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hematology ii coagulation disorders > Hematology Exam 3 > Flashcards

Hematology Exam 3 Flashcards

1
Q

Factor I

A

Fibrinogen

activates GPIIb/IIIa complex

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2
Q

Factor II

A

Prothrombin

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3
Q

Factor III/TF

A

Tissue Factor, Thromboplastin

attracts platelets activates EXTRINSIC patways

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4
Q

Factor IV

A

Ionic Calcium

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5
Q

Factor V

A

Labile factor

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6
Q

Factor VII

A

Stable factor

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7
Q

Factor VIII

A

Antihemophilc factor

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8
Q

Factor IX

A

Christmas factor

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9
Q

Factor X

A

Stuart-Prower factor

activation starts COMMON pathway

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10
Q

Factor XI/PTA

A

Plasma thromboplastin atecedent

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11
Q

Factor XII

A

Hageman factor

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12
Q

Factor XIII/FSF

A

Fibrin-stabilizing factor

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13
Q

VWF

A

Von Willebrand factor
Factor VII carrier
Platelet adhesion to vessel wall
absence causes pseudohaemophilia

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14
Q

Pre-K

A

Prekallikrein/Fletcher factor

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15
Q

HMWK

A

High molecular weigh kininogen/ Fitzgerald factor

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16
Q

PF3

A

Platelet factor 3/Phosphoplids, phosphatidylserine
stimulates coagulation process
activates INTRINSIC pathway
activates EXTRINSIC pathway

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17
Q

PF4

A

Platelet factor 4
stimulated by PF3
starts the coagulation cascade

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18
Q

t-Pa

A

Tissue Plasma activator

converts plasminogen to plasmin

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19
Q

PAI-1/PAI-2

A

Plasminogen activator inhibitor- 1 or 2

Inactivate t-Pa (stops plasminogen -> plasmin)

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20
Q

Define intima

A

inner vessel wall

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21
Q

Define media

A

middles vessel wall

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22
Q

Define adventitia

A

outer vessel wall

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23
Q

Define thrombocytopenic purpura

A

bruising associated with a reduced number of circulating platelets

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24
Q

Define fibrin

A

fibrillar protein produced by the action of thrombin on fibrinogen in the clotting process. Fibrin is responsible for the semisolid character of a blood clot.

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25
Q

Define Disseminated Intravascular Coagulation (DIC)

A

occurs after traumatic event. Affected person has used up all of their clotting factors and begins to hemorrhage. Lethal within an hour. True STAT situation.

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26
Q

What is Coumandin (Warfarin)

A

anticoagulant medication which inhibits the uptake of vitamin K uptake in liver cells.

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27
Q

Define serine protease inhibitor

A

inactivates fibrynolytic enzymes when no longer needed, stops fibrinolysis when it is complete

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28
Q

Define Kinin System

A

important in inflammation, vascular permeability, and chemotaxis

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29
Q

What is the complement system?

A

cell membrane lysis of antibody-coated target cell

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30
Q

Define Plasminogen activator inhibitor

A

neutralize fibrinolytic enzymes; too much leads to a risk of thrombosis

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31
Q

Describe adhesion

A

the attachment of platelets to the subendothelial collagen. Reversible; seals endothelial gaps, some secretion of growth factors. In arterioles VWF (von Willebrand factor) is necessary for adhesion.

32
Q

Describe Aggregation

A

Platelets adhere to each other. Irreversible; platelet plug forms, platelet contents are secreted, requires fibrinogen.

33
Q

Describe Secreation

A

platelets discharge to contents of their granules. Irreversible; occurs during aggregation, platelets contents are secreted, essential to coagulation.

34
Q

Define Primary Hemostasis

A

the role of blood vessels and platelets in the initial formation of a primary hemostatic plug in response to vascular injury. Limits bleeding immediately. Initiates the clotting cascade and maintains vascular integrity

35
Q

How is primary hemostasis activated?

A

“Injuries to the blood vessel

Exposure of collagen and TF (tissue factor/factor III)”

36
Q

Define Mucocutaneous hemmorrhage

A

bleeding on surface of the skin

37
Q

Define Eccymoses

A

purpue, bruising

38
Q

Define epistaxis

A

nosebleeds

39
Q

Define petechia

A

broken cappillaries

40
Q

What factors are needed for platelat adhesion?

A

VWF, collagen, GPIB

41
Q

Define dense bodies

A

granules containing ADP in platelets, occurs after platelet is activated

42
Q

Platelets secrete granules containing ADP for

A

energy, attraction of other platelets

43
Q

What is required to make the primary hemostatic plug?

A

ATP (for energy), Ca2+, GPIIB and GPIIIa, Fibrinogen (factorI)- this activates a GPIIb/GPIIIa complex

44
Q

What starts the coagulation cascade?

