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Cardiopulmonary pathology > Hemostasis > Flashcards

Hemostasis Flashcards

1
Q

Hemostasis

A

the prevention of blood loss and maintenance of blood flow

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2
Q

vascular spasm

why this happen?

A

the reflex contraction of axial and circular smooth muscle

due to blood pressure loss & the blood flow decreases

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3
Q

What will have more severe vascular spasm (sharp cut vessels or crushing vessels)?

A

sharp cut vessels

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4
Q

precapillary sphincter

A

the sphincter that closes down when capillaries pressure drops below critical value

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5
Q

What are the consequences of vascular spasm due to external injuries?

A

vasoconstriction of blood vessels

retraction of vessel into the surrounding tissue to protect the severe end from exposure to foreign materials

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6
Q

What are the mechanisms of vasoconstriction of blood vessel in vascular spasm?

A

resulting from myogenic reflexes

local releases of vasoactive agents such as histamin, serotonin & kinin

blood loss into tissue cause local tissue pressure increase

stimulation of sympathetic nervous system

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7
Q

platelets

A

the cell fragments derived from megakaryocytes in bone marrow

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8
Q

What does platelets do?

A

maintaining the endothelial lining of blood vessels

repair small breaks

restricting blood flow by forming temporary platelet plug

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9
Q

Process of platelet plug formation

A

adhesion

aggregation

viscous metamorphosis

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10
Q

adhesion of platelets plug

A

the positive amino acids on exposed collagen fibers attract platelets to damaged vessel

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11
Q

aggregation of platelets plug

A

the more attraction of platelets around injuries site

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12
Q

viscous metamorphosis

A

the adhered platelets undergo morphology change in order to adhere strongly to damaged site and to each other

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13
Q

What kind of morphology changes in platelets during platelets plug formation?

A

swelling &protruding spinous processes

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14
Q

What are the products released during the

A

ADP + thromboxane A2

Calcium

beta-integrin

vasoactives amines

thromboplastin

platelet factor 3 (PF3)

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15
Q

What do ADP + thromboxane A2 do?

A

inducer of platelet aggregation

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16
Q

What does Calcium do in platelet plug formation?

A

increase the degree of platelets aggregation

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17
Q

plasma coagulation

A

the formation of blood clots (permanent seal)

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18
Q

beta-integrins

A

products that glue platelets together

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19
Q

what are the three stages of coagulation?

A

initiation of coagulation by formation of prothrombin activator

activation prothrombin to thrombin

conversion of fibrinogen to fibrin

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20
Q

What does vasoactive amines do?

A

release serotonin, kinins, epinephrine to restrict blood vessel (vasoconstriction)

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21
Q

thromboplastin

A

help in formation of permanent clots

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22
Q

When does the plasma coagulation happen?

A

when there is more severed damages on blood vessels & platelet plug alone can’t stop the blood loss

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23
Q

platelet factor 3 (PF3)

A

products released during platelets plug that involved in plasma coagulation

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24
Q

When does the extrinsic pathway of forming prothrombin activator happen?

A

when there is extract of fluid from tissue into plasma

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25
Q

When does the intrinsic pathway of forming prothrombin activator happen?

A

when there is trauma to the blood itself or atherosclerosis

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26
Q

clot retraction

A

the process of blood clot shrink or contract after 3D-fibrin network formed

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27
Q

when does the clot dissolution happen?

A

when the new fibroblasts arrive at the injury site & repair proces start

28
Q

during retraction, what also happen to the wound/injuries site?

A

the edges of wounds are pulled together

the fluids also ooze out of the clot in form of serum

29
Q

What is the factor III?

A

thromboplastin

30
Q

What is the factor IV?

A

calcium

31
Q

platelet actomyosin

A

the protein that help the clot retraction

32
Q

The steps in forming prothrombin activator of extrinsic pathway?

A

1) Factor III and tissue phospholipid(TF) are released by damaged cells
2) Factor III + IV act on Factor VII to form complex VIIa
3) Complex VIIa + TF acts on factor X-> complex Xa
4) Complex Xa form with TF & factor V to form prothrombin activator

33
Q

The steps in forming prothrombin activator in intrinsic pathway?

A

1) PF3 and Calcium are released
2) Factor XIIa acts on XI -> complex XIa
3) XIa acts on IX -> IXa
4) IXa + VIIIa + PF3 + Calcium -> Xa
5) Xa + PF3 + Va -> prothrombin activator

34
Q

Where is the prothrombin produced? What vitamin is required for this?

