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Pathophysiology 2 > Hemostasis > Flashcards

Hemostasis Flashcards

1
Q

Hemostasis

A

Stopping blood loss in response to vascular injury

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2
Q

Steps of hemostasis

A
  1. vascular constriction
  2. formation of platelet plug
  3. formation of the blood clot
  4. Fibrous organization
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3
Q

Vascular constriction

A

Reduces blood flow to site of injury

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4
Q

Formation of platelet plug

A

Adhesion and aggregation of platelets at the site of injury

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5
Q

What two factors aid in formation of platelet plug

A

vWF and fibrinogen

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6
Q

Formation of a blood clot

A

Fibrinogen is converted to fibrin which then adheres more firmly to the platelets (sticky). Blood is also transformed into a gel

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7
Q

Fibrous organization

A

Fibrin mesh is produced all around the platelet plug and holds this in place, eventually goes into fibrinolysis (which breaks down the clot and allows for normal blood flow to resume)

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8
Q

Petechiae

A

Small red or purple spot caused by bleeding into the skin

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9
Q

Purpura

A

A rash of purple spots on the skin caused by internal bleeding from small blood vessels

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10
Q

Vasculitis

A

Inflammation of blood vessels (thickening, wearing down, narrowing, scarring)

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11
Q

hematoma

A

Solid swelling or mass of clotted blood within the tissue

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12
Q

Ecchymosis

A

Discoloration of the skin due to bleeding underneath (usually internal structural bleeding)

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13
Q

Thrombosis

A

Local coagulation or clot in circulatory system

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14
Q

Embolism/thromboembolism

A

The obstruction of a blood vessel due to a blood clot or foreign substance that lodges itself in vessel. Migrates from some place else (PE)

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15
Q

Infarction

A

Tissue death (necrosis) due to lack of O2

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16
Q

What is the big cell that makes platelets

A

megakaryocytes

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17
Q

What is the life span of a platelet

A

7-10 days

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18
Q

What factor do platelets contain

A

vWF

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19
Q

What is the role of vWF

A

acts as the glue in platelet plug

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20
Q

What is the initial step of the platelet in clotting

A

Adherence to collagen on the surface of injured vessel

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21
Q

What does collagen do at site of injury

A

It triggers the activation of the platelets which causes them to adhere and aggregate to each other

22
Q

Which factor converts prothrombin to thrombin

A

Factor X(a)

23
Q

Where does conversion of prothrombin to thrombin occur during the pathways

A

It occurs where intrinsic and extrinsic join

24
Q

What catalyzes the conversion of fibrinogen to fibrin

A

Thrombin. It stabilizes and solidifies the aggregates

25
Q

Primary hemostasis

A

Platelet plug formation

26
Q

Secondary hemostasis

A

Coagulation of fibrin

27
Q

Fibrinolytic system

A

Breaks the fibrinogen clot in order for blood flow to be reestablished once vessel is healed

28
Q

What is vitamin K involved in forming

A
  1. Prothrombin
  2. Factors VII, IX, and X
  3. Protein C
29
Q

Where do you get vitamin K from

A
  1. Normal diet

2. Bacteria in the gut

30
Q

Which blood test measures intrinsic pathway factors

A

PTT

31
Q

Which blood test measures extrinsic pathway factors

A

PT

32
Q

What affect will a vitamin K deficiency have

A

Will cause an increase in PT and PTT because it changes the way the pathways function (basically an increase in bleeding, clotting cascade not working properly)

33
Q

Hemophilia

A

Severe bleeding disorders

34
Q

Hemophilia A

A

Factor VIII deficiency

35
Q

Hemophilia B

A

Factor IX deficiency

36
Q

vWF role in disorders

A

most common cause of bleeding disorders (when absent), aids w/platelet adhesion

37
Q

DVT

A

Thrombus occurs in lower extremity vein, can detach and travel to lungs (PE)

38
Q

Thrombocytopenia

A

Abnormally low platelet count in blood stream. Usually anything below 50,000. Pt will not clot properly. Very asymptomatic but may have frequent nosebleeds or petechia

39
Q

Pulmonary embolism

A

An embolus, meaning it is a clot that has migrated to the lungs from other parts of the body. Usually comes from the lower legs

40
Q

Disseminated intravascular coagulation (2 step process)

A
  1. Starts when there is over activation of clotting cascade, results in blood clots in small blood vessels (organ damage)
  2. As the coagulation cascade consumes these clotting factors, normal clotting is disrupted elsewhere and severe bleeding can occur
41
Q

Bleeding time

A

Measures platelet function. Make a small incision on pt forearm (2-9mins)

42
Q

Platelet count

A

Only test that determines platelet number and concentration (150,000-450,000)

43
Q

partial thromboplastin time (PTT)

A

Measurement of the intrinsic pathway. Assess the patients response to heparin.

44
Q

Prothrombin time (PT)

A

Measurement of the extrinsic pathway. Assess the patients response to coumadin/calcium

45
Q

D-dimer

A

Test for DVT/PE but better to rule out than rule in. Tests the fibrin degradation product in the blood (this occurs after the breakdown of clot)

46
Q

Platelet function test

A

Measures the ability of the platelets to aggregate. Helps identify bleeding disorders

47
Q

What mechanisms prevent excess thrombosis

A
  1. TFPI - inhibits extrinsic pathway
  2. Antithrombin 3 - inhibits VII, IX, XI and thrombin
  3. Activated protein C (w/protein S) - inhibits X and thrombin
  4. Plasmin - fibrinolysis
48
Q

Adhesion

A

1st step in blood clot formation, platelets stick to endothelium

49
Q

Aggregation

A

2nd step in blood clot formation. Platelets clump together due to fibrin

50
Q

Spreading

A

3rd step in blood clot formation, platelets change shape, becomes more gel like

51
Q

What factors contribute to developing pathologic thromboses

A
  1. Congenital
  2. Acquired -cancer, anemia, IBS
  3. Fibrinolytic abnormalities
  4. Situational - prolonged immobilization, pregnancy, surgery, birth control
52
Q

What are two compounds that are involved in fibrinolysis

A

urokinase, tPA

Pathophysiology 2 (8 decks)

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