haemostasis, thrombosis and coagulation (L5)

Question 1

What is haemostasis

Answer 1

maintain fluid flow through the vasculature

Question 2

What is thrombosis

Answer 2

pathological, causes restriction or blockage of a blood vessel

Question 3

What are the three stages of haemostasis

Answer 3

1. vascular spasm
2. Platelet plug formation
3. coagulation

Question 4

What is vascular spasm

Answer 4

damaged blood vessels constrict reducing blood flow in the damaged area

Question 5

What is primary haemostasis

Answer 5

platelet activation and plug formation

Question 6

What is secondary haemostasis

Answer 6

coagulation

Question 7

3 critical components of platelets

Answer 7

membrane proteins
secretory granules
surface-connected open cannalicular system

Question 8

What is the most numerous platelet secretory granule

Answer 8

Alpha granules

Question 9

What do alpha granules contain (4)

Answer 9

Adhesive proteins
platelet-specific proteins
membrane protein
alpha granule-specific proteins

Question 10

3 adhesive proteins of alpha granules

Answer 10

fibroinogen
fibronectin
vWF

Question 11

3 things dense granules contain

Answer 11

vasocontructive agents (serotonin)
Platelet agonists (ADP, ATP)
Calcium and magnesium

Question 12

What complex is important for binding vWF

Answer 12

GP2b

Question 13

What is von willebrand factor

Answer 13

blood glycoprotein

Question 14

What receptor id for fibrinogen and platelet aggregation (and vWF interaction)

Answer 14

GP2a3B

Question 15

When vessel damage occurs what is exposed

Answer 15

collagen-associated (vWF on collagen`)

Question 16

What connection is made on the platelet with the exposed vWF

Answer 16

GP1b-vWF interactions

Question 17

How does the platelet form a stronger adhesion with the sub-endothelium

Answer 17

rolling promotes more Gb1b/ vWF associations

Question 18

What does a stronger adhesion of platelet with sub-endothelium cause

Answer 18

platelet activation –> granule release

Conformational change—> stronger adhesion molecules

Question 19

What platelet agonist are released after platelet activation (3)

Answer 19

ADP,
thromboxane
Fibrinogen

Question 20

What does fibrinogen cross bridges bind to

Answer 20

GP2a3b

Question 21

What are zymogens

Answer 21

inactive precursors of enzymes

Question 22

Coagulation factors are a group of____

Answer 22

Zymogens

Question 23

What the two basic pathways for coagulation

Answer 23

extrinsic

intrisic

Question 24

how is the extrinsic pathway triggered

Answer 24

by trauma

Question 25

how is the intrinsic pathway triggered

Answer 25

internal damage to the wall of the vessel

Question 26

What is the end product of coagulation

Answer 26

robust clot made up of fibrin which traps platelets and blood cells

Question 27

intrinsic pathway

Answer 27

``` 12--> 12a 11-> 11a 9->9a 8a -d10 complex X--> Xa ```

Question 28

Extrinsic pathway

Answer 28

3 7->7a 7a-3 complex 10-->10a (Xa)

Question 29

Final common pathway

Answer 29

10a (Xa) Prothrombin--> thrombin Fibrinogen-->fibrin fibrin + 13a --> cross-linked clot

Question 30

What does tissue factor pathway inhibitor (TFPI) inhibit

Answer 30

active factor 10

Question 31

What anti-coagulants stop the cascade

Answer 31

anti-thrombin | tissue factor pathway inhibitor

Question 32

2 coagulation tests

Answer 32

prothrombin time PT) | partial thromboplastin time (PTT)

Question 33

Thrombocytopenia=

Answer 33

low circulating platelets

Question 34

Most common primary thrombocytopenia

Answer 34

immune thrombocytopenia

Question 35

What antibodies coat platelets in immune thrombocytopenia

Answer 35

IgG

Question 36

Where are coated IgG platelets removed

Answer 36

splenic macrophages or kupfer cells in the liver

Question 37

What does mild immune thrombocytopenia cause

Answer 37

petechia (rash)

Question 38

Risks of severe ITP

Answer 38

extensive hematomas and cerebral haemorrhage

Question 39

What is Glanzmann's thrombasthenia (GT)

Answer 39

autosomal recessive bleeding syndrome that affects the megakaryocyte lineage results in lack of platelet aggregation

Question 40

What specific changes happen in GT

Answer 40

changes in expression and/ or function of GP2b and/or 3a

Question 41

What is hemophilia characterized by

Answer 41

changes in clotting patterns

Question 42

What sex are most haemophillia sufferers

Answer 42

male

Question 43

What is haemophillia A a deficiency in

Answer 43

FV3

Question 44

What is haemophillia B a deficiency in

Answer 44

F9

Question 45

What does Aspirin inhibit

Answer 45

platelet cyclooxygenase (enzyme)

Question 46

What is cyclooxygenase important in

Answer 46

Thromboxane A2 generation

Question 47

Aspirin lasts____

Answer 47

life of the platelet

Question 48

Aspirin is also (2)

Answer 48

Anti-inflammatory (COX-2 inhibitor) | Anto-thrombotic (COX-1)

Question 49

use of aspirin

Answer 49

ischemic stroke prevention and previous MI Angina

Question 50

Side effects of aspirin

Answer 50

GI bleeding | hemorrhagic stroke

Question 51

What is clopidogrel

Answer 51

ADP antagonist

Question 52

Use of clopidogrel

Answer 52

reduce thrombotic events

Question 53

What type of drug is Clopidogrel

Answer 53

pro-drug

Question 54

Side effects of Clopidogrel

Answer 54

bleeding | Thrombotic thrombocytopenic purpura

Question 55

Warfarin=

Answer 55

vitamin K antagonist

Question 56

Warfarin in pregnancy?

Answer 56

Noooo can cross the placenta

Question 57

heparin=

Answer 57

an anticoagulant

Question 58

Two types of heparin

Answer 58

unfractionated heparin | low molecular weight heparin

Question 59

Unfractionated heparin can affect both

Answer 59

factor Xa and Thrombin

Question 60

Low molecular weight heparin can only affect

Answer 60

Factor Xa