A

in the liver by endothelial cells

vitamin K

35
Q

What is the last step of blood clot (or plasma coagulation)?

A

conversion of fibrinogen into fibrin

36
Q

What are the two factors in plasma coagulation that are not proteins?

A

factor IV (calcium)

PF3 (tissue phospholipid)

37
Q

Lack of factor VIII will cause what disease? What pathway in forming prothrombin activator is affected?

A

hemophillia

intrinsic pathway

38
Q

Mechanism of forming thrombin from prothrombin?

A

prothrombin activator and Ca2+ act on prothrombin to produce thrombin

39
Q

The steps in conversion of fibrinogen to fibrin

A

1) thrombin split fibrinogen molecule into fibrin monomer
2) fibrin monomer unites -> fibrin polymers
3) Complex XIIIa acts on fibrin polymers to form strong 3D fibrin network surround the platelet plug

40
Q

Is it true that factors, once activated adhere to original site of injury and act spreadly?

A

No, they all act locally

41
Q

Is it true that extrinsic and intrinsic pathway doesn’t have anything in common?

A

No, they share the similarites in steps fornming fibrin from prothrombin

42
Q

NSAIDs

Example of this type of family drug

How long does it take for platelets restores it functions if we stop this drug?

A

reversible cox 2 inhibitor

ibuprofen, acetaminophen, naproxene

right away

43
Q

What does thrombin do?

A

activate factor XIII and I

activate platelet plug to increase aggregation

44
Q

hemophillia

Example of this disease

A

inherited disease that lack of factor VIII

uncontrolled bleeding on “Clean” cut vessel while damaged tissue may clot

45
Q

Mechanism of clot dissolution?

A

clot produce plasminogen and clot dissolution occur

46
Q

thrombocytopenia

Cause of this disease?

Consequence of it?

A

the inadequate number of platelets

dietary deficiency of vitamin B12 & folic acid

prolong bleeding time & impaired clot retraction

47
Q

Coumadin

How long does it take for this drug to work?

A

the anticoagulant that inhibit the sysnthesis of vitamin K -> key plasma proteins factors are not produced

36-48 hours

48
Q

what are the mechanisms to prevent coagulation under normal condition?

A

the repellence btw negative charge of plasma proteins & of endothelial cells

the circulation of anti-coagulant agents

49
Q

What are the anti-coagulant agents? Each effect on plasma proteins?

A

fibrin absorbs most thrombin

antithrombin II binds to excess thrombin

heparin: interferes with activation of factor X

50
Q

aspirin

What does it do?

A

the irreversible cox-2 inhibitor

inhibit the production of platelet & thromboxane A2

51
Q

When should a patient have a surgery if he/she is using aspirin?

A

in one week after the day stop using aspirin

52
Q

plasminogen

A

the enzyme that degrade the fibrin clots

53
Q

What is the cause of Von Willibrand’s disease?

Consequence?

A

the deficiency of vWF

poor platelet adherence to injuries site & low lvl of factor VIII

prolong bleeding time

54
Q

What is chelator used for? Why?

A

in blood being draw for testing

because it binds with Ca2+ -> inhibit the coagluation pathways

55
Q

What test is used to measure the deficiency of platelet number?

What does this test also measure?

A

complete blood count

RBC/ WBC/ hematocrit & hemoglobin

56
Q

What blood test is used to evaluate the intrinsic pathway?

extrinsic pathway?

A

partial thromboplastin time (PTT)

prothrombin time (PT)

57
Q

What blood test is used to evaluate the vW disease?

A

platelet aggregation test

58
Q

What blood tests that are used to confirm the heparin contamination?

What do these tests measure in common?

A

prothrombin & thrombine time test

partial thromboplastin time test

time to clot

59
Q

What drug that inhibit platelet production & thromboxane A2?

A

aspirin

60
Q

What drug is used in blood being drawn to prevent coagulation?

A

chelator

61
Q

What drug that will have platelet restored its function right away when it is stoped?

Why?

A

NSAIDs

because it is reversible cox 2 inhibitor

62
Q

What drugs that inhibit the vitamin K synthesis so the plasma factors will not be produced?

A

Coumadin

63
Q

What drug is use to be anti-coagulant to interfere with activation of factor X?

A

heparin

64
Q

What proteins that adhere platelets to collagen fibers?

A

von WIllibrand’s factor

65
Q

What blood diseases that have inadequate platelets & is caused due to deficiency of vitamin B12 & folic acid?

A

thrombocytopenia

Cardiopulmonary pathology (12 decks)

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