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3 Haematology > Haemostasis > Flashcards

Haemostasis Flashcards

1
Q

define haemostasis

A

the arrest of bleeding AND

the maintenance of vascular patency

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2
Q

what is formed in primary haemostasis?

A

a platelet plug

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3
Q

what is formed in secondary haemostasis?

A

fibrin clot

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4
Q

is a platelet plug or fibrin clot more secure?

A

fibrin clot

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5
Q

what happens to stop formation of the fibrin clot?

A

fibrinolysis

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6
Q

name the 4 stages of haemostasis

A

primary
secondary
fibrinolysis
anticoagulant defences

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7
Q

biggest cell in the bone marrow?

A

megakaryocyte

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8
Q

describe the relationship between platelets and megakaryocytes

A

formed in the cytoplasm of megakaryocytes and “bud” off

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9
Q

when should you stop aspirin before surgery? why?

A

7 -10 days before

this is the mean life span of platelets

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10
Q

when endothelial cells are damaged what attracts the platelets to adhere to them?

A

collagen

von willebrand factor

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11
Q

what happens to platelets after they adhere to damaged endothelial cells?

A

release chemicals that cause them to aggregate (stick together)

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12
Q

causes of failure of the platelet plug?

A

vascular
reduced function/number of platelets
VWF deficiency

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13
Q

what vitamin is responsible for making collagen? what effect does this have on clotting and why?

A

C

no collagen = no signal for platelets to adhere to the wall

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14
Q

what happens in ITP (immune thrombocytopaenic purpura)?

A

antibodies stick to platelets and cause them to be removed -> thrombocytopaenia

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15
Q

commonest inherited bleeding disorder?

A

VWF deficiency

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16
Q

VWF affects __% of the popn

A

1%

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17
Q

signs of failure of the platelet plug in patients

A 
lower limb purpura (gravity pushes platelets down = more leaking)!!
blood blisters in mouth
epistaxis
GI bleed
conjunctival haemorrhage
menorrhagia
intracranial haemorrhage if severe
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18
Q

Ix primary haemostatic problems

A

platelet count

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19
Q

phospholipids tend to be __vely charged

A

negatively

20
Q

what forms the surface of the platelet plug and why?

A

calcium

the neg charged phospholipids within the platelet attract positively charged Ca

21
Q

what does the “a” mean on a clotting factor?

A

activated form

22
Q

what is released from damaged endothelium?

A

tissue factor

23
Q

what is the first clotting factor to respond to tissue factor?

A

factor 7

24
Q

factor _ and _ form prothrombin

A

5 and 10

25
Q

what clotting factors are needed to form factor 5 and 10

A

TF
factor 7
VIII
IXa

26
Q

haemophilia A is a deficiency of what CF?

A

8

27
Q

haemophilia B is a deifciency of what CF?

A

9

28
Q

clotting factors are made..

A

in liver

29
Q

causes of failure of fibrin clot formation?

A

single CF deficiency
multiple CF deficiency
increased fibrinolysis

30
Q

give an example of a multiple CF deficiency

A

DIC

31
Q

what enzyme breaks fibrin down?

A

plasmin

32
Q

plasmin is formed from..

A

plasminogen

33
Q

Hx questions in bleeding disorders?

A 
bleeding/bruising
duration
previous surgery/dental extraction
menstrual history
DH
FH
34
Q

prothrombin time measures what CF formation?

A

TF

VIIa

35
Q

activated partial thromboplastin time measures what CF formation?

A

VIII

IXa

36
Q

name the 2 ways in which factor 10a can be formed

A

combine factor 8 and 9a

combination of tissue factor and factor 7

37
Q

what CFs are involved in the initiation phase

A

7
TF
10

38
Q

what CFs are involved in the amplification phase

A

5
8
9
10

39
Q

what activates factor 8 and 9

A

thrombin

40
Q

protein _ switches off CFs to stop haemostasis

A

protein c

41
Q

what does thrombin bind to when it senses haemostasis has been achieved and what effect does this have?

A

thrombomodulin

stops haemostasis

42
Q

name the deficiency in thrombophilia?

A

naturally occuring anticoagulants

43
Q

name the body’s naturally occurring anticoagulants

A

protein C

serine protease inhibitors

44
Q

causes of thrombocytosis

A

bone marrow disease
splenectomy
inflammatory disease

45
Q

what cancers can present as thrombocytosis

A 
LEGO-C
lung
endometrial
gastric
oesophageal
colorectal

3 Haematology (30 decks)

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