Hemostasis Flashcards
Blood clot dissolution.
Fibrinolysis
What are the 2 Major Parts of Physiologic Hemostatic System?
Cellular components and Plasma Proteins
What are the cellular components of Physiologic Hemostatic System?
Platelets, Endothelial cells (ECs), Neutrophils, Monocytes
Group of plasma proteins participates in _____, _____ and _____.
Clot formation (coagulation); Dissolution of clots (fibrinolysis); Naturally occurring serine proteas inhibitions (Anti- coagulant)
What happens during primary hemostatis? _____-> _____-> _____-> _____->.
Vasoconstriction → Platelet Adhesion → Platelet Aggregation → Platelet Secretion
Constriction or narrowing of the (lumen) diameter of blood vessel to decrease blood flow.
Vasoconstriction
The purpose is to decrease the blood flow especially when a blood vessel is injured to prevent continuous bleeding.
Vasoconstriction
During vasoconstriction, collagen (sub-endothelial collagen) residing in the connective tissue will _______.
activate platelets
Bring deoxygenated blood from body tissues to heart.
Veins
Where the gas exchange happen, when venous and arterial blood components are found.
Capillaries
Brings oxygenated blood from heart to body tissues.
Arteries
Outermost layer of blood vessels.
Vascular Adventitia
Middle layer of blood vessel.
Vascular Media
Inner layer of blood vessel.
Vascular Intima
Made up of simple squamous epithelium cells which are involved in clotting process by producing and storing clotting component.
endothelial cells (endothelium)
Produces majority of the collagen.
Fibroblast
Regulates the permeability of the inner vessel wall.
Connective tissue Matrix
Highly active metabolically; involved in the clotting process by producing or storing clotting components.
Endothelium
Upon vessel injury, endothelium will release ______ and once healed, it will release _______.
prothrombotic components; antithrombotic or fibrinolytic component
The platelet will stick/bind to the endothelial cells.
Platelet adhesion
True/ false. Platelet adhesion is a reversible process.
True
Platelet bind to a non-platelet surfaces (sub-endothelial collagen).
Platelet adhesion
Promotes platelet adhesion and Binds to platelet via platelet glycoprotein receptor (GP Ib/IX/V).
VWF
Important components in Platelet adhesion are ____ and ____.
VWF and Glycoprotein membrane
VWF is absent or defective; Bleeding tendencies/risk.
VWF Disease
True/ False. Platelet Aggregation is irreversible.
True
The platelet will stick/bind to other platelets.
Platelet Aggregation
Important components in Platelet aggregation are ____, ______ and _______.
GP IIb/IIIa receptor, fibrinogen and calcium
When platelets are activated, a change in _____ allows binding of fibrinogen as well as VWF and fibronectin which results in ______.
GP IIb/IIIa receptor; PLATELET CLUMPING
Fibrinogen is one of the coagulation factor known as _____.
FACTOR I
____act as glue for GP IIb/IIa receptors but with the presence or help of calcium.
Fibrinogen
Binds to GP IIb/IIIa receptors on adjacent platelet and joins them together in the presence of Ionized/Activated calcium (Ca2+).
Fibrinogen
____is also one of the coagulation factor also known as FACTOR IV but preferred to be called by its chemical name.
Calcium
Absence of GP IIb/IIIa platelet membrane receptor that is a problem with the aggregation process.
Glanzmann thrombasthenia
Lack of fibrinogen.
Afibrogenemia
Low levels of normal fibrinogen (functional but decrease in concentration.
Hypofibrogenemia
Dysfunctional or defective fibrinogen (normal in count but dysfunctional).
Dysfibrogenemia
The platelet will release granules (alpha and dense granules).
Platelet Secretion
Platelet discharged the contents of its granules.
Platelet Secretion
Platelet Secretion occurs during _____ (accd. to Rodaks) and (accd. to Henry’s).
aggregation; late stage of platelet activation
What are the Platelet a-granules?
B-thromboglobulin, Factor V, Factor XI, Protein S, Fibrinogen, VWF, Platelet Factor 4, Platelet-derived Growth factor
What are the Platelet Dense granules?
Adenosine diphosphate (activates neighboring platelets), Adenosine triphosphate, Calcium (Ca++), Serotonin (vasoconstrictor)
Activates phospholipase A2. ADP and Ca++
Activates phospholipase A2.
