FIBRINOLYSIS Flashcards

1
Q

is defined as the dissolution of clot by plasmin.

A

Fibrinolysis

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2
Q

is derived from plasminogen, which is produced by the liver.

A

Plasmin

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3
Q

Dissolution of clot to restore and reestabish blood flow

A

FIBRINOLYSIS

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4
Q

Clot=

A

Thrombosis = ↑ Blood pressure = Aneurysm

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5
Q

-Dissolution of clots

A

FIBRINOLYSIS

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6
Q

-systematic, accelerating hydrolysis of fibrin by bound plasmin

A

FIBRINOLYSIS

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7
Q

-Proteins involved:

A

Plasminogen
Tissue plasminogen activator
Urokinase
Plasminogen activator inhibitor-1
a2-Antiplasmin Thrombin-activatable
fibrinolysis inhibitor

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8
Q

Plasma serine protease, plasmin digests fibrin/fibrinogen

A

Plasminogen

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9
Q

Serine protease secreted by activated endothelium, activates plasminogen

A

Tissue plasminogen activator

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10
Q

Serine protease secreted by kidney, activates plasminogen

A

Urokinase

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11
Q

Secreted by endothelium, inhibits tissue plasminogen activator

A

Plasminogen activator inhibitor-1

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12
Q

Inhibits plasmin

A

a2-Antiplasmin

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13
Q

Suppresses fibrinolysis by removing fibrin C-terminal lysine binding sites

A

Thrombin-activatable fibrinolysis inhibitor

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14
Q

: Serine protease; substrate for activation; activates plasmin (digests fibrin to fibrinogen)

A

Plasminogen

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15
Q

: digests fibrin/fibrinogen

A

Plasmin

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16
Q

: injured blood vessel that releases procoagulant substances like collagen and tissue factor

A

Activated endothelium

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17
Q

Endothelium → Activation of plasminogen →

A

TPA → Plasmin

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18
Q

: regulator of TPA/Urokinase plasminogen activator

A

Plasminogen activator inhibitor-1

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19
Q

: specifically inhibits free plasmin

A

a2-Antiplasmin

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20
Q

: activated by thrombin

A

TAFI

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21
Q

: form the kidneys and can also be produced by monocyte and macrophage

A

UPA

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22
Q

• Serine protease activated to plasmin

A

PLASMINOGEN

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23
Q

• Produced by the liver

A

PLASMINOGEN

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24
Q

• Structure: five glycosylated loops (kringles)

A

PLASMINOGEN

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25
Q

is made up of lysine amino acid

A

Plasminogen

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26
Q

: located at the C-terminal end of every loop

A

Lysine

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27
Q

allows binding to TPA or UPA in plasminogen to activate it

A

Lysine

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28
Q

binding site of the activators of plasminogen

A

Lysine

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29
Q

attaches lysine to activate plasminogen (FIBRINOLYTIC SYSTEM)

A

TPA/UPA

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30
Q

Other activators: (COAGULATION SYSTEM)

A

FXIIa, Kallikrein, and Thrombin + Protein C, Protein S, Protein Z, thrombomodulin

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31
Q

(EXOGENOUS)

A

urokinase and streptokinase

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32
Q

not produced by the body but can imitate the action of urokinase from the kidney

A

EXOGENOUS

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33
Q

synthetically produced outside the body

A

EXOGENOUS

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34
Q

can come from bacteria, medications, and food

A

EXOGENOUS

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35
Q

Functions of Plasmin

A

Promotes clot dissolution

Activates complement system

Fragments FXIIa

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36
Q

activated form of plasminogen, which digests the clot

A

Plasmin

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37
Q

: excess plasmin is released and destroyed by antiplasmin

A

→ Normal

38
Q

: excessive free plasmin is released, antiplasmin is depleted, plasmin destroys other components

A

→ Abnormal

39
Q

(substrates for plasmin: [?])

