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Cardiovascular > Hemostasis > Flashcards

Hemostasis Flashcards

1
Q

Describe the difference between primary and secondary hemostasis:

A
  • Primary hemostasis = process by which a wound is initially plugged by platelets
  • Secondary hemostasis = the process of fibrinogen binding platelets and becoming cross linked
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2
Q

What is hemostasis?

A

-a process which causes bleeding to stop, keeping blood within a damaged vessel

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3
Q

What is hemorrhage?

A

-bleeding, blood changing from a liquid to a solid state

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4
Q

What are the major components that contribute to hemostasis?

A
  • coagulation factors (I-XIII)
  • Von Willebrand factor
  • Platelets
  • endothelial cells
  • collagen
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5
Q

What receptors on platelets bind to collagen in hemostasis?

A

-GPIa

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6
Q

What binds to collagen if a wound is large, or if the flow is fast?

A

-Von Willebrand factor

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7
Q

What binds to Vh factor?

A

-Platelets

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8
Q

What does fibrinogen use to bind to platelets in hemostasis?

A

-GPIIb/IIIa

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9
Q

What activates platelets in hemostasis?

A

-binding to collagen

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10
Q

What is fibrinolysis?

A
  • cleanup of the blood clot

- Tissue plasminoge activator (tPA) released by endothelial cells

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11
Q

What converts plasminogen into plasmin?

A

-Tissue plasminogen activator along with Urokinase

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12
Q

What does plasmin do?

A

-breaks up cross linked fibrin into fibrin degradation products (FDP) and fibrin split products (FSP)

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13
Q

What are the two coagulation cascade pathways?

A

-Intrinsic & extrinsic

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14
Q

What converts fibrinogen into fibrin?

A

-Thrombin

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15
Q

What converts prothrombin into thrombin?

A

-Xa

Cofactors:

  • Va
  • Ca2+
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16
Q

Where is most tissue factor located?

A

-on the monocyte and macrophage

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17
Q

How many coagulation factors are there?

A

-12, no factor 6

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18
Q

What converts fibrin into cross-linked fibrin?

A

-XIIIa

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19
Q

What activates factor XIII?

A

-Thrombin

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20
Q

Describe the prothrombin time (PT) test:

A
  • Measures extrinsic pathway (injury pathway)
  • measures clotting time of plasma after addition of thromboplastin (Tissue factor & phospholipids) and calcium
  • end point is non-cross linked fibrin formation
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21
Q

Describe the activated partial thromboplastin time (PTT) test:

A
  • Measures intrinsic pathway
  • Measures clotting time of plasma after addition of facter XII activator, phospholipid, & Ca2+
  • end point is non-cross linked fibrin formation
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22
Q

Describe the fibrinogen assay test:

A
  • Measures fibrinogen activity

- Fibrinogen concentration is inversely proportional to thrombin time

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23
Q

What is a necessary cofactor for gamma-carboxylation of prothrombin precursor?

A

-Vitamin K

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24
Q

Which coagulation factors need vitamin k?

A
  • II
  • VII
  • IX
  • X
25
Q

What coagulation factor are deficient in hemophilia?

A

-8 and 9

26
Q

What are the three major steps of hemostasis?

A
  1. Vasoconstriction
  2. Temporary blockage of a break by a platelet plug
  3. Blood Coagulation/formation of a fibrin clot
27
Q

How does heparin work?

A
  • Anticoagulant
  • forms complex with antithrombin
  • inhibits thrombrin and Xa
28
Q

What is heparin monitored by?

A

-PTT

29
Q

How does warfarin/Coumadin work?

A

-Inhibits vitamin K synthesis

30
Q

What monitors warfarin?

A

-PT INR

31
Q

Is von willebrand factor involved in primary or secondary hemostasis?

A

Primary

32
Q

What is the end product of coagulation?

A

cross linked fibrin

33
Q

What are the three functions of von Willebrand factor?

A
  1. Acts as bridge between platelets and collagen
  2. Carrier protein for VIII
    3.
34
Q

List the natural coagulation inhibitors:

A
  • Protein C
  • Protein S
  • Antithrombin
35
Q

What activates Protein C?

A

-thrombin-thrombomodulin complex on endothelial cells

36
Q

What does protein C do?

A

-inactivates Va and VIIIa

37
Q

What is protein S?

A

-coenzyme for Protein C

38
Q

What does Antithrombin do?

A

-Inactivates Xa and Thrombin

39
Q

What accelerates the function of Antithrombin?

A

-Heparin

40
Q

Are platelets involved in primary or secondary hemostasis?

A

-Primary

41
Q

What are platelets derived from?

A

-cytoplasm of megakaryocytes

42
Q

What does thrombopoietin do? (TPO)

A

-Negative feedback regulation of platelet count

43
Q

Where is Thrombopoietin mainly produced?

A

-Liver

44
Q

What will decrease thrombopoietin?

A

-Increased platelet number

45
Q

What is thrombocytopenia?

A

-low platelet count

46
Q

What is thrombocytosis?

A

-high platelet count

47
Q

What are the 3 main causes of Thrombocytopenia?

A
  • low platelet synthesis
  • destruction of platelets
  • sequestration of platelets
48
Q

What are the 4 main causes of Thrombocytosis?

A

-Reactive thrombocytosis

49
Q

What releases PDGF?

A

-Platelets

50
Q

What does PDGF do?

A

-grows smooth muscle cells to heal wounds

51
Q

What are the steps in platelet activation?

A
  1. Adhesion
  2. Shape change
  3. Secretion
  4. Aggregation
52
Q

What are the endothelial cell functions for hemostasis?

A
  • Antithrombotic AND

- Prothrombotic

53
Q

What synthesizes von Willebrand factor?

A
  • megakaryocytes

- endothelial cells

54
Q

What protects factor VIII?

A

-Von Willebrand factor

55
Q

What is a Weibel Palade body?

A

-Stores Von Willebrand factor in endothelial cells

56
Q

What is the first step in platelet function after an injury?

A

adhesion to collagen

57
Q

Why do we not test for factor XII in a prolonged intrinsic pathway result when bleeding is occuring?

A
  • Factor XII deficiency will not cause bleeding

- deficiency is asymptomatic

58
Q

What is usual range for PT INR?

A

2.0-3.0

59
Q

What cofactor does protein C depend on?

A

Vitamnin K

Cardiovascular (6 decks)

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