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Hematology MLT Unit 5 > Hemostasis > Flashcards

Hemostasis Flashcards

Coagulation

1
Q

What is hemostasis?

A

The process by which the body control bleeding and maintains blood in a fluid form.

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2
Q

Hemostasis is composed of? (4)

A
  • Vascular system (blood vessels)
  • Platelets
  • Coagulation (factors)
  • Fibrinolysis
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3
Q

What activates the primary hemostasis system? What 2 functions are primarily involved?

A
  • Activated by small vessel damage.
    • Vasoconstriction
    • Platelet function
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4
Q

What activates the secondary hemostasis system? What 2 functions are mainly involved?

A
  • Activated by major trauma, surgery, or hemorrhage
    • Coagulation proteins
    • Enzymatic reactions
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5
Q

What is vasoconstriction?

A

ability of small vessels to contract which decreases the diameter of of blood vessels and decrease blood flow.

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6
Q

What do platelets do?

A

Form a platelet plug

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7
Q

Coagulation is is dependent on a series of _______ that take part in a series of ______ ______ resulting in the formation of ______.

A

Proteins enzymatic reactions Fibrin

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8
Q

The secondary system also includes _______ which is clot _____ once the blood loss has stopped and the vessel repaired.

A

Fibrinolysis dissolution

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9
Q

The vascular system prevents bleeding through? (3)

A
  • Vessel constriction
  • Activation of PLTs
  • Activation of coagulation system
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10
Q

The vessel wall contains Fibrous tissue consisting of? (3)

A
  • Collagen
  • elastic fibers
  • smooth muscle
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11
Q

An injured vessel exposes collagen which reacts with PLTs via what factor?

A

von Willebrand factor

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12
Q

What is the life span of a PLT?

A

7 - 10 days

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13
Q

What stimulates PLT production?

A

Thrombopoietin

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14
Q

PLT parent cell is the _______ that undergoes ________.

A

Megakaryocyte Endomitosis

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15
Q

There are no significant # of PLTs in bone marrow, _____ in circulation, and _____ in spleen.

A

67% Circulation 33% Spleen

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16
Q

What are the 3 phases of PLT function?

A

Adhesion Amplification Aggregation

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17
Q

What happens during PLT adhesion?

What factor and PLT receptor is required? (2)

What is secreted?

A
  • PLTs adhere to collagen and change shape (when they interact)
    • Required: von Willebrand factor (vWF) and Glycoprotein 1b (GpIb)
    • Secretion of PLT and clot activating substances.
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18
Q

What happens during Amplification?

What helps this?

A
  • Secreted substances recruit more PLTs to aggregate.
  • Thromboxane A2
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19
Q

What happens during Aggregation?

What receptors do PLTs use to adhere?

A

PLTs adhere to other PLTs

Uses GpIIb and GpIIIa to adhere with oth. PLTs via plasma proteins such as fibrinogen.

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20
Q

T/F: PLTs play and important roles in the formation of the primary PLT plug (primary hemostasis) as well and the coagulation cascade (secondary hemostasis)

A

True

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21
Q

PLTs serve as the site for?

A

Coagulation

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22
Q

What are coagulation factors?

A

Blood proteins that conclude with an insoluble fibrin clot

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23
Q

Where are all coagulation factors produced? Which one is not produced here?

A

Liver EXCEPT factor VIII

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24
Q

What are the two different pathways for clotting?

A
  • Extrinsic (Tissue factor pathway): Rapid response to tissue injury.
  • Intrinsic (Contact activation pathway): slower response, but quantitatively more significant.
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25
Q
  1. Factor I (Fibrinogen) is a substrate for?
  2. and a precursor for?
  3. Is the largest?
  4. What 2 forms is it converted to?
  5. Polymerized clot forms when exposed to _____.
A
  1. Thrombin
  2. Fibrin
  3. Largest molecular weight
  4. Insoluble (fibrin that forms clot) Soluble (soluble peptides cleaved from fibrinogen to make fibrin)
  5. Thrombin
26
Q

What is Factor II (prothrombin) converted to?

What does its converted form do?

A

Converted to Thrombin IIa (activated), which cleaves fibrinogen

27
Q

What does Factor II (prothrombin) activate? (3)

A
  • Cofactors,
  • protein C,
  • and Factor XIII
28
Q

Factor III (thromboplastin) activates this factor when blood is exposed to ____ ____.

