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A Haematology and Immunology > Haemostasis > Flashcards

Haemostasis Flashcards

1
Q

What does the endothelium produce?

A
  • Heparins
  • TFPI
  • Thrombomodulin
  • Prostacyclin
  • Nitric oxide
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2
Q

What is the key job of the endothelium?

A
  • Prevent cells sticking to the walls
  • Encourage flow
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3
Q

What happens when you cut yourself?

A
  • You bleed at the site of injury
  • It stops and a clot forms
  • The clot remains confined to the site of injury
  • 1 week later the clot has vanished
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4
Q

What is clotting dependent on?

A
  • Platelets
  • vWF factor
  • Coagulation factors
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5
Q

Why does the clot remain confined to the site of injury?

A

So that the whole system does not become occluded.

This is done by anti-coagulants

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6
Q

How is the clotting system activated?

A
  • Resting platelets and coagulation factors are activated by signals and localised to the area of damage
  • These signals include abnormal wall surface and physiological activators
  • Vessel damage leads to platelet adhesion
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7
Q

What receptors are present on the surface of platelets?

A
  • ADP receptor
  • Epinephrine receptor
  • Thrombin receptor
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8
Q

What granules are present in platelets?

A
  • Alpha granule
  • Dense granule
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9
Q

What do alpha granules produce?

A
  • VWF
  • Thrombin
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10
Q

What do dense granules produce?

A
  • ATP
  • Calcium
  • Serotonin
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11
Q

What do the glycoprotein receptor on the surface of platelets binds to?

A

Some bind to:

  • Collagen and the vessel wall
  • von Willbrand factor
  • Fibrinogen
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12
Q

What role do platelets play in haemostasis?

A
  • Adhere to area of damage
  • Activate EDP pathway and cylo-oxygenase pathway
  • Aggregate
  • Provide a phospholipid surface for coagulation
  • Form a plug with fibrinogen in primary haemostasis
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13
Q

What forms the primary haemostatic clot?

A

Platelets

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14
Q

What forms the definitive haemostatic clot?

A

Fibrin

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15
Q

What is the clotting factor cascade which activates clot formation?

A
  • Factor XII
  • Factor XI
  • Factor IX
  • Factor VIII
  • Factor X
  • Prothrombin
  • Fibrinogen
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16
Q

What prevents the clotting cascade?

A

Anticoagulants

17
Q

Where is the defect in haemophilia A?

A

Factor IX is deficient

18
Q

Where is the defect in haemophilia B?

A

Factor VIII is deficient

19
Q

How is tissue factor produced?

A

Produced by damaged tissues

20
Q

Give examples of natural anticoagulants and what they target.

A
  • Tissue factor pathway inhibitor
    • Binds to and inactivates the activated factor X and VII
  • Protein C and S
    • Inactivates activated factor V and VIII
  • Antithrombin
    • Inactivates activated factor X and thrombin
21
Q

What is fibrinolysis?

A

Process in which clots are broken down

22
Q

How does fibrinolysis occur?

A
  • Endothelium produces activators of plasminogen: t-PA and u-PA
  • Plasminogen is cleaved to active plasmin
  • Plasmin breaks the clot down resulting in fibrin degradation products including D-dimer
23
Q

What ensures there is not too much fibrinolysis?

A

Inhibitors of plasminogen and plasmin

24
Q

What is the mechanism of clopidogrel and ticagrelor?

A

Acts on the EDP pathway

25
Q

What is the mechanism of warfarin?

A
  • Reduces the amount of coagulation factors 2,7,9 and 10 (vitamin K dependent)
  • It inhibits vitamin K
26
Q

What is the mechanism of riveroxaban?

A

Target factor X and inactivate it

27
Q

What is the mechanism of dibigatran?

A

Oral inhibitor of thrombin

28
Q

What is the mechanism of heparin?

A

Increases ability of anti thrombin

A Haematology and Immunology (20 decks)

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