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Hematology > Hematology Week 1: Hemostasis > Flashcards

Hematology Week 1: Hemostasis Flashcards

1
Q

Hemostasis Definition

A

The stopping of a flow of blood

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2
Q

3 things that can kill the patient in seconds that are hemostatic disorders

A

Massive Stroke

Massive MI

Massive pulmonary embolism

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3
Q

Disseminated Intravascular Coagulation

A
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4
Q

The importance of balance in hemostasis

A
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5
Q

Vasoconstriction

A
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6
Q

Primary hemostasis

A

Platelet adhesion to injury sites

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7
Q

Secondary Hemostasis

A

formation of a fibrin clot

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8
Q

Fibrinolysis

A

enzymatic breakdown of fibrin clot

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9
Q

The stages of hemostasis

4 listed

A
  • Vasoconstriction
  • Primary hemostasis
  • secondary hemostasis
  • Fibrinolysis
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10
Q

Platelets

made in?

A
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11
Q

Platelets

Lifespan?

A
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12
Q

Platelets

The amount in circulation?

A
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13
Q

Platelets

where are they?

A
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14
Q

Functions of Platelets

4 Listed

A
  • Stick to damaged epithelium
  • Store ADP, Ca2+, proteins for coagulation
  • Stack aggregate
  • Surface phospholipids for coagulation reactions
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15
Q

Anatomy of a platelet

Membrane Receptors

3 listed

A
  • glycoprotein 1b
  • Glycoprotein 2b-3a
  • Platelet agonist receptors
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16
Q

Anatomy of a platelet

Granules

A
  • Alpha Granules
  • Dense Granules
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17
Q

Glycoprotein 1b

A

Surface receptor on platelets that binds Von Willebrand Factor (vWF)

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18
Q

Glycoprotein 2b-3a

A

Surface receptors on platelet that bind fibrinogen

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19
Q

Glycoprotein 6

A

Surface receptor on platelet that binds collagen

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20
Q

Thromboxane A2

A

Surface receptor on platelet that binds

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21
Q

ADP Receptor on platelets

A
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22
Q

Platelet Alpha Granules Proteins

3 listed

A

Von Willebrand Factor

Fibrinogen

Factors 5, 8, 13

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23
Q

Platelet Dense Granule chemicals

3 listed

A
  • ADP/ATP
  • Calcium
  • Serotonin
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24
Q

How are platelet granules released?

A

released upon platelet activation aiding hemostasis

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25
Q

Platelet adhesion and aggregation inhibition

A

endothelium secretes

NO

PGI2

ADPase

to inhibit platelet adhesion and aggregation

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26
Q

Endothelium secretes what to inhibit platelet activation

3 listed

A

NO

PGI2

ADPase

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27
Q

Platelet receptor that binds to von Willebrand Factor

A

Glycoprotein 1b

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28
Q

Platelet receptor that binds to collagen

A

Glycoprotein VI

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29
Q

Platelet receptor that binds fibrinogen and vWF

A

Glycoprotein IIb-IIIa

mainly binds Fibrinogen but binds some to vWF

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30
Q

Coagulation cascade

A

a series on enzymatic reactions that amplifies until there is a thrombin burst that overcomes the natural anticoagulants present and polymerizes fibrinogen into an insoluble fibrin clot sealing injured vessels

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31
Q

The receptor that allows platelets to:

initial attachment and activation

A

GPIb

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32
Q

The receptor that allows platelets to:

Activation and spreading

A

GPVI

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33
Q

The receptor that allows platelets to:

Aggregation

A

GPIIb-IIIa

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34
Q
A
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35
Q

Formation of a fibrin clot steps

A

Platelet surface

fibrinogen interacts with thrombin to form a fibrin clot

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36
Q

Fibrinogen is cleaved by?

A

the enzyme thrombin

releases fibrinopeptides and forms fibrin monomer

37
Q

What crosslinks fibrin monomers to form fibrin polymers?

A

Factor 13

38
Q

Fibrinogen polymerization to fibrin

A
39
Q

What clotting factors need to work?

4 listed

A
  • Clotting factor (FI-XIII)
  • Phospholipids
  • Calcium
  • Co-factors (if necessary)
40
Q

Thrombin generation common pathway

A
  • the intrinsic and extrinsic thrombin generation pathways converge on the common pathway
  • Factor X is where the extrinsic and intrinsic pathways converge
  • Factor X and cofactor Factor V activate prothrombin to thrombin which cleaves fibrinogen to fibrin
41
Q

Thrombin actions

A
42
Q

Factor IIa

A

Thrombin

43
Q

Factor II

A

Prothrombin

44
Q

Factor VIIa Cofactor

A

Tissue Factor

45
Q

The extrinsic pathway

A

Factor VII

46
Q

Tissue factor is a?

