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Block 2 > Haemostasis > Flashcards

Haemostasis Flashcards

1
Q

What is haemostasis?

A

A precisely orchestrated series of regulatory process that culminate in the formation of a blood clot that limits bleeding from and injured vessel

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2
Q

What does haemostasis allow?

A

Blood to be in a fluid state in normal vessels

Formation of localised haemostatic clot at sites of injury

Prevents haemorrhage

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3
Q

List 3 causes of oedema

A

Heart failure

Liver failure

Kidney failure

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4
Q

What are the 3 key components of haemostasis?

A

Vascular wall

Platelets

Coagulation cascade

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5
Q

What are the 3 layers of a blood vessel?

A

Intima - endothelium, basement membrane, connective tissue, internal elastic lamina

Media - smooth muscle

Adventitia - connective tissue

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6
Q

What cells are in the endothelium of the blood vessel?

A

Stratified simple squamous

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7
Q

In what layer of the blood vessel is the vascular and neural supply?

A

Adventitia

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8
Q

Normally endothelium cells are:

A

Antiplatelet

Anticoagulant

Fibrinolytic

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9
Q

The role of platelets is to:

A

Provide the initial haemostatic plug

Provide a surface for recruitment and concentration of coagulation factors

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10
Q

Name the three stages by which platelets carry out their 2 roles:

A

Adhesion to extracellular matrix at sites of vascular injury

Activation by secretion of granules

Aggregation of platelets

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11
Q

What are the four stages of haemostasis?

A

Vasoconstriction

Primary haemostasis

Secondary haemostasis

Clot stabilisation and resorption

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12
Q

What factor is released from the sub endothelium in primary haemostasis?

A

von Willebrand factor (vWF)

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13
Q

What two things do platelets come in contact with in primary haemostasis?

A

Collagen

vWF

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14
Q

Which cells secrete tissue factor?

A

Smooth muscle cells

Fibroblasts

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15
Q

Which factor does TF bind to and activate?

A

Factor VII

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16
Q

Which glycoprotein binds fibrinogen to platelets?

A

GP IIa/IIIb

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17
Q

Which factors does Vit K synthesise?

A

VII, IX, X

18
Q

Where are most of the coagulation factors synthesised?

A

The liver

19
Q

Which glycoprotein binds vWF to exposed collagen?

A

GP Ib.

20
Q

Coagulation requires:

A

Coagulation factors

Cofactors

-ve charged phospholipid surface

Calcium ions

Vitamin K

21
Q

Which factors are dependent on vitamin K?

A

VII, IX, X, prothrombin

22
Q

What are the two cofactors of the clotting cascade?

A

V and VIII

23
Q

Which factors are involved in the clotting cascade?

A

Activated versions of XII, XI, IX, X, VIII

24
Q

Which factors does thrombi activate?

A

XI, VIII, V

25
Q

Which blood test measures the function of the extrinsic pathway?

A

PT blood test

26
Q

Which blood test measures the function of the intrinsic pathway?

A

apTT blood test

27
Q

What does thrombin do that amplifies the clotting response?

A

Activates factors XI, V and VIII

Activates platelets (more -ve charged surfaces)

28
Q

What does heparin bind to?

What does this enhance the inactivation of?

A

Antithrombin III

Enhances inactivation of thrombin, IXa, Xa, XIa, XIIx

29
Q

What does unfractioned heparin enhance the inactivation of?

A

Xa and thrombin

30
Q

What does LMWH enhance the inactivation of?

A

Xa

31
Q

Warfarin effects the metabolism of

A

Vitamin K

32
Q

The fibrinolytic system

A

Plasminogen is activated to plasmin by tPA. Plasmin breaks down fibrin to fibrin degradation products (D-Dimer blood test)

33
Q

Which factors does warfarin inhibit the activation of?

A

Factors IX, VII, X, prothrombin

34
Q

Define haemorrhage

A

Extravasation of blood into the extravascular space (tissues, cavities, out of body)

35
Q

Factors affecting clinical significance of haemorrhage are:

A

Volume of blood lost
Rate of blood loss
Medical fitness
Site of bleeding

36
Q

Define thrombosis

A

The pathological formation of a thrombus

37
Q

3 factors in Virchow’s Triad

A

Endothelial injury

Hypercoagulability

Abnormal blood flow

38
Q

List the 4 fates of a thrombus

A

Propagation

Embolisation

Resolution/dissolution

Organisation

39
Q

Define embolism

A

A detached intravascular solid, liquid, or gas that is carried by the blood to a site distant from its point of origin

40
Q

Define infarction

A

Area of ischaemic necrosis caused by inadequate blood supply

Block 2 (10 decks)

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