Hema Lec #6: Fibrinolytic Series

Question 1

What is the main stimulus of contact group?

Answer 1

negatively-charged substance

Question 2

All but one is true about D-Domains.
A. it is known as N-DSK where the 3 pairs of fibrinopeptide chains linked together by disulfide bonds
B. Alpha and beta fibrinopeptide chains
C. still connected with disulfide bonds, short polar appendage of the carboxy-terminal ends of the alpha chain
D. no longer connected with disulfide bonds, long polar appendage of the carboxy-terminal ends of the alpha chain

Answer 2

D. no longer connected with disulfide bonds, long polar appendage of the carboxy-terminal ends of the alpha chain

Question 3

What Steps in conversion to fibrin where thrombin cleaves the alpha and beta fibrinopeptide chains of the fibrinogen in the E-domain.

Answer 3

Enzymatic

Question 4

What mechanism is used during formation of fibrin polymer of polymerization

Answer 4

D-E contact

Question 5

Substances that can dissolve the fibrin polymer

Answer 5

5M urea

1% Monochloroacetic acid

Question 6

What fragment is produced during the first attack of plasmin

Answer 6

Fragment X

Question 7

Inhibits factor Xa and TF:VIIa

Answer 7

TFPI(Tissue Factor Pathway Inhibitor)

Question 8

effective cofactor to protein C

Answer 8

Free Protein S

Question 9

Come from outside the body that is Usually commercially prepared thrombolytic agents

Answer 9

Exogenous Plasminogen Activators

Question 10

Primary inhibitor of thrombin

Answer 10

Heparin Cofactor II

Question 11

The Routinely used thrombolytic agent in the market is derived from what specific beta-hemolytic streptococci

Answer 11

Streptococcus equisimilis

Question 12

Inhibits activated forms of Factors XII, XI, X, IX and

prothrombin, Also inhibit plasmin and kallikrein

Answer 12

Antithrombin III OR Heparin Cofactor I

Question 13

What happens during the third attack or action of plasmin.

A. cleave/destroy carboxy-terminal ends of the
alpha chains in the D-domain
B. destroy the attachment of the D-domain to
the E domain of fragment Y
C. One of the D domains from fragment X is
cleaved

Answer 13

B. destroy the attachment of the D-domain to

the E domain of fragment Y

Question 14

2 forms of Protein S in the circulation

Answer 14

Free Protein S
Protein S Bound to complement C4 Binding
Protein

Question 15

Test for FDP’s

Answer 15

Thrombo-Wellcotest

D-Dimer test

Question 16

The degradation of the stable clot by plasmin is done in what specific process?

Answer 16

Proteolysis

Question 17

What cell is associated with storage and trasportation of the zymogen in the plasma that will give rise to the active enzyme responsible for the events in the fibrinolytic system

Answer 17

eosinophil

Question 18

Principle used in test for FDP’S Thrombo-Wellcotest and D-Dimer test

Answer 18

Direct latex agglutination slide test

Question 19

Specific fragments produced by the degradation of

fibrinogen or fibrin

Answer 19

• Fibrinogen/Fibrin Degradation Products OR

- Fibrinogen/Fibrin Split Products)

Question 20

principle for D-Dimer (D-DI test)

Answer 20

Direct latex agglutination slide test

Question 21

True or False. Reagent in D-Dimer is sensitized with anti-fibrinogen antibodies

Answer 21

False.

Question 22

Staphylokinase is derived from?

Answer 22

• Staphylococcus aureus

- Yersinia pestis

Question 23

What term is used to call the fibrin polymer product with cleaved carboxy-terminal ends of alpha chain?

Answer 23

Fragment X

Question 24

What inhibitor of fibrinolysis removes the lysine binding sites in the fibrin surface?

Answer 24

Thrombin Activatable Fibrinolysis Inhibitor

Question 25

Enzyme that is Capable of attacking the protein molecules in | the body and cause massive destruction

Answer 25

Serine protease enzyme

Question 26

What molecule is responsible for the indirect liberation of tPA from the endothelial cells?

Answer 26

Activated protein C

Question 27

What are the two degradation products of fibrin?

Answer 27

- Fragment E | - D-dimer

Question 28

Degrades both fibrin in clots and fibrinogen in the | circulation

Answer 28

Plasmin

Question 29

Measures plasminogen activator concentration

Answer 29

Euglobulin Lysis Time

Question 30

True or False. Reagents is coated with monoclonal antibodies in Test for FDP's

Answer 30

False.

Question 31

What test that forms a forms a visible gel in the reaction.

