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HEMA2 > Hemostasis > Flashcards

Hemostasis Flashcards

1
Q

MODERN CONCEPT OF BLOOD COAGULATION

A

Cascade or “Waterfall” Hypothesis

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2
Q

MODERN CONCEPT OF BLOOD COAGULATION STAGES

A

STAGE 1 : Generation of thromboplastin activity (“intrinsic” and “extrinsic”)
STAGE 2 : Conversion of prothrombin to thrombin by “thromboplastin” in the presence of calcium

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3
Q

CONTACT GROUP

Includes:

A

Prekallikrein
Kallikrein
Factor XII
Factor XI

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4
Q

PROTHROMBIN (VITAMIN K DEPENDENT) GROUP

Includes:

A

Factor II, VII, IX, and X

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5
Q

Synthesized in the liver with Vitamin K as Co-Factor

A

PROTHROMBIN

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6
Q

is needed to carboxylate glutamate of the vitamin K dependent factors

A

Vitamin K

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7
Q

FIBRINOGEN GROUP

Includes :

A

Factor I, V, VIII, and XIII

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8
Q

Highest molecular weights of all factors
Most labile
Consumed in coagulation

A

FIBRINOGEN GROUP

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9
Q

Act as substrates for plasmin

A

FIBRINOGEN GROUP

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10
Q

FIBRINOGEN GROUP

All are found in the alpha granules of platelets EXCEPT __ and ___

A 
Factor XIII (platelet cytoplasm)
Factor VIII:C
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11
Q

A globulin (MW 341,000)

A

FACTOR I - Fibrinogen

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12
Q

FACTOR I - Fibrinogen NV

A

NV: 200-500mg/dL

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13
Q

FACTOR I - Fibrinogen Strengthened by Factor

A

Strengthened by Factor XIII

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14
Q

Stable protein of alpha globulin type (MW 63,000)

A

FACTOR II - Prothrombin

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15
Q

Related to Factor VII

A

FACTOR II - Prothrombin

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16
Q

A powerful proteolytic enzyme
Potent platelet aggregating substance
MW = 40,000

A

THROMBIN

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17
Q

The _ is the amount that will coagulate 1mL of standard fibrinogen solution in 15 seconds at 28C

A

THROMBIN UNIT

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18
Q

Protein intermediate between beta and gamma globulin

A

FACTOR V - Proaccelerin

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19
Q

Labile, deteriorating rapidly in oxalated plasma and even in frozen (-20C) specimens

A

FACTOR V - Proaccelerin

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20
Q

Not destroyed or consumed in the clotting process

Appears to be a beta globulin

A

FACTOR VII - Proconvertin

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21
Q

In-vivo survival after transfusion = 50% is lost within 8-12H More stable in FFP stored in -30 to -70C

A

FACTOR VIII – Antihemophilic Factor

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22
Q

The entire molecule as it circulates in the plasma

Composed of VIII:C and VIII:vWF portions which is not covalently bound

A

VIII/vWF

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23
Q

Portion capable of binding to endothelium and supporting normal platelet adhesion and function. Tested by the bleeding time

A

VIII:vWF

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24
Q

Portion acting in intrinsic system as cofactor to factor Ixa.
Tested by PTT

A

VIII:C

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25
Q

Antigenic property of procoagulant portion as measured by monoclonal immunologiocal techniques

A

VIIIC:Ag

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26
Q

Factor VIII related antigen
Large vWF portion and measured by immunologic techniques of Laurell rocket or immunoradiometric assay using heterologous antibodies

A

VIIIR:Ag

27
Q

Ristocetin (antibiotic) cofactor activity

Required for platelet aggregation studies

A

VIIIR:RCo

28
Q

Stable protein factor
Not consumed during clotting
Not destroyed by ageing
No significant loss in blood and plasma stored at 4C X 2W
Adsorbed by aluminum hydroxide and barium sulfate

A

FACTOR IX – Plasma Thromboplastin Component

29
Q

Stable a-globulin protein factor

Activity related to Factor VII

A

FACTOR X – Stuart-Prower Factor

30
Q

B-globulin protein factor

Activity related to Factor VII

A

FACTOR XI – Plasma Thromboplastin Antecedent

31
Q

Stable globulin
Adsorbed into powdered glass, Celite, or bentonite (negatively charged)
Activity is accelerated by Fletcher (Prekallikrein) and Fitzgerald factor (HMWK)

A

FACTOR XII – Hageman Factor

32
Q

Thrombin splits 4 arginyl-glycine bonds of fibrinogen to produce two peptides A, two peptides B and a fibrin monomer