A

Transmembrane receptor on cells outside of the circulation that binds Factor VIIa to activate the extrinsic pathway of coagulation

47
Q

Are platelets needed for the extrinsic pathway?

A

No only need Factor VII to come in contact with Tissue Factor

48
Q

The Intrinsic Pathway of Coagulation

A
49
Q

Procoagulant proteins

A
50
Q

Anti-coagulant Proteins

A

Also Anti-thrombin!!!

51
Q

Anti-thrombin function

A

inactivate thrombin

52
Q

Fibrinolysis

A

dissolution of fibrin clot

53
Q

tPA function

A

Endothelial cells release tissue plasminogen activator after stimulation by thrombin

tPA binds tightly to fibrin

54
Q

tPA AKA

A

Tissue plasminogen activator (tPA)

55
Q

tPA & Factor XII activates

A

Plasminogen into plasmin

56
Q

Plasminogen is cleaved into

A

Plasmin

57
Q

Plasminogen is cleaved by?

A

tPA and Factor XII

58
Q

Production of plasmin

A
59
Q

Plasmin Function

A

cleaves fibrin into breakdown products

  • fibrin degradation products
  • D-dimers
60
Q

D-dimers are formed by?

A

Plasmins cleavage of a fibrin clot

61
Q

tPA is inactivated by?

A

Plasminogen activator inhibitor (PAI-1)

62
Q

PAI-1 AKA

A

Plasminogen activator inhibitor

63
Q

PAI-1 is released from?

A

The endothelium

64
Q
A
65
Q

The primary site of synthesis for most proteins involved with hemostasis?

A

Liver

66
Q
A
67
Q

Hemostatic proteins synthesized by the live

A

Procoagulants 2, 5. 7, 9, 10. 13

Anticoagulants: Protein C, Protein S, Anti-thrombin

Fibrinogen

Plasminogen

68
Q

Chronic liver disease hemostatic consideration

A

can result in both bleeding and thrombosis

69
Q

Vitamin K dependent facotrs and proteins for hemostasis

A

SNoTT Factors: Factor 7, 9, 10, 2

Protein C and S

70
Q

GLA domain requires

A
  • Vitamin K for carboxylation of the enzyme GLA domain
  • GLA domains on factors bind Ca2+ which allows enzyme to bind phospholipid
71
Q

What is a GLA domain

A

on clotting factors bind calcium and phospholipids

72
Q

Intrinisic pathway relates to what test?

A

Partial Thromboplastin Time (PTT)

73
Q

Extrinsic Pathway relates to what test?

A

Prothrombin Time

74
Q

Prothrombin Time (PT)

A

evaluates the extrinsic pathway and common pathway

time it takes to take prothrombin to thrombin

75
Q

Warfarin is monitored by this test

A

PT

76
Q

PT reagent

A

Thromboplastin

77
Q

Thromboplastin

A

Reagent for PT made of tissue factor and phospholipid

78
Q

INR

A
79
Q

INR is not designed for?

A

Patients with liver disease

80
Q

PTT AKA

A

PArtial Thromboplastin Time

81
Q

PTT

A

evaluates intrinsic pathway and common pathway

82
Q

hypercoagulable state considerations

4 listed

A
  • increased procoagulant factors
  • decreased anticoagulant factors
  • reduced fibrinolysis
  • increased fibrin degradation products
83
Q

Neonates hemostatic considerations

3 listed

A
  • lower levels of procoagulant factors compared to adults
  • lower amount of intrinsic pathway factors
  • Vitamin K factors also lower (prophylactic Vitamin K is given at birth)
84
Q

Why is vitamin K given to neonates?

A

Vitamin K factors are lower at birth

85
Q

Coagulation in different life stages

A
86
Q

Three parts of the circulatory system

3 listed

A
87
Q

Arterial hemostatic considerations

A

Platelets are more active here

antiplatelet agents for preventing arterial thrombosis (Myocardial infarctions)

88
Q

Venous hemostatic considerations

2 listed

A

Clotting factors are more active here

anticoagulants targeting clotting factors for preventing venous thrombosis

89
Q

Microcirculation hemostatic considerations

2 listed

A
  • Large endothelial surface
  • Platelet dysfunction is observable here

Hematology (26 decks)

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