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Anatomy / Physio II > Hemostasis > Flashcards

Hemostasis Flashcards

1
Q

Define Hemostasis

A

The physiological processes that stop bleeding

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2
Q

What are the four steps that constrain bleeding?

A
  1. Physical factors
  2. Platelets form hemostatic plug
  3. Coagulation due to production of fibrin clot
  4. Clot retraction
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3
Q

What are the two physical factors that slow bleeding?

A
  1. Back Pressure

2. Vasoconstriction

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4
Q

Why do black eyes form?

A

Bleeding below eye not easily stopped

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5
Q

What chemicals contribute to vasoconstriction?

A

Serotonin
Epinephrine
Thromboxane A2

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6
Q

What does thromboxane do?

A
  1. Vasoconstriction

2. Platelet aggregation

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7
Q

What reduces uterine blood loss after birth?

A

Compression of blood vessels due to underlying muscles

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8
Q

Where is thrombopoietin produced?

A

Liver and Kidney

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9
Q

The release of platelets from bone marrow is induced by _____

A

thrombopoietin

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10
Q

What is the von Willebrand factor?

A

Glycoprotein that:

  1. Forms bridge between platelet surface receptors and collagen
  2. Important in platelet adhesion to wound sites
  3. Not an enzyme
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11
Q

What is the von Willebrand factor produced by?

A

Endothelial cells due to adherence of platelets

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12
Q

What other protein does the von Willebrand factor bind to?

A

Factor VIII

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13
Q

What activates thrombin?

A

Membrane phospholipids

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14
Q

What initiates a cascade that ends in clot formation?

A

thrombin activation

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15
Q

What induces factor VIII to dissociate from von Willebrand factor?

A

thrombin activation

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16
Q

Is von Willebrand factor bound to Factor VIII in normal circulation or during clot formation?

A

normal circulation

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17
Q

What does the released of ADP from ruptured cells cause?

A

Platelet aggregation

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18
Q

When ADP binds to platelet ADP receptors, what is released?

A

thrombin

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19
Q

Drugs such as _____ irreversibly inhibit the platelet ADP receptor?

A

Plavix

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20
Q

fibrin stabilizing factor is also known as _______

A

Factor XIII

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21
Q

During coagulation, thrombin cleaves ______ into ______ that assemble into ordered arrays of _____

A

Thrombin cleaves fibrinogen into fibrin monomers which assemble into fibrous arrays of fibrin

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22
Q

What does Factor XIII do?

A

Stabilizes and tightens polymerized fibrin by forming covalent bonds between fibrin strands

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23
Q

What replaces unstable platelet aggregates during coagulation?

A

Factor XIII

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24
Q

Coagulation factors are _____

A

serine proteases

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25
The intrinsic pathway of the coagulation cascade is initiated by
factor XII
26
Does a lack of Factors XII lead to bleeding disorders?
Hell no. We don't need no Factor XII
27
The extrinsic pathway of the coagulation cascade is initiated by released of ______
tissue factor: | Factor III, thromboplastin
28
What is tissue factor produced by?
Subendothelial tissues: smooth muscle cells Neutrophils Monocytes
29
Endothelial cells produce tissue factor in response to _______
inflammatory mediators
30
What three main conversions take place during the final common pathway of the coagulation cascade?
1. Conversion of inactive factors X to its active form (Xa) 2. Conversion of prothrombin to thrombin 3. Conversion of fibrinogen to fibrin
31
What is purpura?
Red/purple discolorations of skin that do not blanch with pressure
32
Prothrombrin time (PT) is a coagulation test of the ______ system
extrinsic
33
What does the Prothrombin time test measure
How long plasma takes to clot after mixed with tissue factor and CaCl2
34
What time defines a failed PT test?
more than 11 seconds
35
The PT test measures effectiveness of __________ drugs
coumarin-type anticoagulant drugs (Coumadin-Warfarin)
36
What do coumarin-type anticoagulant drugs do?
Inhibit vitamin K-dependent synthesis of prothrombin and factors VII, IX, and X
37
What is a coagulation test of the intrinsic system?
Activated partial thromboplastin time (aPTT)
38
What does the Activated Partial Thromboplastin Time test measure?
clotting time from activation of factor XII through the formation of fibrin clot
39
What is a normal aPTT test time?
25 - 38 seconds
40
What is the aPTT test used for?
monitor heparin therapy
41
What does Heparin bind to in heparin therapy?
enzyme inhibitor antithrombin
42
Hypocoagulation is the word for ________ disorders
bleeding disorders
43
Hypercoagulation is the word for ______ disorders
thrombin disorders
44
Thrombocytopenia is characterized by _____
low platelet number
45
What is thrombocytopenia thought to be caused by?
autoimmune disease | "idiopathic thrombocytopenia purpura"
46
What is Von Willebrand disease?
reduced von Willebrand factor
47
What is the most common hereditary coagulation abnormality in humans?
Von willebrand disease
48
What is Hemophilia?
Lack of factors VIII or IX
49
Most Hemophilia is inherited in what way?
X-linked recessive
50
Vitamin K is required for ______ production by the liver
coagulation factor production
51
Hypercoagulation can lead to _____ which can lead to _____
Hypercoagulation -> Intravascular clot formation -> Stroke
52
What is a regulatory protein that functions as an anti-coagulant?
Protein S
53
In the gene therapy drug study, a single intravenous injection of __________ that expresses _______ improved the bleeding phenotype in all six patients
injection of adenovirus-assocatied virus (AAV) -> | expresses factor IX
54
________ disease was successfully treated by AAV injection in six patients
hemophilia B
55
Retraction occurs within ____ to ____ of clot formation
minutes or hours
56
What does clot retraction do?
Stabilizes inured site by pulling torn edges o vessels closer together
57
Clot retraction requires ______
platelet actin and myosin filament
58
Dissolution is also known as _____
fibrinolysis
59
Dissolution is mainly a function of ______
plasmin
60
Plasmin circulates as inactive ______
proenzyme plasminogen
61
How is plasminogen converted to plasmin?
plasminogen activator (tPA)
62
What is tissue plasminogen activator released by?
Activated endothelial cells in response to thrombin
63
Plasmin inhibits _____ and degrades
inhibits factors V and VIII | degrades fibrin
64
tPA is used to dissolve _____ in brain. Not useful if clot is due to ______
clots | hemmorhage
65
tPA is used to dissolve clots if used less than or equal to _____ hours of clot formation
4.5 hours
66
Healthy endothelial cells produce ______
prostacyclin
67
Prostacyclin does what?
inhibits platelets
68
tPA in aqueous humor converts ______ to ______, which keeps ouflow channels clear and activates ________, which plays a role in matrix remodeling
plasminogen to plasmin | plasmin activates TGF-Beta
69
chemoattractants attract _______, ________, and ______ to the wound
smooth muscle cells inflammatory cells fibroblasts
70
______ and growth factors induce smooth muscle cells, inflammatory cells, and fibroblasts to proliferate
Mitogens
71
What are the two growth factors that induce Chemoattractant molecules to proliferate?
Platelet-derived growth factor | Epidermal growth factor
72
Angiogenesis is mainly involved with ______
vascular endothelial growth factor (VEGF)

Anatomy / Physio II (9 decks)

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