Answer 31

Ethanol Gelation Test

Question 32

State the two plasmin inhibitors before it causes massive destruction in circlation.

Answer 32

- Alpha2-antiplasmin | - Alpha2-macroglobulin

Question 33

What is the direct stimulus for the liberation of tPA from the sub-endothelium?

Answer 33

Bradykinin

Question 34

Blank 1: what are the 2 types of Plasminogen Blank 2: They are differentiated according to what component

Answer 34

Blank 1: Glu-plasminogen AND lys-plasminogen Blank 2: amino acid terminal end component

Question 35

A kininogen activator successor of HMWK and only produced when HMWK is activated/ stimulated by kallikrein

Answer 35

bradykinin

Question 36

Blank 1: Is a molecule seen in the Protein C Pathway Blank 2: What is found in this path that is Vitamin K dependent regulatory proteins

Answer 36

Blank 1: Activated Protein C Blank 2: Protein C and Protein S

Question 37

Blank 1: Primarily a procoagulant enzyme that takes part in fibrinolysis Blank 2: Name of the receptor site. Blank 3: Name the complex when they are bound from each other.

Answer 37

Blank 1: Thrombin Blank 2: Thrombomodulin Blank 3: Thrombomodulin-bound thrombin OR thrombin:thrombomodulin complex

Question 38

The Only plasminogen molecule that can attach | to the surface of the stable clot

Answer 38

Lys-plasminogen

Question 39

An inactive enzyme which is also known for its first and most important in the fibrinolytic system. Secreted in the liver and normaly seen in plasma

Answer 39

plasminogen

Question 40

Plasminogen Activation Inhibitors that is produced by endothelial cells, from bradykinin stimulation and primary inhibitor of t-PA

Answer 40

Plasminogen Activator Inhibitor 1

Question 41

True or False. Extrinsic endogenous plasminogen activators are Substances coming from the tissues and it is associated with tissue factor

Answer 41

False.

Question 42

Plasminogen Activation Inhibitors that Removes the lysine binding sites at the surface of stable clot and Removes the lysine carboxy-terminal ends from fibrin

Answer 42

Thrombin-Activatable Fibrinolysis Inhibitor OR Plasma | Carboxypeptidase B2

Question 43

Plasminogen Activation Inhibitors that is Found in placenta and macrophages, Primary inhibitor of u-PA

Answer 43

PAI-2

Question 44

An active form of plasminogen that destroys clot through what action or mechanism?

Answer 44

proteolysis

Question 45

Plasminogen Activation Inhibitors that is Primary inhibitor of Activated Protein C

Answer 45

Plasminogen Activator Inhibitor III

Question 46

Mechanism in the Change of Behavior of Thrombin Includes: A. Less ability to clot fibrinogen B. When attached to receptor site, it can further activate the platelet C. ability to acivate Factor V and Factor VIII D. No production of activated Factor Va and Factor VIIIa E. less ability to become platelet agonist

Answer 46

A,D,E

Question 47

True or False. Plasmin is normally seen in plasma once plasminogen gets activated

Answer 47

False

Question 48

Blank 1: An extrinsic endogenous plasminogen activator that is Found in both plasma and urine Blank 2: What is its inactive form and active form.

Answer 48

blank 1: urokinase plasminogen activator Blank 2: single-chain urokinase plasminogen activator or scu-PA (inactive form) two-chain urokinase plasminogen activator or tcu-PA (active form)

Question 49

where does this substances secreted as inactive enzyme where it is normally found in the plasma and it is the most important in the fibrinolytic system

Answer 49

liver

Question 50

what is the normal plasma content of this enzyme where when active, destroys the stabled clot of platelet

Answer 50

20 mg/dL

Question 51

what is the shelf life of this enzyme when in active state is not normally seen in the plasma, and when escape to circulation, it needs to immediately destroy by a inhibitor

Answer 51

2 days

Question 52

how will the protein C get activated?

Answer 52

thru formation of thrombin:thromboglobulin complex

Question 53

T/F. Activated Protein C cannot inactive Factors Va and VIIIa and synthesize t-PA without the help from the cofactor Protein S

Answer 53

true

Question 54

it is an effective cofactor for protein C

Answer 54

free protein S

Question 55

A protein that neutralizes the PAI-1 so that t-PA can successfully activate enzyme

Answer 55

Activated Protein C

Question 56

Primary inhibitor of plasmin

Answer 56

A2-antiplasmin

Question 57

secondary inhibitor of plasmin; inhibit the remaining plasmin that is not inhibit by the first inhibitor of plasmin

Answer 57

A2-macroglobulin