A

FACTOR XIII – Fibrinase

33
Q

Fine clot is produced from further polymerization

Fine clot is soluble in 5M urea and 1% monochloroacetic acid

A

FACTOR XIII – Fibrinase

34
Q

FACTOR XIIa
Initiates the
Initiates
Initiates

A

intrinsic coagulation system
fibrinolysis
kinin and complement systems

35
Q 
KALLIKREIN
Perpetuates _ activation and its own production
Initiates the _
Initiates _&_
Directly activates \_\_
A

Factor XII
kinin system
fibrinolytic and complement systems
Factor IX

36
Q

Most important
Found in plasma and serum
Acts on thrombin to form metathrombin

A

ANTITHROMBIN III

37
Q

ANTITHROMBIN III Made up of:

A

Alpha 2 globulin
Alpha 2 macroglobulin (Heparin cofactor)
Alpha 2 antitrypsin

38
Q

ATIII-deficiency

A

Thromboembolism and liver disease

39
Q 
ALPHA2 MACROGLOBULIN
Inhibits _ but not completely
Protect its bound enzymes against other circulating antithrombins
Inhibits _ by inhibiting plasmin
Inhibits _
A

thrombin

fibrinolysis
kallikrein

40
Q

ALPHA1 ANTITRYPSIN
Potent inhibitor of _
Inactivates_ and _

A

Factor Xia

plasmin and thrombin

41
Q

C’1 ESTERASE INHIBITOR
Inhibitor of _ and _
Inhibits _ _ and _

A

fibrinolysis and coagulation

Factor XIIa, XIIf and XIa

42
Q

Vitamin K dependent
Potent inhibitors of coagulation
Destroys Factors Va and VIIIa

A

PROTEIN C and S

43
Q

_ is the cofactor of Protein C

A

Protein S

44
Q

C:S complex enhances fibrinolysis by activating __ __

A

plasminogen activators

45
Q

an enzyme that cleaves fibrinogen, fibrin, and other coagulation factors (ie. _ and _ )

A

PLASMIN

VIII and V

46
Q

Present in the blood are large amounts of alpha globulins with antiplasmin activity

A

INHIBITORS OF PLASMINOLYSIS

47
Q

INHIBITORS OF PLASMINOLYSIS

Two types:

A

Immediate acting

Slow acting

48
Q

Inhibitors of Plaminogen activators : _ and _

A

EACA and Tranexamic acid

49
Q

Fine chromatin

Abundant cytoplasm

A

MEGAKARYOBLAST

50
Q

(+) globules
Many polyribosomes
DMS first appears

A

PROMEGAKARYOCYTE

51
Q

Marginated chromatin

Multinucleation

A

MEGAKARYOCYTE

52
Q

Coagulation factors, permeability factors, PDGF (smooth muscle cell proliferation), fibrinogen, B-thromboglobulin and PF4 (heparin inhibition), and Factor Va

A

ALPHA GRANULES

53
Q

Adenosine and guanosine di- and triphosphates, calcium, magnesium, serotonin

A

DENSE BODIES

54
Q 
Platelet Factors:
PF-1 : Absorbed to \_\_
PF-2 : A _ _
PF-3 : Involved in intrinsic cascade acting as prothrombin activator by catalyzing the reactions between Factors _ _ and _
PF-4: Inhibitor of _ and _ like activity
A 
factor 5
-
thrombin accelerator
-
Xa, V, and calcium
-
 heparin and Factor XIII
55
Q

PLATELET SYSTEM

Subdivided into 4 major zones under the electron microscope:

A

PERIPHERAL ZONE
SUBMEMBRANE AREA
SOL-GEL ZONE
ORGANELLE ZONE

56
Q

PERIPHERAL ZONE

A

– Glycocalyx and Plasma Membrane

57
Q

SUBMEMBRANE AREA

A

– Filaments

58
Q

SOL-GEL ZONE

A

– Microtubular

59
Q

Blood vessels and tissues injured; bleeding begins through _ and _

__ of the injured vessels

The torn endothelium__ and curls up

_ _ are released from damaged tissues

A

transected and injured vessels

Nervous vasoconstriction

retracts

Thromboplastic substances

60
Q

Plasma flows over the damaged tissues – __is activated and triggers the activation of the intrinsic system; __ activates tissue thromboplastic substances and activates the extrinsic system

A

Factor XII

Factor VII

61
Q

The activated _ thromboplastin(s) in the presence of calcium then interacts with _ and _ , forming definitive thromboplastin which converts prothrombin to thrombin

A

extrinsic

Factor V and X

62
Q

In the meantime, _ adhere to damaged endothelium; _ from extrinsic pathway and _ adhere with the platelets adhering to __, causing aggregation to a plug

A

platelets

thrombin

ADP

subendothelial collagen

63
Q

In the meantime, the intrinsic mechanism is activated  _ _

Fibrinogen  Fibrin

Fibrin absorbs excess thrombin and the remainder is neutralized by _

The _ so produced between and on the framework of the platelet plug polymerizes and contracts, thus effectively anchoring the platelet plug and sealing the defect of the vessel

_ grows over the plug and clot within the lumen is dissolved for _

A

increased thrombin

antithrombins

fibrin latticework

Endothelium

recanalization

HEMA2 (17 decks)

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