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Path Pro > Haemostasis > Flashcards

Haemostasis Flashcards

1
Q

Define Haemostasis and state 2 functions

What are the 3 steps in Haemostasis

A

The stopping of bleeding

Prevents bleeding
Prevents unnecessary coagulation

Make clot
Control clotting
Breakdown of clot (Fibrinolysis)

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2
Q

What 5 things are essential for Haemostasis

A 
Keep blood moving 
Blood vessels 
Platelets
Coagulation factors
Anticoagulant factors
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3
Q

Compare primary and secondary Haemostasis

A

Primary: Platelets aggregate to form a plug at the vessel hole

Secondary: Plug strengthened with fibrin filaments

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4
Q

Describe Platelet Adhesion

A
  • Damage to vessel wall
  • Exposure of underlying tissues
  • Platelets adhere to collagen via vWF receptor
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5
Q

Describe platelet activation

A
  • Platelets secrete ADP and other substances to become activated and activate other platelets
  • Involved in activation of clotting cascade
  • Secrete coagulation factors from internal stores
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6
Q

Describe Platelet Aggregation

A

Cross linking of platelets to form a platelet plug

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7
Q

Identify 7 mediating factors that stimulate clotting

A 
Platelet receptors- Glycoprotein complexes
Von willebrands factor 
Fibrinogen 
Collagen surfaces 
ADP
Thrombin
Thromboxane
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8
Q

Outline the clotting cascade mechanism to make fibrin

A
  1. Intrinsic and extrinsic pathways activate Factor X
  2. Factor Xa activates Prothrombin II-> Thrombin IIa
  3. Thrombin IIa activates Fibrinogen 1-> Fibrin Ia
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9
Q

What are 2 ways that coagulation is controlled

A
  • Natural anticoagulants inhibit activation of clotting cascade
  • Clot destroying proteins, which are activated by the clotting cascade
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10
Q

Name 4 Natural Anticoagulants

A

Protein C
Protein S
Antithrombin
Tissue factor pathway inhibitor

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11
Q

What are Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT)

A

PT: A diagnostic test used to evaluate the extrinsic and common pathway

APTT: A diagnostic test used to evaluate the intrinsic and common pathways

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12
Q

A problem with which factors cause Prolonged PT

Which pathways are each factor in

A

7- Extrinsic

5,10,Prothrombin, Fibrinogen- Common

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13
Q

A problem with which factors cause Prolonged APPT

Which pathways are each factor in

A

8,9,11,12- Intrinsic pathway

5,10, Prothrombin, Fibrinogen- Common Pathway

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14
Q

What are D dimers

A

Fibrin degradation products

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15
Q

What does Von Willebrand Factor do

A

Involved in;

  • Platelet aggregation
  • Platelet adhesion
  • Carries factor 8
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16
Q

What are 3 functions of the vessel wall

A
  • Vasoconstriction
  • Production of Von Willebrand’s Factor
  • Exposure of collagen and tissue factor, initiating activation of clotting factors
17
Q

Outline fibrinolysis

A

Plasminogen activator activates PLASMIN from PLASMINOGEN

Plasmin breaks down FIBRIN to D-Dimers

18
Q

What are 3 causes of bleeding disorders and what are the 2 types

A

Inherited and acquired

Abnormalities in;

  • Vessel wall
  • Platelets
  • Coagulation factors
19
Q

What are 2 types of Coagulative Disorders

A

Congenital and acquired

20
Q

Identify 3 congenital coagulation factor disorders

Identify 3 acquired coagulation factor disorders

A 
Haemophilia A ( Deficiency in factor 8)
Haemophilia B (Deficiency in factor 9)
Von Willebrand’s disease

Liver disease
Vit K deficiency (Causes more bleeding)
Anticoagulants

21
Q

Identify 4 signs of Coagulation factor disorders

A
  • Intercerebral haemorrhage
  • Severe post op, post traumatic bleeding
  • Joint pain and deformity
  • Prolonged bleeding after dental extraction
22
Q

What is the inheritance pattern for Haemophilia
How does it present
How is it treated

A

X-linked recessive

Bleeding into muscles and joints, and post-operatively

Treated with recombinant factor 8 or DDAVP (releases factor 8 from vessels)

23
Q

What is the inheritance pattern for Von Willebrand’s Disease

Identify 2 signs

What is the main genetic defect

A

Autosomal dominant

  • Abnormal platelet adhesion to vessel wall
  • Reduced Factor 8 amount/ activity

Main: Reduced vWF production

24
Q

What are 3 clinical signs of von Willebrand’s Disease

A

Skin and mucous membrane bleeding

Prolonged bleeding after trauma

Spontaneous joint/ muscle bleeds (Rare)

25
Q

Name 2 vessel wall abnormalities

Where do these occur

A

Easy bruising
Spontaneous bleeding from small vessels

Mainly skin but can be from mucous membranes

26
Q

How does Disseminated Intravascular Coagulopathy affect;

PT
APTT
Fibrinogen count
D dimer count

What must happen for DIC to occur

A

Raised PT
Raised APTT
Low fibrinogen
Raised D dimers

Must be a trigger

27
Q

Identify 5 triggers for DIC

A 
Malignancy 
Massive tissue Injury
Infections
Massive haemorrhage and transfusion
ABO transfusion reaction
28
Q

What are Thrombophilias

How common are these? Do patients with these develop clots

A

Acquired/ congenital defects of haemostasis

Rare conditions, not unless patients have additional risk factors

29
Q

What are the Congenital and Acquired causes of Thrombophilias

A

Congenital causes include deficiency in Natural Anticoagulants and an Abnormal Factor 5

Acquired causes include Antiphospholipid syndrome

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