final lecture 3

Question 1

important functions of hemostasis

Answer 1

upon damage- arrests bleeding

normally-maintains blood flow

Question 2

thrombosis

Answer 2

forms a blot in an intact blood vessel

Question 3

hemostasis & thrombosis involve 4 major components

Answer 3

vascular endothelium, plts, coagulation system, fibrinolytic system

Question 4

each rxn results from the interactions of:

Answer 4

an enzyme, substrate, and cofactor

Question 5

vitamin K dependent factors

Answer 5

II, VII, IX, X

Question 6

contact activated factors/ beginning of intrinsic cascade

Answer 6

XII, prekallikrein, high molecular weight kininogen

Question 7

thrombin sensitive factors

Answer 7

I-fibrinogen, V, VIII, XI, XIII

Question 8

hemostasis events in response to vascular injury

Answer 8

localized vascular spasms, primary hemostasis, secondary hemostasis, clot dissolution

Question 9

primary hemostasis

Answer 9

formation of primary plt plug & involves plts, blood vessel wall & von willeebrand factor

Question 10

plt adhesion is mediated by ____ in primary hemostasis

Answer 10

von willebrand factor

Question 11

Plt-plt binding is mediated by___

Answer 11

fibrinogen which binds to GPIIb/IIIa on adj plts

Question 12

secondary hemostasis

Answer 12

formation of fibrin through the coagulation cascade

Question 13

initiation of coagulation

Answer 13

extrinsic pathway aka rapid response

Question 14

thrombin-sensitive factors

Answer 14

V, VIII, XI

Question 15

secondary hemostasis actions

Answer 15

plt activation & aggregation, fibrinogen->fibrin, activates XIII

Question 16

scope of secondary hemostasis is to:

Answer 16

stabilize the initial soft clot. takes longer than primary hemostasis!

Question 17

plts contain COX-__ only!

Answer 17

one

Question 18

> intracellular Ca and activation of PKC

Answer 18

shape change & activation, release of secretory factors, aggregation

Question 19

TxA2 stimulates

Answer 19

activation of new platelets & favor plt aggregation

Question 20

expression of negatively charged phospholipid complexes on plt surface

Answer 20

bind Ca & serve as assembly sites & activation for coagulation factor complexes

Question 21

ADP activates

Answer 21

P2Y1(>Ca) & P2Y12(<cAMP)

Question 22

factor XIIIa aka fibrin stabilizing factor

Answer 22

crosslinks firbin forming an insoluble clot (2* hemostatic plug)

Question 23

tenase complex

Answer 23

IXa & VIIIa

activates factor X

Question 24

prothrombinase complex

Answer 24

Xa & Va

converts prothrombin->thrombin

Question 25

extrinsic pathway cascade

Answer 25

TF: VII->VIIa which activates X->Xa

Question 26

thrombin prothrombic actions

Answer 26

fibrinogen->fibrin
activates PAR1 &4
activates V, VIII, and XI and XIII

Question 27

thrombin anti-thrombotic effects

Answer 27

activates protein C (inhibits coagulation)

Question 28

mutation in factor V gene ->

Answer 28

thrombophilia bc cannot be broken down by protein C

Question 29

___ reduces vitamin K to its active form

Answer 29

vitamin K epoxide reductase (VKOR)

Question 30

warfarin target

Answer 30

blocks VKOR and creates vitamin K deficiency

Question 31

calcium & phospholipids are required for

Answer 31

tenase & prothrominase complexes to form

Question 32

tissue factor aka

Answer 32

factor III

Question 33

how long does it take blood to clot in a glass tube?

Answer 33

4-8 minutes

Question 34

prothrombin time (PT)

Answer 34

assess extrinsic pathway (12-14 sec)

monitor warfarin

Question 35

activated partial thromboplastin time (aPTT)

Answer 35

assess intrinsic pathway (26-33sec)

monitor heparin

Question 36

prolongation of PT & aPTT indicates defect in

Answer 36

common pathway

Question 37

hemophilia A

Answer 37

deficiency of factor VIII

Question 38

hemophilia B

Answer 38

deficiency in factor IX

Question 39

hemophilia C

Answer 39

deficiency in factor XI