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Pathology Exam II > Hemodynamic Disorders III > Flashcards

Hemodynamic Disorders III Flashcards

1
Q

Where do intrisnic and extreinisic pathways merge

A

factor X

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2
Q

many of the factors need to be bound to what for max activity

A

phospholipid surface

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3
Q

what is necessary for coagulation

A

calcium

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4
Q

what is the end result of the coagulation cascade

A

cross-linked fibrin

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5
Q

Prothrombin time (PT)

A

extrinsic

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6
Q

what pathways is prolonged by warfarin

A

extrinsic

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7
Q

Partical thromboplastin time (PTT)

A

intrinsic

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8
Q

what pathway is prolonged by heparin

A

intrinsic

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9
Q

what pathway is slower

A

intrinsic

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10
Q

antithrombin III

A

directly inactivated serine proteases

increased by heparin

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11
Q

protein C

A

inhibits cofactors Va and VIIIa
decreases rate of clot formation
requires activation

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12
Q

plasmin

A

breaks down fibrin

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13
Q

protein S

A

enhances activity of protein C

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14
Q

thrombomodulin

A

activated by thrombin
binds to thrombin
activates protein C

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15
Q

tissue pathway factor inhibitor

A

inhibits VIIa-tissue factor complex

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16
Q

how is free plasmin inactivated

A

circulating alpha2 antiplasmin

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17
Q

urokinase

A

present in plasma

activates plasminogen

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18
Q

tPA

A

actives highest degree of activation when attached to fibrin

activates plasminogen

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19
Q

streptokinase

A

bacterial product

activates plasminogen

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20
Q

anticoagulants

A

prevent clot formation and extension

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21
Q

antiplatelet drugs

A

interfere with platelet activity

22
Q

thromboytic agents

A

dissolve existing thrombi

23
Q

what factors does heparin inhbit

A

thrombin
factor IXa
factor X

24
Q

what is heparin produced by

A

basophils and mast cells

25
Q

how does heparin affect already fromed clots

A

does not disintegrate them

26
Q

how is heparin given

A

IV or subcutaneous injection

27
Q

how is warfarin given

A

orally

28
Q

how does warfarin work

A

interferes with vit K metabolism

29
Q

what are the vitamin K dependent clotting factors

A

VII
XI
X
II

30
Q

dabigatran

A

direct thrombin inhibitor

31
Q

rivaroxaban and apixaban

A

direct factor Xa inhibitors

32
Q

besides the K dependent clotting factos, what does warfarin affect

A

protein C and S

33
Q

PT and PTT for low dose heparin

A

PT - normal

PTT- prolonged

34
Q

PT and PTT for high does heparin

A

PT - prolonged

PTT - prolonged

35
Q

PT and PTT for low dose warfarin

A

PT - prolonged

PTT - normal

36
Q

PT and PTT for high does warfarin

A

PT- prolonged

PTT - prolonged

37
Q

contraindication to warfarin

A

pregnancy

elderly

38
Q

warfarin necrosis most liley to happen where

A

thighs, breasts ,buttocks

39
Q

patients with warfarin necrosis have low levels of what

A

protein C

40
Q

herparin-induced thrombocytopenia

A

antibodies to herparin bind to heparin/platelet factor 4 complex
results in endothelial injury and platelet activation which induces a prothrombotic state

41
Q

heparin - induced thrombocytopenia occurs more commonly in what

A

unfractionated heparin than low molecular weigh heparin

42
Q

bernad soulier disease

A

defect of platelet adhesion

problem with glycoprotein IB

43
Q

glanzmann’s thrombasthenia

A

defect of platelet aggregation

problem with glycoproetin IIB/IIIa

44
Q

thrombotic thrombocytopenic purpura

A

antibodies directed against von willebrand factor cleaving protease

45
Q

von willebrand’s disease

A

defiency of von willebrand’s antigen

most common bleeding disorder

46
Q

Hemophilia A

A

factor VIII deficiency

X-linked recessive

47
Q

Hemophilia B

A

factor IX deficiency

X-linked recessive

48
Q

Hemophilia C

A

more mild
factor XI deficiency
autosomal recessive

49
Q

DIC

A

results from release of any substance into bloodstream that results in widespread activation of thrombin

50
Q

what are biochemical markers of DIC

A

plasmin and thrombin activity

51
Q

what can you use to diagnose DIC

A

D-DIMER

Pathology Exam II (11 decks)

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