hematologyagents1

Question 1

what is hemostasis

Answer 1

is a physiological process that haltws bleeding that involves the following systems. Vasculatreu platelet coagulation antigulation and fibronolyti

Question 2

name the antiplatelet drugs

Answer 2

aspirin and dipyridamole, P2y12 receptor antaonists, glycoprotein GP2b 3a antagonists, and patelet thrombin recport antagonists.

Question 3

what is the importance of collagen and vonwilderbrand factor

Answer 3

not normally found in the blood but with injury it will bind and cause caugolation

Question 4

what binds vonwilderbrand and collagen

Answer 4

Gp1B and and GP 1A

Question 5

what binds to fibrongen

Answer 5

GP2b and3a ill bind fibrinogin when activated allowing the platelests to aggragate and coagulate.

Question 6

what does a plateate that is directly teathard to the site of injury release to activate other plateletes

Answer 6

ADP TXA and 5-HT

Question 7

what do the intrinsic and extrinsic coagulation pathways converge on

Answer 7

convertin prothrombin to thrombin

Question 8

what does thrombin do

Answer 8

converts fibrinogin to fibrin and can bind to platelles and active the protease activated receptor PAR

Question 9

tell me the intrinsic system

Answer 9

12-11-9-common factor 10

Question 10

tell me about the extrinsic system

Answer 10

7 directly acts on factor 10

Question 11

tell me about the common system

Answer 11

10 activated by either pathway -10a and 5a -prothrombin to thrombin and that leads to fibrinogin to fibrin and thrombin also does 13- 13a to stable fibrin clot

Question 12

how does antithrombin work

Answer 12

inactivates factor 10a

Question 13

how does thrombin work as an anticoagulant

Answer 13

decrase futher thrombine production, activates protien c and degrades facto 5 and factor 8

Question 14

how does plaminogin get activated

Answer 14

tPA converts it and is relaesd by the endothelium cells

Question 15

what do the antiplatelet drugs do

Answer 15

work on stopping platelet aggregation

Question 16

what do the antocoagulation do

Answer 16

work on thrombus

Question 17

why are anticoagulates used for

Answer 17

to prevent venous thrombosis and thromboembilism

Question 18

how does heparin sulfate work

Answer 18

binds to antithrombin to increase inhibition of factor Xa and thrombin. A specific sequence of pentasaccharide will bind to antithrombin causing it to have a higher affinity for thrombin, it can also increase the AT induced inhibition by acting as a molecular bridge and bringing it into close contact only longer molecules can do this.

Question 19

tell me about heparin

Answer 19

has to be used intravenously short half life 90 min so inejected every hours, and is effected by binding to other protein and is unique from person to person so no good fixed dose.

Question 20

how is heparin cleared

Answer 20

non saturate involving liver and kidneys and a repaid process of binding to and being taken up by endothelial cells this can be saturated. So t1/2=0.693x Vd/CL so aoo units per kg is aout 1 hour 400 is 2.5 and 800 is 5 hours.

Question 21

what is the activated partial thromboplastin time

Answer 21

how long it takes for your blood to coagulate,

Question 22

what are the side effects of heparin

Answer 22

bleeding even in normal range, usually can be treated by stopping dose but if its bad use protamine sulfate. Also long term use can lead to osteoperosis. And thrombocytopenia

Question 23

what is type 1 thrombocytopenia

Answer 23

not enough thrombocytes in the blood, but type one is mild and will return on its own.

Question 24

what is type 2 thrombocytopenia

Answer 24

uncommon but mortality high, immune response to heparin PF4 complex so antibodies bind to platelets and activate them and then they are cleared by macrophages can cause thrombosis.

Question 25

what is enoxaparin

Answer 25

low molecular weight heparin the large pieces are removed. Can be administered subcutaneously instead of by IV. This does not inhibit thrombin because its not large enough instead just inhibits factor 10a. Longer half life more bioavailible, and dose independent clearance so more predictable lower risk for heparin induced thrombocytopenia and osteoperosis, but its not as reactive to protamine so its not as reversible in case of an emergancy.

Question 26

how is enoxaprin cleared

Answer 26

primarily through the kidney, so do not use by people with renal insufficiency .

Question 27

what is fondaparinux

Answer 27

sythetic sezuence of pentasacharide only inhibits factor Xa and protamine does not reverse it.

Question 28

how do you monitor LMWH and fondaparinux

Answer 28

Anti-factor Xa assay.