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YEAR 3 HAEM > HAEMOSTASIS > Flashcards

HAEMOSTASIS Flashcards

1
Q

what is haemostasis

A

arrest of bleeding and maintenance of vascular patency

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2
Q

what is primary haemostasis

A

formation of a platelet plug

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3
Q

what is secondary haemostasis

A

formation of a fibrin clot

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4
Q

what 2 mechanisms moderate the haemostatic system

A

fibrinolysis and anticoagulation

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5
Q

how are platelets formed

A

budding off from megakaryocytes

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6
Q

what are platelets made of

A

negatively charged phospholipids

Ca2+ ions

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7
Q

do platelets have a nucleus

A

no - they are buds of cytoplasm rather than true cells

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8
Q

what is the lifespan of a platelet

A

7-10 days

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9
Q

give an example of an antiplatelet drug

A

aspirin

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10
Q

endothelial (vessel wall) damage exposes ____ and releases ____

A

collagen

VWF

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11
Q

how do platelets bind to VWF

A

they possess receptors

glycoprotein 1B

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12
Q

what happens following the initial binding of platelets to VWF

A

activation of platelets which involves a change of shape

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13
Q

release of ___ and ____ stimulates platelet aggregation and adhesion to form plug

A

ADP

thromboxane A2

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14
Q

how do platelets bind to eachother

A

glycoprotein 2B3A

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15
Q

give 3 causes of failure of platelet plug formation

A

vascular
platelet - reduced number or function
VWF - low or absent

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16
Q

what is the name for reduced platelets

A

thrombocytopenia

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17
Q

what are some s/s of platelet plug formation failure

A

bruising
purpura
mucosal bleeding - epistaxis, GI, conjunctival, menorrhagia
ICH

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18
Q

what should you look for in the eyes of someone with a suspected bleeding disorder

A

conjunctival / retinal haemorrhages

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19
Q

how can failed primary haemostasis be screened

A

platelet count

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20
Q

why do elderly patients bleed more easily

A

less collagen so less efficient haemostasis

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21
Q

what organ produces all the clotting factors involved in secondary haemostasis

A

liver

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22
Q

what are the vitamin K dependent factors

A

2 7 9 10

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23
Q

how do clotting factors bind to platelets

A

bind to Ca2+ ions

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24
Q

what factors are involved in the initiation of the fibrin clot

A

tissue factor - factor VIIa

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25
Q

what factors are involved in the propagation of the fibrin clot

A

factor VIII - IXa

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26
Q

describe the intrinsic pathway of clotting

A 
12 - 12a
II - IIa
9 - 9a
9a:8a
10 - 10a
10a:5a 
prothrombin - thrombin
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27
Q

what clotting factor is prothrombin

A

2 (II)

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28
Q

what clotting factor is thrombin

A

2a (IIa)

29
Q

describe the extrinsic pathway of clotting

A

endothelial trauma –> tissue factor : factor 7a
10 - 10a
10a:5a
prothrombin - thrombin

30
Q

what pathway initiates clotting

A

extrinsic

31
Q

what pathway propagates clotting

A

intrinsic

32
Q

what causes fibrinogen –> fibrin

A

thrombin

33
Q

give the name of a serine protease that blocks all pathways of the cascade

A

anti-thrombin III

34
Q

what factor is involved in the stabilising of the fibrin clot

A

XIIIa (13)

35
Q

what switches on protein C and S

A

thrombomodulin

36
Q

active protein C negatively acts on what factors

A

5 (V)

8 (VIII)

37
Q

_____ amplifies the clotting cascade

A

thrombin

38
Q

_____ uses thrombomodulin to switch roles and inhibit coagulation

A

thrombin

39
Q

activated ____ has a negative feedback control

A

fibrin

40
Q

what breaks down fibrin

A

plasmin

41
Q

where are protein S and C found

A

surface of platelets

42
Q

what inhibits factor VII - VIIa

A

tissue factor pathway inhibitor

43
Q

what would cause failure of fibrin clot formation (3)

A

single clotting factor deficiency
multiple clotting factor deficiency
increased fibrinolysis

44
Q

what activates plasminogen –> plasmin

A

tissue plasminogen activator (tPA)

45
Q

what is something that fibrin is broken down to

A

D-dimer

46
Q

what is an example of a single clotting factor deficiency

A

haemophilia

47
Q

what factor is deficient in haemophilia a

A

factor VIII (8)

48
Q

what factor is deficient in haemophilia b

A

factor IX (9)

49
Q

what is DIC

A

disseminated intravascular coagulation - widespread clotting which depletes the clotting factors and platelets leading to widespread bleeding

50
Q

what is fibrinolysis

A

clot breakdown

51
Q

what is used to screen for fibrin clot formation problems

A

prothrombin time

activated partial thromboplastic time

52
Q

with bleeding disorders you can get bleeding into ___ and ____

A

joints and muscles

53
Q

what is thrombophilia

A

deficiency of naturally occurring anticoagulants

54
Q

what are you increased likelihood of getting with thrombophilia

A

venous thrombosis

55
Q

what are some examples of naturally occurring anticoagulants

A

serine protease inhibitors - antithrombin III

protein S and C

56
Q

what measures the common pathway

A

thrombin time

57
Q

what measures the extrinsic pathway

A

prothrombin time

58
Q

what measures the intrinsic pathway

A

APPT

59
Q

what vitamin is required to form collagen

A

vitamin C

60
Q

why are purpuric rashes more common on lower limbs

A

oncotic pressure due to gravity pushes fluid (+blood) out of capillaries

61
Q

megakaryocytes are derived from the same lineage as ___

A

RBCs

62
Q

what measurement is good for warfarin monitoring

A

prothrombin time (factor VII)

63
Q

what measurement is good for heparin monitoring

A

APTT (factor VIII/IXa)

64
Q

what is the most common type of inherited thrombophilia

A

factor V leiden

65
Q

heparin inhibits the activation of what factors

A

2 9 10 11

66
Q

the activation of factor _ is where the extrinsic and intrinsic pathways meet

A

10

67
Q

_____ inhibits ADP - platelet activator

A

ADPase

68
Q

____ keeps the blood soluble and prevents platelet activation in normal conditions

A

prostacyclin

YEAR 3 HAEM (2 decks)

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