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Hematology > Hemostasis > Flashcards

Hemostasis Flashcards

1
Q

Factor I

A

Fibrinogen

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2
Q

Factor II

A

Prothrombin

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3
Q

Factor III

A

Thromboplastin

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4
Q

Factor IV

A

Calcium

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5
Q

Factor V

A

Proccelerin

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6
Q

Factor VII

A

Proconvertin

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7
Q

Factor VIII

A

Antihemophilic factor

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8
Q

Factor IX

A

Christmas factor

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9
Q

Factor X

A

Stuart-Prower factor

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10
Q

Factor XI

A

Plasma thromboplastic antecedent (PTA)

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11
Q

Factor XII

A

Hageman factor

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12
Q

Factor XIII

A

Fibrin stabilizing factor

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13
Q

Fibrinolysis Fragments

A

D fragements double bond with each other, E single bonds
DD/E
DxD/DD
DY/YD

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14
Q

Primary Hemostasis

A

Involves the function of blood vessels and platelets in blood clot formation

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15
Q

Platelets

A

80% are in circulation, 20% are in the spleen
4-5 days to mature, 9-12 days in circulation
Activated by thrombin, PTA, lysophosphatidic acid, thromboxane A2, ADP, and serotonin

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16
Q

Peripheral Zone

A

Membrane: negatively charged phospholipids, GPIb bind vWF, GPIIIb/IIIa bind fibrinogen
Glycocalyx: gives a negative charge to platelets, provides a thick layer of glycoproteins/glycolipids/mucopolysaccharides where coagulation factors can bind (I, II, VII, vWF, IX, X)

17
Q

Structural Zone

A

Microfilaments

Microtubules (actin and myosin)

18
Q

Membrane Zone

A

Open canalicular system: channels leading from plt surface to interior, release granule content
Dense tubular system: smooth ER from megakaryocyte, acts as store of Ca2+

19
Q

Organelle Zone

A

Mitochondria: 50% of ATP from respiration, glycolysis
Glycogen
Storage granules

20
Q

Dense Granules

A

ADP, ATP, Ca2+, Serotonin

21
Q

Alpha Granules

A

Hemostatic proteins (I, V, XI, XIII, vWF, plasminogen)

22
Q

Protease Inhibitors

A

AAT, alpha 2macroglobulin, C1 esterase inhibitor, alpha2 antiplamin

23
Q

Platelet Specific Proteins

A

PF4, B thromboglobulin, PDGF, thrombospondin

24
Q

Platelet Adhesion vs Aggregation

A

Adhesion: plts adhere to exposed collagen/vWF through GPIb receptor, causes shape change, Ca2+ released from DTS
Aggregation: attachment of plts to each other, ATP dependent process, fibrinogen binds to the GPIIb/IIIa receptor

25
Q

Granules Release

A

1st group: dense granules

2nd group: 1 release (alpha), 2 release (dense and lysosomes)

26
Q

Secondary Hemostasis

A

Involves the coagulation cascade which forms a fibrin mesh around the platelet plug

27
Q

Extrinsic Pathway

A

Activated by tissue damage/factor and trauma
Shorter pathway
Measured by PT
Vessel injury - TF and VII - TF and Ca++ and VIIa (Xase complex)

28
Q

Intrinsic Pathway

A

Activated by negatively charged surface
Measures by PTT
Roles in fibrinolysis, inflammation, and complement activation
Contact - XII and XIIa - XI and XIa - Ca++ - IX - IXa and VIIIa and PL and Ca++ (Xase)

29
Q

Factor VIII and vWF

A

Factor VIII: produced by liver, circulated bound to vWF to prevent degrading, activated by thrombin which releases it from vWF, binds to platelet phospholipid surface
vWF: made by endothelial cells, large glycoprotein cut by ADAMTS13, links platelets to collagen via the GPIb receptor

30
Q

Xase

A

Extrinsic: TF, VIIa, X, IX (intrinsic IX to IXa, prothrombinase X to Xa)
Intrinsic: VIIIaH, VIIIaL, X, IXa (prothrombinase X to Xa)
Prothrombinase: VaH, VaL, II, Xa (protein case II to IIa)
Protein case: Tm, IIa, PC (PC to APC)

31
Q

Common Pathway

A 
Converts fibrinogen (factor I) into fibrin
Also converts prothrombin (factor II) into thrombin 
X - Xa - Xa and Va and PL and Ca++ - Prothrombin to thrombin - XIII to XIIIa - Fibrin to cross-linked fibrin
32
Q

Fibrinolysis

A

Degrades fibrin to keep vessels clear to carry blood
Inhibitors: a2-antiplasmin, TAFI, PAI1, PAI2, a2-macroglobulin
Plasminogen activators: tPA, urokinase, streptokinase, XII/HMWK/PK
Plasminogen is a zymogen and acute phase reactant protein
Called plasmin when it activates and degrades fibrin polymers

33
Q

Intrinsic, Extrinsic, and Exogenous Pathway

A

Intrinsic: XII (contact HMWK) XIIA – Prekallikrain to Kallikrein
Extrinsic: tPA and urokinase
Exogenous: Plasminogen (streptokinase) plasmin – Fibrin to fibrin degradation products

34
Q

Fibrin Digestion by Plasmin

A

X fragment: DED
Y fragment: DE
Plasmin can’t break crosslinked Ds (how we test for clots)
All act as competitive inhibitors of plasmin

35
Q

Physiological Inhibition of Coagulation

A

Protein C system, TF pathway inhibitor, antithrombin

36
Q

Protein C System

A

Protein C and S are vitamin K dependent
Protein C is activated by thrombin-thrombomodulin complex
Protein C-S complex degrades factors Va and VIIIa

37
Q

Tissue Factor Pathway Inhibitor

A

Function enhanced by Protein S

Only inhibits extrinsic pathway after factor Xa has been made

38
Q

Antithrombin

A

Can inhibit thrombin and any other serine proteases

IXa, Xa, XIa, XIIa, kallikrein, and plasmin

Hematology (28 decks)

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