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module 103 - theme 2 > haemostasis > Flashcards

haemostasis Flashcards

1
Q

how do endothelial cells help to control blood fluidity and flow?

A
  • control the size of blood vessels
  • when intact: contributes to preventing clots
  • when injured: promote local clotting on exposed basement membrane
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2
Q

what is haemostasis?

A

a process which causes bleeding to stop

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3
Q

what is the opposite of haemostasis?

A

haemorrhage

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4
Q

what is the first stage of wound healing?

A

haemostasis

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5
Q

what happens with the endothelium is injured?

A

it stops secreting inhibitors and instead secretes Von Willebrand Factor

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6
Q

what are the 3 stages of forming the haemostatic plug?

A
  • platelet adhesion
  • platelet activation
  • platelet aggregation
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7
Q

what do platelets release?

A

vasoconstrictors and pro-thrombotic agents

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8
Q

where are megakaryocytes found?

A

in the bone marrow

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9
Q

what is a thrombocyte?

A

a platelet

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10
Q

what is thrombocytopenia?

A

low platelet count in blood

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11
Q

what is platelet activation?

A

exocytose + change shape + increase respiratory rate

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12
Q

what is the process of platelet activation?

A

extracellular ADP –> activation of P2Y receptor –> cation flow

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13
Q

what do platelets release during activation?

A

thromboxane A2 (TXA2)

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14
Q

what is factor Xa?

A

the activated version of factor X

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15
Q

what are factor V and factor VIII?

A

co-factors that allow enzymes to function

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16
Q

what is plasma?

A

fluid portion of the blood

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17
Q

what is serum?

A

fluid left after clotting

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18
Q

what is thrombosis?

A

abnormal formation of a clot locally

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19
Q

what is an embolism?

A

abnormal migration of clot

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20
Q

what are the 2 coagulation cascades?

A
  • extrinsic (tissue factor) pathway

- intrinsic (contact activation) pathway

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21
Q

what are the 3 pathways to activate factor X to factor Xa?

A
  • extrinsic Xase
  • intrinsic Xase
  • thrombin also activates it
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22
Q

what is extrinsic Xase

A

tissue factor + factor VIIa

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23
Q

what is intrinsic Xase?

A

factor VIIIa + factor IXa

24
Q

what are the 2 coagulation factors?

A

prothrombin group & thrombin group

25
Q

what is prothrombin group?

A
  • factors II, VII, IX & X
  • they are enzymes
  • vitamin K needed for synthesis
  • require calcium ions for activation
  • stable
26
Q

what is thrombin group?

A
  • factors I, V & VII
  • thrombin activates them
  • V & VIII are co-factors
  • factor I is fibrinogen
27
Q

when is thrombin group increased?

A

in inflammation, pregnancy & with oral contraceptives

28
Q

what is vitamin K?

A
  • a class of related fat-soluble vitamins
  • is required to synthesise enzyme coagulation factors
  • essential for gamma-carboxylation of clotting enzymes
29
Q

what enzyme coagulation factors does vitamin K synthesise?

A

prothombin II, VII, IX and X

30
Q

what does plasmin do?

A

lyses fibrin

31
Q

what is protein C?

A

a coagulation inhibitor

32
Q

what is antithrombin III

A

peptide in blood made by liver that blocks activity of thrombin

33
Q

what does vitamin K deficiency lead to?

A

insufficient clotting

34
Q

what is vitamin K deficiency caused by?

A

GI disease or no fat absorption

35
Q

what prevents the recycling of vitamin K?

A

warfarin

36
Q

what is haemophilia A?

A

a clotting disorder that affects larger blood vessels, joints and muscles and causes wounds to bleed for days

37
Q

what is haemophilia A caused by?

A

lack of factor VIII

38
Q

what type of disease is haemophilia A?

A

X linked

39
Q

how do you treat haemophilia A & what are the issues with it?

A

inject purified factor VIII but it is rare and expensive

40
Q

what is christmas disease and what is it caused by?

A

haemophilia B and it is caused by a defect in factor IX

41
Q

describe the process of inflammation atherogenesis

A
  • monocytes enter lesion
  • become macrophages: consume cholesterol esters
  • can become foam cells
  • can die and release their contents which attracts more monocytes, cytokines and chemo-attractants
42
Q

describe lipid atherogenesis

A
  • LDL deposits lipids in lesions
  • cholesterol esters are oxidised making oxygen radicals
  • oxidised lipids are consumed by macrophages
43
Q

describe endothelium atherogenesis

A
  • endothelium expresses chemoattractants
  • when endothelium is lost, collagen stimulates coagulation
  • when endothelial is lost, vessel cannot control its dilation
44
Q

what 3 types of drugs can be given to control blood clotting?

A
  • anti-platelet agents
  • anti-coagulants
  • fibrinolytics
45
Q

when are anti-platelet agents used?

A

to block platelet activation and good for treating arteriole disease

46
Q

when are anti-coagulants used?

A

to block production or activity of clotting factors and used to treat venous disease

47
Q

when are fibrinolytics used?

A

to dissolve fibrin in arterial disease

48
Q

what is aspirin?

A

a cyclo-oxygenase (COX) inhibitor

49
Q

what does aspirin do?

A
  • blocks formation of thromboxane A2 in platelets
  • lengthens bleeding time
  • does NOT increase coagulation time
50
Q

name 2 ADP receptor inhibitors

A
  • prasugrel

- clopidogrel

51
Q

what conditions can anticoagulants be used for?

A
  • deep vein thrombosis

- pulmonary embolism

52
Q

name 2 oral anti-coagulants

A
  • dabigatran

- rivaroxaban

53
Q

what is warfarin?

A
  • vitamin k antagonist
  • slow onset (days)
  • requires monitoring
54
Q

what do heparins do?

A
  • inhibit coagulation by inhibiting factor Xa
55
Q

what are fibrinolytics?

A
  • clot busting drugs

- tissue plasminogen activator

56
Q

name 2 fibrinolytics

A
  • streptokinase

- urokinase

module 103 - theme 2 (8 decks)

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