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Hem/Onc > hemostasis > Flashcards

hemostasis Flashcards

1
Q

process which causes bleeding to stop

A

hemostasis

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2
Q

what is the goal of hemostasis

A

keep blood within a damaged blood vessel

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3
Q

the opposite of hemostasis is ?

A

hemorrhage

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4
Q

4 phases of hemostatic process

A
  1. create platelet plug
  2. propagation of clotting process by the coagulation cascade
  3. termination of clotting by antithrombotic control mechanisms
  4. removal of the clot by fibrinolysis
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5
Q

what are the 3 hemostatic system players

A
  1. blood proteins
    - procoagulant factors
    - anticoagulant factors
  2. platelets
  3. vessel wall
    - procoagulant factors
    -anticoagulant factors
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6
Q

endogenous PLTs circulate for how long before being cleared from circulation?

A

~10 d

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7
Q

PLTs promote clotting in 2 ways:

A
  1. at site of active bleed, PLTs bind to exposed collagen to form primary plug (first response)
  2. after plug is formed, more PLTs come to expand and propagate the clot
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8
Q

secretion and granule content release and causes what? (3)

A

active coagulation
vasoconstriction
promote wound healing

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9
Q

von willebrand factor is synthesized and stored in: (2)

A
  1. endothelial cells
  2. PLTs
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10
Q

primary function of von willebrand factor

A

binding to other proteins
(does not require a catalytic event bc not an enzyme)

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11
Q

3 coagulation functions of von willebrand factor

A
  1. binds to endothelium and promotes and PLT adhesion to sites of vessel (through platelet glycoprotein Ib)
  2. plasma carrier for factor VIII, prevents its degradation
  3. binds to collagen when exposed
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12
Q

factor VIII is released from ___ by ____

A

vWF
thrombin

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13
Q

which hemostasis pathway is activated by tissue factor found outside the blood

A

extrinsic

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14
Q

which hemostasis pathway has factors required for activation found in the blood

A

intrinsic

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15
Q

all hemostasis pathways lead to ?

A

common pathway - activation of factor X

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16
Q

what are the 3 essential steps of blood coagulation

A
  1. prothrombin activator formed
  2. prothrombin activator causes conversion of prothrombin to thrombin
  3. thrombin converts fibrinogen to fibrin
17
Q

what are the 2 ways to form prothrombin factor

A

extrinsic pathway
intrinsic pathway

18
Q

most coagulation factors are synthesized in the ?

A

liver

19
Q

what coagulation factors require vitamin K (6)

A

II, VII, IX, X, protein C, protein S

20
Q

levels of vitamin K go down in: (3)

A
  1. fat malabsorption/malnutrition
  2. antibiotic therapy (esp. cephalosporin)
  3. newborn
21
Q

what is a vitamin K antagonist

A

warfarin (coumadin)

22
Q

3 steps of extrinsic pathway

A
  1. release of tissue thromboplastin from traumatized tissue
  2. activation of factor VII (VIIa)
  3. activation of factor X (Xa) = prothrombin activator (common pathway)
23
Q

5 steps of intrinsic pathway

A
  1. exposure to collagen causes activation of factor XII (XIIa)
  2. causes activation of factor XI (XIa)
  3. causes activation of factor IX (IXa) with help of Calcium
  4. IXa, VIIIa, calcium = complex = activates factor X
  5. activation of factor X = prothrombin activator
24
Q

prothrombin is produced continuously in ?

A

liver

25
Q

lack of vit K or presence of liver disease prevents ?

A

normal prothrombin formation

26
Q

fibrinogen is a protein formed in the

A

liver

27
Q

what converts fibrinogen into fibrin

A

thrombin

28
Q

what is the most abundant coagulation protein

A

fibrin (factor I)

29
Q

what stabilizes the fibrin after its been converted

A

factor XIIIa

30
Q

what protein predominantly synthesized in the liver

A

glycoprotein

31
Q

when activated, these proteins have almost a direct effect on conversion of prothrombin to thrombin

A

protein C and S

32
Q

anti-thrombin (III) inactivates what?

A

thrombin, IXa, Xa, XIa, and XIIa

33
Q

4 anticoagulant plasma proteins

A
  1. protein C and S
  2. anti-thrombin (III)
  3. tissue factor pathway inhibitor
  4. fibrinolysis system
34
Q

what is the function of the activated protein c

A

inhibition of factors Va and VIIIa

35
Q

what is the function of tPA

A

conversion of plasminogen to plasmin

Hem/Onc (13 decks)

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