Flashcard Review

Question 1

What coagulation factors bind membrane surface?

Answer 1

5, 10
8, 9
7
Protein C, protein S, protein Z

Question 2

What can stimulate micro particle formation?

Answer 2

Cytokines (TNFa, IL 6)
Thrombin
Shear stress
Hypoxia

Question 3

Under normal conditions where do MP come from and what other cells can produce them in disease states ?

Answer 3

endothelial cells, platelets, monocytes

can also be made from granulocytes and erythrocytes

Question 4

When thrombin binds thrombomodulin and this complex activates protein C, what does APC (with co-factor protein S) then inactivate? Where is this process most efficient?

Answer 4

Inactivates 5 and 8
Inactivates PAI-1 (inhibits the inhibitor- up regulates lysis of any fibrin formed)

aPC inactivates factor 5 better on ENDOTHELIAL SURFACE rather than platelet surface- efficient at limiting thrombin generation on healthy resting EC but not on activated platelets.

Question 5

When thrombin binds thrombomodulin, what function does this complex have?

Answer 5

Activate TAFI

Question 6

Action of TF-F7 complex?

Answer 6

Activates additional 7 as well as 9, 10.

Question 7

3 phases of coagulation in the cell-based model version

Answer 7

1- Initiation - on surface of TF bearing cell- produces small amount of thrombin. Thrombin and factor 9 then diffuse away towards the platelet.

2- Amplification - Thrombin activates platelets, releasing VWF from factor 8, leading to activated f5, 8, 11.

3- Propagation - on surface of the platelet - factor 8 and 9 form tenase complex, producing large amount of factor 10 on platelet surface.
Factor 10 and 5 form prothrombinase which generates large amounts of thrombin on platelet surface

Question 8

What does antithrombin inactivate?

Answer 8

Mainly 10 and thrombin

Also 9, 11, 12 and TF-7 complex

Question 9

Adverse effects of lasix

Answer 9

1. acute kidney injury
2. low thiamine levels
3. insulin inhibition -> hyperglycemia
4. altered mucociliary clearance
5. ototoxicity
6. delayed wound healing
7. interference with thyroid binding
8. RAS activation
9. dehydration

Question 10

Calcium dependent clotting factors

Answer 10

5, 7, 8, 9, 10, 11
Protein C,
Protein S

Question 11

Formula MAP

Answer 11

CO x SVR (aka ohms law)

Question 12

For TEG does the pin or cup move?

Answer 12

Cup moves.

Question 13

Causes of elevated PTT with normal PT

Answer 13

Inherited deficiencies, DIC, liver disease, unfractionated heparin therapy, artifact of collection

Question 14

Causes of elevated PT with normal PTT

Answer 14

Inherited factor VII deficiency, early vitamin K deficiency or antagonism, DIC, warfarin treatment, liver disease (cholestatic, liver failure)

Question 15

What is normal BMBT?

Answer 15

<4 minutes

Question 16

What endocrine diseases can cause increased magnesium

Answer 16

hypoadrenocorticsm
hyperparathyroidism
hypothyroidism

Question 17

What hormones cause increased tubular reabsorption of P in proximal tubule?

Answer 17

GH
Insulin
Insulin like GF1
Thyroxine

Question 18

What hormones cause increased excretion of phosphorus in the proximal tubule?

Answer 18

Phosphatonins (FGF23) 
Calcitonin
ANP 
High dose vasopressin
High dose dex

Question 19

What are spurious causes of low phosphorus

Answer 19

monoclonal gammopathy
hemolysis
increased bilirubin
mannitol

Question 20

What endocrine diseases can cause low MG

Answer 20

DKA, hyperthyroid, primary hyperparathyroidism

- all cause increased renal loss