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Haematology > Haemostasis > Flashcards

Haemostasis Flashcards

1
Q

What cell components are involved when you form a clot?

A

1 - Platelets

2 - Von Willebrand Factor

3 - Coagulation factors

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2
Q

Why blood clots not spread past the site of injury?

A

Natural anticoagulants

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3
Q

What blood system is responsible for the blood clot vanishing 1 week after the injury?

A

Fibrinolytic system

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4
Q

What sorts of things can cause platelets and coagulation factors to become activated to form a clot?

A

Abnormal vessel surface

Physiological activator

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5
Q

Heparans and prostacyclin are both found within the endothelial surface of blood vessels to prevent what from happening?

A

Clotting

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6
Q

How do platelets react to vessel damage?

A

They are attracted to the non-sticky surface of the sub-endothelium which has been exposed by the damage

The platelets stick to the collagen on the surface of the subendothelium

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7
Q

What are the roles of platelets in haemostasis?

A

1 - Adhere

2 - Activation

3 - Aggregation

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8
Q

What are the 3 major steps of haemostasis?

A

1 - Vasoconstriction

2 - Temporary blocakge by a platelet plug

3 - Coagulation

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9
Q

What molecules are responsible for causing vasoconstriction following damage to a vessel?

A

Paracrines

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10
Q

Once platelets have adhered to the collagen on the exposed sub-endothelium surface, what happens next?

A

Cytokines are released which reinforce vasoconstriction and attract more platelets which aggregate and form a platelet plug

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11
Q

How does the formation of the blood clot begin?

A

Tissue factor attaches to collagen and sets off the coagulation cascade

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12
Q

Once the coagulation cascade has been activated, what happens?

A

1 - Thrombin formation

2 - Thrombin converts fibrinogen to fibrin

3 - Fibrin reinforces the platelet plug already formed

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13
Q

What is the final product of the coagulation cascade?

A

Fibrin

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14
Q

How are blood clots dissolved once the tissue has been repaired?

A

Plasmin dissolves the fibrin in the blood clot

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15
Q

What is the 1st enzyme activated in the coagulation cascade in the intrinsic pathway?

A

Factor XII

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16
Q

What is the 1st enzyme activated in the coagulation cascade in the extrinsic pathway?

A

III (Tissue Factor)

17
Q

Tissue Factor activates which enzyme to begin the extrinsic coagulation cascade?

A

VII

18
Q

What is the common goal of the extrinsic and intrinsic pathways of the coagulation cascade?

A

To produce Thrombin

19
Q

What is the function of Thrombin?

A

Convert fibrinogen into fibrin

20
Q

What enzyme converts fibrin into a more stable version that stabilizes the clot?

A

XIII

21
Q

How is plasmin (breaks down fibrin) formed?

A

Thrombin + Tissue plasminogen activator

22
Q

What is a breakdown product of fibrin?

A

D-dimer

23
Q

What can D-dimer be used for?

A

Detection of:

DVT

Pulmonary Embolism

24
Q

What are the 2 mechanisms that prevent clots from growing indefinitely?

A

1 - Inhibition of platelet adhesion

2 - Inhibition of coagulation cascade & fibrin production

25
Q

What are the three anticoagulants produced by the body?

A

1 - TFPI

2 - Antithrombin III

3 - Protein C & S

26
Q

If clots have formed in the body due to diseases (e.g. MI’s, DVT’s, PE’s), what are the medication options for dissolving the clots?

A

1) Fibrinolytic/Throbolytic drugs
2) Antiplatelets
3) Anticoagulants

27
Q

What are examples of thrombolytic drugs?

A

1) Streptokinase
2) Alteplase (tissue plasminogen activator)

28
Q

What are examples of anticoagulant drugs?

A

1) LMWH
2) Warfarin

29
Q

What are examples of antiplatelet drugs?

A

1) Aspirin
2) Clopidogrel
3) Ticagrelor

30
Q

What is the target of thrombolytic/fibrinolytic drugs?

A

Fibrin

31
Q

What is the action of aspirin?

A

Inhibits cyclooxygenase (COX)

32
Q

What is the action of clopidogrel and ticagrelor?

A

ADP receptor inhibitor

33
Q

What is the mechanism of action of warfarin?

A

Prevents prothrombin production by antagonising Vitamin K

34
Q

What is the mechanism of action of LMWH?

A

Binds to antithrombin making it more active

Blocks Xa coagulation factor

35
Q

What are the 5 DOAC’s most commonly used?

A

1 - Rivaroxaban

2 - Edoxaban

3 - Apixaban

4 - Dabigatran

36
Q

What are the 2 main actions of the DOAC’s?

A

1 - Thrombin inhibition

2 - Factor Xa inhibition

Haematology (13 decks)

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