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Year 1 Pathology > Hemodynamics I > Flashcards

Hemodynamics I Flashcards

1
Q

What is an early sign of anasarca?

A

Periorbital edema

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2
Q

What are the three most common causes of cardiogenic pulmonary edema?

A
  1. Left ventricular failure 2. Myocardial infarction 3. Systemic hypertension
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3
Q

What are the features of interstitial pulmonary edema?

A
  1. Poorly defined pulmonary vessels 2. Visible lung fissures 3. Septal lines 4. Thick bronchial walls
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4
Q

What is the main feature of alveolar pulmonary edema?

A

Bilateral symmetric perihilar lung consolidation

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5
Q

What are the roles of PGI-2 and NO?

A

Inhibit aggregation

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6
Q

What is the role of ADP and TXA-2?

A

Released by platelets, mediate platelet aggregation

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7
Q

What is the role of thrombomodulin?

A

Converts thrombin to an anticoagulant

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8
Q

Which cell makes TPA?

A

Endothelial cell

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9
Q

Which molecules are cofactors for antihrombin?

A

Heparin-like molecules

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10
Q

vWF links platelets to the subendothelium via what surface molecule?

A

Gp1b

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11
Q

What is the role of platelet factor 4?

A

In platelet granules, binds and inactivates heparin

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12
Q

Does serotonin induce vasoconstriction or vasodilation?

A

Vasoconstriction

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13
Q

Prothrombin time tests which arm of the coagulation cascade?

A

Extrinsic

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14
Q

PT is prolonged by what compound?

A

Warfarin

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15
Q

Partial thromboplastin time tests which arm of the coagulation cascade?

A

Intrinsic

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16
Q

PTT is prolonged by what compound?

A

Heparin, hemophilia, antiphospholipid Ab

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17
Q

Which factors are involved in the intrinsic arm?

A

TENET - 12, 11, 9, 8, 10 (plus calcium and phospholipid)

18
Q

What are the roles of antithrombin III?

A
  1. Directly inactivates thrombin and factors IXa, Xa, XIa, XIIa 2. Potentiated by heparin
19
Q

What are the roles of Protein C?

A
  1. Inhibits (cleaves) cofactors Va and VIIIa 2. Decreases rate of clot formation 3. Requires activation 4. Enhanced by Protein S
20
Q

What is the role of plasmin?

A

Breaks down fibrin

21
Q

What are the roles of thrombomodulin?

A
  1. Activated by thrombin 2. Binds to thrombin to alter its conformation 3. Complex activates Protein C, which inhibits Va / VIIIa
22
Q

What is the role of tissue pathway factor inhibitor?

A

Inhibits VIIa-TF complex (extrinsic arm)

23
Q

What molecule inactivates free plasmin?

A

alpha-2 antiplasmin

24
Q

Which substances can activate plasminogen?

A
  1. TPA (endothelial cells) 2. Urokinase (plasma, various tissues) 3. Streptokinase (bacterial product)
25
Q

Does heparin dissolve clots that have already formed?

A

No

26
Q

What is the mechanism of action of heparin?

A

Activates antithrombin III, and inhibits thrombin, factor IXa, and factor Xa

27
Q

What is the mechanism of action of warfarin?

A

Interferes with vitamin K metabolism, stops blood from clotting within vessels, getting bigger, and breaking off

28
Q

What are the vitamin K dependent clotting factors?

A

10, 9, 7, 2

29
Q

Does warfarin have more of an effect on the intrinsic or extrinsic pathway?

A

Extrinsic

30
Q

Which drug is a direct thrombin inhibitor?

A

Dabigatrin

31
Q

Which drugs are direct factor Xa inhibitors?

A

Rivaroxaban and apixaban

32
Q

Which drug is a tissue factor pathway inhibitor?

A

TFPI

33
Q

Most patients with warfarin necrosis have low levels of what compound?

A

Protein C

34
Q

What is the cause of heparin-induced thrombocytopenia?

A

Antibodies to heparin bind heparin / platelet factor 4 complex, activation of platelets leads to intravascular coagulation and low platelet counts

35
Q

Bernard Soulier disease

A

Defect of platelet adhesion, lack of Gp1b

36
Q

Glanzmann’s thrombasthenia

A

Defect of platelet aggregation, lack of GpIIb-IIIa

37
Q

Thrombotic thrombocytopenia purpura

A

Antibodes directed against vWF cleaving protease ADAMTS-13 - thrombi form in small vasculature

38
Q

Hemophilia A lacks what clotting factor? B? C?

A

A - VIII B - IX C - XI

39
Q

What is the first step in DIC?

A

Activation of thrombin systemically

40
Q

How is DIC measured?

A
  1. D-DIMERS - measures plasmin-cleaved insoluble cross-linked fibrin 2. Indirect measurement of plasmin and thrombin activiy

Year 1 Pathology (25 decks)

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