A

I, V, VIII, XIII

40
Q

Plasmin cannot recognize the difference between

A

fibrinogen and fibrin

41
Q

Fibrinogen will be depleted and exhausted from the liver until I, V, VIII depletes = [?] due to excess plasmin not destroyed by antiplasmin

A

prolonged bleeding

42
Q

(participates in the activation of C1a, C1b, and other complement factors)

A

Activates complement system

43
Q

(along with K, activates plasminogen to plasmin; plasmin feeds back to XII to fragment it)

A

Fragments FXIIa

44
Q

Types of Plasmin

A
  1. Bound plasmin
  2. Free plasmin
45
Q

: digest clots (needed by the body)

A
  1. Bound plasmin
46
Q

: digest fibrinogen, FV, VIII and fibronectin

A
  1. Free plasmin
47
Q

imp in plt adhesion; can destroy a lot when free in the circulation & without antiplasmin

A
  1. Free plasmin
48
Q
  • activates fibrinogen to become fibrin
A

Thrombin

49
Q
  • Fibrin (composition: [?] – soluble)
A

fibronopeptide A and fibronopeptide B

50
Q
  • independent; weaker; subjected to proteolysis =
A

soluble (no clot)

51
Q
  • Cross-linked fibrin is insoluble and acted upon by plasmin forming
A

FDPs (fibrin degradation products)

52
Q

-: connects and cross-links domains/fibrinopeptides A and B

A

FXIII

53
Q

FDPs

A
  • Fibrin degradation products
54
Q

(has both alpha and beta knobs)with 2 D domains

A

E central domain

55
Q

connects with other D to create fibrin link

A

E

56
Q

connects D dimer

A

Alpha knob

57
Q

connects D domain

A

Beta knob

58
Q
  • is activated to plasmin
A

Plasminogen

59
Q
  • Plasmin works on fibrin and split them into
A

FDPs

60
Q
  • TPA and UPA is inhibited by
A

Plasminogen Activator Inhibitor (PAI-1) and Lipoprotein A (Lp-a)

61
Q

– these two are controlled by TPA and UPA

A

Plasminogen Activator Inhibitor (PAI-1) and Lipoprotein A (Lp-a)

62
Q
  • Free plasmin (plasmin that did not participate in the clot) is inhibited by
A

a-2 antiplasmin

63
Q

-: activates fibrinogen to fibrin, XIII to XIIIa and TAFI to TAFIa

A

Thrombin

64
Q

(needed to control plasmin)

A

TAFIa

65
Q

TAFI

A
  • Thrombin-Activatable Fibrinolysis Inhibitor (TAFI)
66
Q

Plasminogen is activated to Free plasmin and Bound plasmin (attached to a clot) by [?]

A

TPA

67
Q

attaches to bound plasmin degrading fibrin to firbin degradation products (FDPs: X, Y, D, E, D-dimer)

A

TPA

68
Q

: targets bound plasmin

A

3) Thrombin-activatable fibrinolysis inhibitor (TAFI)

69
Q

: targets free plasmin; works on the dangerous free plasmin

A

2) a-2 antiplasmin

70
Q

: targets activator of plasminogen

A

1) Plasminogen activator inhibitor-1 (PAI-1)

71
Q

deactivates fibrinolysis at once/primary inhibitor/regulator of fibrinolysis

A

1) Plasminogen activator inhibitor-1 (PAI-1)

72
Q

Fibrin (& Fibrinogen) Degradation Products (FDP):

A

X, Y, D (DD DIMER), E

73
Q

• Four principal products by plasmin:

A

Fragment X,Y,D (D-D dimer) and E

74
Q

: early degradation products

A

• X and Y

75
Q

: late degradation products

A

• D and E

76
Q

: indication of in-vivo fibrinolysis

A

• D-D dimer

77
Q

tested for px w/ DIC where coagulation occurs inside the body by administering anticoagulants to inhibit some factors and stop coagulation

A

• D-D dimer

78
Q

production indicates that coagulation has stopped and clot has dissolved

A

• D-D dimer

79
Q

indicates successful fibriolysis

A

• D-D dimer

80
Q
A

Fibronopeptide A

Fibronopeptide B

81
Q

Fibronopeptide A is degraded by plasmin by working first on the alpha chain =

A

Fragment X

82
Q

E and D is degraded by plasmin by working first on the D domain =

A

Fragment Y

83
Q

composed of 1 E dmain and 1 D domain

A

Fragment Y

84
Q

Does not contain alpha chain and 1 D-dimer

A

Fragment Y

85
Q

E and D connects = (indication of in vivo fibrinolysis)

A

D-d dimer

86
Q

Effects of FDP:

A

inhibits coagulation

87
Q

: with anticoagulant effect (V and VIII)

A

Fragment Xand Y

88
Q

: inhibit fibrin polymerization

A

Fragment Y and D

89
Q

do not allow fibrin to connect w/ each other/no cross-linking

A

Fragment Y and D

90
Q

: inhibits thrombin (the body cannot coagulate in the presence of FDP – control of coagulation and anticoagulant)

A

Fragment E