ADP and Ca++
Converts membrane phospholipids to Arachidonic Acid.
Phospholipase A2
Converts arachidonic acid to prostaglandin endoperoxidase.
Cyclooxygenase
Caused ionized calcium to be released; Promoted platelet aggregation; Promotes vasoconstriction.
Thromboxane A2
Happens when a person takes aspirin.
Aspirin Acetylation/Aspirin Light Effect
If this occur, it will permanently inactivates cyclooxygenase.
Aspirin Acetylation/Aspirin Light Effect
Blocks thromboxane A2 production.
Aspirin Acetylation/Aspirin Light Effect
When there’s normal Platelet Count but with bleeding risk, qualitative and quantitative exam like when there’s normal Platelet Count but with bleeding risk → qualitative and quantitative exam like ______ is done to assess platelet function of the patient.
CTBT
Key surface for coagulation enzyme-cofactor-substrate complex formation.
Platelet Membrane
Secondary hemostasis: ______ → ______ → ______.
Coagulation → Fibrin Clot formation → Fibrin Stabilization
During secondary hemostasis, at least ______ is transported by plasma.
16 pro-coagulants
What are the 4 Categories of Plasma-based Components of the Coagulation System of Blood clotting?
Zymogens, cofactors, control proteins, fibrinogen substrate
Inactive form of enzymes.
Zymogens (Procoagulants)
What are the procoagulant in secondary hemostasis?
• Pre-Kallikrein
• FXII
• FXI
• FX
• FVII
• Prothrombin
• FXIII
Binds (to zymogen in their activated form), stabilized and enhance activity of their respective enzymes.
Cofactors
What are the cofactors in secondary hemostasis?
• HMWK
• Tissue factor
• FVII
• FV
• Protein Z
• Protein S
• Thrombomodulin
Serve the important functions of regulating the coagulation process to avoid unnecessary blood clotting.
Control Proteins
Substrate for the enzymatic action of thrombin, the primary enzyme of the coagulation system.
Fibrinogen Substrate
What is the name of factor 1?
Fibrinogen
What is the name of factor 2?
Prothrombin
What is the name of factor 3?
Tissue thromboplastin
What is the name of factor 4?
Plasma cation calcium
What is the name of factor 5?
Proaccelerin
What is the name of factor 7?
Proconvertin
What is the name of factor 8?
Antihemophilic factor
What is the name of factor 9?
Plasma thromboplastin component
What is the name of factor 10?
Stuart factor
What is the name of factor 11?
Plasma thromboplastin antecedent
What is the name of factor 12?
Hageman factor
What is the name of factor 13?
Fibrin- stabilizing factor
What is the alternative name of factor 3?
Tissue factor
What is the alternative name of factor 5?
Labile Factor, Ac globulin
What is the alternative name of factor 7?
Stable Factor, SPCA (serum prothrombin conversion accelerator *1949) Prev: cothromboplastin, stable component, convertin
What is the alternative name of factor 8?
AHG, Antihemophilic Factor A
What is the alternative name of factor 9?
Christmas Factor, Antihemophilic Factor B
What is the alternative name of factor 10?
Stuart-Prower Factor
What is the alternative name of factor 11?
PTA, Antihemophilic Factor C
What is the alternative name of factor 12?
Glass or contact factor
What is the alternative name of factor 13?
FSF
Alternative name of Prekallekrein.
Fletcher Factor
Alternative name of HMW Kininogen.
Fitzgerald Factor
Alternative name of VWF.
Factor VIII-related antigen
What are the Classification of Coagulation Factors?
Fibrinogen group, prothrombin group, contact group
What are the factors in fibrinogen group?
I, V, VIII, XIII
What are the factors in prothrombin group?
II, VII, IX, X
What are the factors in contact group?
XI, XII, PK, HMWK
Consumed during the process of coagulation; Calcium dependent; Vitamin K independent.
Fibrinogen group
Adsorbable and affected by coumadin (PIVKAS); Calcium and vitamin K dependent; Inhibited by Warfarin.
Prothrombin group
Not consumed during the process of coagulation; Calcium and vitamin K dependent; Involved in intrinsic coagulation pathway.
Contact group