A

The release of platelet factor 4 (PF4)

45
Q

Define secondary hemostasis

A

second phase of coagulation involving the activation of plasma coagulation proteins to produce a fibrin clot. This is the coagulation cascade. The polymerization of multiple fibrin strands into a single clot.

46
Q

Which pathway does platelet factor 3 (PF3) trigger?

A

Both the INTRINSIC and EXTRINSIC pathways

47
Q

Symtpoms of Secondary Hemostasis

A

Factor deficiencies, coumadin toxicity, heparin therapy, DIC, haemophilia)

48
Q

What is the intrinsic pathway?

A

sequence of serine protease reactions leading to fibrin formation, beginning with the in vitro activation of factor XII, followed by the sequencial activation of factors XI and IX, and resulting in the activation of factor X, which initiates the common pathway of coagulation. Triggered by internal injuries such as bruising.

49
Q

What is the extrinsic pathway?

A

primary in vivo coagulation pathway. Exposure of tissue factor activates factor VII. Factor VIIa activates factor IX and X, which triggers the common pathway of coagulation and the formation of fibrin. Triggered by injuries from the outside (surgery, trauma, ect)

50
Q

What is the common pathway?

A

the steps in the coagulation cascade from the activation of factor X through the conversion of fibrinogen to fibrin. The common pathway begins at the junction of the intrinsic and extrinsic pathways and involves factor X, V, II (prothrombin), and fibrinogen in order of reaction.

51
Q

Heparin limits which pathway?

A

INTRINSIC

52
Q

Coumadin limits which pathway?

A

EXTRINSIC

53
Q

The intrinsic pathway is activated by…

A

“Collagen

PF3”

54
Q

The extrinsic pathway is activated by…

A

“TF (tissue factor/factor III)
calcium
PF3”

55
Q

How long does a fibrin clot typically last?

A

3-5 days

56
Q

Symtpoms of fibrinolysis disorders

A

“Hemorrhage
Oozing
DIC”

57
Q

In fibrinolysis, what converts plasminogen to plasmin?

A

tissue plasma activator (t-Pa) and urokinase

58
Q

In fibrinolysis, what inihbits the conversion of plasminogen to plasma?

A

plasminogen activator inhibitor 1 and 2 (PAI-1/2)

59
Q

X and Y products

A

are larger FDPs

60
Q

D and E products

A

are smaller FDPs, fibrin splits

61
Q

What stops fibrinolysis when the cot is dissolved?

A

Thrombin-activatable fibrinolysis inhibitor

62
Q

Define thrombopoiesis

A

the formation of platelets

63
Q

How many nuclei does a promegakaryocyte have?

A

two - four

64
Q

How many nuclei does a magakaryocyte have?

A

eight to thirty two

65
Q

Where are megakaryocytes stored?

A

lungs and bone marrow

66
Q

How many platelets does one megakaryocyte produce?

A

2,000-7,000

67
Q

What is the normal range for platelets?

A

150,000-350,000

68
Q

Define splenomegaly

A

enlargement of the spleen

69
Q

Define hypersplenism

A

increased hemolytic activity of the spleen caused by splenomegaly, resulting in deficiency of peripheral blood cells and compensatory hypercellularity of the bone marrow

70
Q

Platelets provide a negatively charged phospholipid surface for the activation of which factors?

A

factor X (stuart-prower) and factor II (prothrombin)

71
Q

Plateles provide surface membrane glycoproteins too…

A

attract other platelets

72
Q

What platelets secretions can be used as activation markers?

A

Beta-thromboglobulin, PF4, thrombosondin, and PDGF

73
Q

Where are most platelets found? Name 1 exception

A

“The liver

VWF portion of factor VII is produced in epithelial cells and platelets”

74
Q

Define cofactor

A

A substance whose prescence is essential for the activity of an enzyme

75
Q

In coagulation, one of the main cofactors is…

A

calcium

76
Q

Define protrombin time (PT)

A

measures the extrinsic pathway. Thromboplastin and calcium are added to plasma and the clotting time is recorded. Widely used to measure Coumadin therapy.
more sensitive to the loss of factor VII than to factor II
inhibited by Coumadin which inhibits vitamin K uptake in liver cells

77
Q

Define partial prothrombin time (PTT)

A

“measures the intrinsic pathway. Calcium chloride, phospholipid, and activator are added to patient plasma. The interval from the addition of reagent to clot formation is recorded. The test is used to monitor unfractionated heparin therapy, to screen for intrinsic pathway deficiencies, and to screen for lupus anticoagulation.
most sensitive to intrinsic pathway deficiencies occuring in the cascade prior to factor II
inhibited by heparin
when T is prolonged by Coumadin, the PTT is also slightly prolonged.
“

hematology ii coagulation disorders (2 decks)

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