A

Factor VII, tissue fluids

29
Q

What is Factor IV (ionized (active) calcium) needed for? (2)

A
  • Activation of thromboplastin (factor III)
  • Conversion of prothrobin to thrombin
30
Q

Factor V (proaccelerin or labile factor) speeds up which process?

A

prothrobrin to thrombin.

31
Q

What factor is consumed during clotting?

A

V

32
Q

20% of what factors are found on platelets?

A

V

33
Q

Which factor is nonexisitent?

A

VI

34
Q

What factor is activated by tissue thromboplastin (factor III) and activates Factor X?

A

Factor VII (proconvectin or stable factor)

35
Q

What factor is needed for the cleavage of Factor X to Xa by IX?

A

Factor VIII (antihemophilic factor)

36
Q

What factor is deficient in hemophilia A?

A

Factor VIII (antihemophilic factor)

37
Q

What factor is a plasma thromboplastin (factor III) component?

A

Factor IX

38
Q

What factor is deficient in hemophilia B

A

Factor IX

39
Q

What factor known as Stuart-Prower merges to form conversion of prothrombin to thrombin

A

Factor X

40
Q

What factor is independently activated by Russell’s Viper Venom.

A

Factor X

41
Q

What factor is essential to the intrinsic pathway, with a decreased frequency in the Jewish population, and bleeding tendencies vary?

A

Factor XI, a plasma thromboplastin antecedent

42
Q

Known as Hageman factor, it is an activated contact factor that is activated by collagen. A deficiency may cause a prolonged PTT but not a bleeding problem, with a tendency toward thrombosis.

A

Factor XII

43
Q

This is a firbrin stabilizing factor, stabilizes polymerized fibrin monomers in the initial clot when exposed to calcium.

A

Factor XIII

44
Q

What are the 3 receptors on PLTs?

A

GpIb, GpIIb, and GpIIIa

45
Q

This the surface contact factor activated by kallikrein.

A

High-molecular weight kininogen (HMWK) *Homework

46
Q

Known as Fletcher factor, this is a surface contact activator.

A

Pre-kallikrein

47
Q

Identify the process involved in the coagulation cascade from activation to stable clot formation? (4)

A
  1. Vessel injury activates common pathway
  2. results/leads to formation of fibrin clot
  3. factor XIII stabilizes fibrin clot
  4. Thrombin feedback activation of V, VIII, and XI amplify process.
48
Q

What are Regulatory Inhibitors?

A

Soluble proteins that are natural anticoagulants

49
Q

Protease inhibitors (3)

A
  • Antithrombin
  • Protein C / Protein S
  • Tissue Factor Pathway Inhibitor (TFPI)
50
Q

What is the Fibrinolytic System?

A

System that dissolves blood clots

51
Q

Plasminogen is converted to plasmin which does what in the fibrinolytic process?

A

breaks down fibrin clot into fibrin products

52
Q

What are the characteristics of inhibitors (3)

A
  • Block activated coagulation factors, so widespread coag not occur.
  • Limit fibrinolysis and neutralize activated factors in circulation.
  • Each has a specific role.
53
Q

PT measures which pathway?

A
  • Extrinsic pathway
54
Q

aPTT (activated Partial Thromboplastin Time) measures which pathway?

A

Intrinsic Pathway

55
Q

Abnormal PT/Normal PTT

A

Factor VII defieciency (Extrinsic)

56
Q

Abnormal PTT/ Normal PT

A

Defieciency of Factors:

  • XII
  • XI
  • IX
  • VIII
57
Q

Abnormal PTT and PT

A

Deficiency of Factors:

  • X
  • V
  • II
  • I
58
Q

What is in the Contact group?

A
  • PreKal
  • HMWK
  • XI
  • XII
59
Q

These factors are in the Prothrobin Group, and are Vitamin K dependent?

A
  • 1972
    • X
    • IX
    • VII
    • II
60
Q

What factor is common to all 3 pathways?

A

X

61
Q

What medications are used w/ abnormal PT?

What medications are used w/ abnormal aPTT?

A
  • Warfarin
  • Coumadin
  • Heparin

Hematology MLT Unit 5 (5 decks)

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