants
  • fibrinolytics
  • vasodilators
  • vasoconstrictors
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4
Q

What is the purpose of vWF?

A

Help platelets adhere to subendothelial layer

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5
Q

What is the purpose of tissue factor?

A

Activate the clotting cascade

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6
Q

What mediators control blood flow by vasoconstriction?

A
  • TXA-2
  • adenosine diphosphate (ADP)
  • Serotonin
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7
Q

What mediators control blood flow by vasodilation?

A

NO, prostacyclin

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8
Q

What are the 5 procoagulants?

A
  • (C)ollagen
  • (C)oagulation factors
  • (F)ibronectin
  • (T)hrombomodulin
  • (v)WF
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9
Q

What is the function of Collagen?

A

Tensile strength of the plug

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10
Q

What is the function of Fibronectin?

A
  • Mediates cell adhesion/anchoring fibrin
  • (Fibronectin is the “Hitch” of fibrins)
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11
Q

What is the function of Thrombomodulin?

A

Regulates anticoagulation pathway

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12
Q

What is the function of Antithrombin III?

A

Degrades factors II, IX, X, XI, & XII
(2 & 9-12)

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13
Q

What medication helps to keep fibronectin in place?

A

TXA

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14
Q

What vessel layer influences blood flow via contraction?

A

Adventitia

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15
Q

Delineate the Nitric Oxide pathway?

A
  • NOS converted into NO by L-arginine.
  • NO diffuses into muscle cell & stimulates SGC to convert GTP into cGMP -> causing relaxation.
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16
Q

Name the 3 prostanoids/eicosanoids?

A

Prostacyclin,
Leukotriene,
TXA

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17
Q

What are the 2 functions of prostacyclin?

A

Vasodilation & interferes with platelet formation & aggregation

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18
Q

What are the 4 phases of hemostasis & coagulation?

A

Vascular phase (vascular spasm).
Primary hemostasis (plug formation).
Secondary hemostasis (coagulation & formation of fibrin).
Fibrinolysis (Clot lysis)

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19
Q

What hormones are involved in the vascular phase & they do what?

A
  • Endothelins.
  • Stimulate smooth muscle contraction, endothelial- smooth muscle- & fibroblast cell division
20
Q

What are the 3 phases of platelet formation?

A
  • Adherence
  • Activation
  • Aggregation
21
Q

Where are about 1/3 of platelets sequestered?

A

In the spleen

22
Q

What & where are platelets cleared?

A

By macrophages in the (R)eticulo(e)ndothelial (s)ystem & spleen

23
Q

What is all (7) contained inside of platelets per lecture?

A
  • (F)ibrin-stabilizing factor,
  • (A)ctin & myosin,
  • (C)alcium,
  • (T)hrombosthenin,
  • (s)erotonin,
  • ADP,
  • growth factor
24
Q

What is present on platelet’s external surface?

A

Glycoproteins & phospholipids

25
Q

What is the function of platelet’s glycoproteins?

A

Adhere to endothelium, collagen & fibrinogen.
GpIIb-IIIa complex links activated Plt together.
GpIb sticks Plt to vWF.

26
Q

What happens during adherence?

A

vWF emerges from endothelial cell.
GpIb emerge from Plt surface.
GpIb attach to vWF

27
Q

What happens during the Activation phase?

A

Plt conformational change –> swells, oval & irregular.
GpIIb & IIIa project outward from Plt’s surface & link to other platelets.

28
Q

What happens during the Aggregation phase?

A
  • Plt release mediators (alpha & dense granules, contractile granules, thrombin, etc).
  • Mediators for primary unstable clot.
  • Primary plug maintains hemostasis or clotting cascade is activated if injury is large.
29
Q

What clotting factors are required for Fibrin production?

A

All of them

30
Q

Which clotting factors are vitamin K dependent?

A

II, VII, IX & X

31
Q

Which clotting factors are not made in the liver?

A

III, IV, VIII

32
Q

What pathway will not work very well with a calcium deficiency?

A

Extrinsic pathway

33
Q

What factors initiate the extrinsic pathway?

A

III & VII (37 cents buy the extrinsic pathway)

34
Q

Delineate the extrinsic pathway?

A
  • Tissue factor III activates pathway –> III activates factor VII to VIIa,
  • VIIa w/ calcium (factor IV) activates factor X to Xa.
  • Xa activates Prothrombin activator to convert Prothrombin to Thrombin (factor II).
  • Factor V accelerates positive feedback & increases prothrombin activator production.
35
Q

The extrinsic pathway needs___ to form a clot & the intrinsic pathway needs ___ to form a clot?

A

12-15sec & 6mins

36
Q

What sets off the intrinsic pathway?

A

Blood trauma / exposure to collagen (factor XII)

37
Q

Delineate the intrinsic pathway?

A

-Collagen exposure activates factor XII to XIIa conversion.
- XIIa activates XI to XIa.
- Factor XIa activates factor IX to IXa conversion.
- IXa & VIII activate factor X to Xa.
- Factor Xa activates prothrombin activator.

38
Q

What factor is missing with hemophilia A?

A

Factor VIII

39
Q

Delineate the common pathway?

A
  • Prothrombin activator changes Prothrombin (II) to Thrombin (IIa).
  • IIa changes Fibrinogen (I) to Fibrin
  • Prothombin (II) activates XIIIa (Activated fibrin-stabilizing factor ) .
40
Q

What prevents excessive fibrin deposition?

A

Fibrinolysis

41
Q

Urokinase is produced & released where?

A

By the kidneys to prevent small clots getting lodged in the kidney tissue

42
Q

What are 2 fibrinogenic factors?

A

(K)allikrien & (N)eutrophil (e)lastase

43
Q

What is the function of Kallikrien & neutrophil elastase?

A

Convert plasminogen to plasmin

44
Q

How does tPA work?

A
  • Converts Plasminogen to Plasmin –>
  • Breaks down Fibrin into Fibrin degradation split products
45
Q

What are the values for BT, PT, aPTT, TT, ACT & Fibrinogen?

A

BT= 3-10mins
PT= 12-14sec
aPTT= 25-35sec
TT= 30sec
ACT= 80-150sec
Fibrinogen= >150 mg/dL

Health Assessment (Spring 2023) (11 decks)

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