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Term 1 MD > Hemostasis and Coagulation > Flashcards

Hemostasis and Coagulation Flashcards

1
Q

Aspirin function

A

Inhibits platelet thromboxane (TXA2) formation
-Irreversible inhibitor of cyclooxygenase (COX)
-Decreases TXA2: PGI2 ratio

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2
Q

Heparin

A

Activates antithrombin III and inactivates thrombin

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3
Q

Warfarin (oral anticoagulant)

A

Blocks vitamin K epoxide reductase (VKOR) in liver and prevents regeneration of the active form of vitamin K
-Inhibits synthesis of mature vitamin K dependent clotting factors

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4
Q

Streptokinase/Urokinase

A

Thrombolytic agent; plasminogen activator
-Converts plasminogen to plasmin enabling dissolution of clots

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5
Q

Tissue Plasminogen activator

A

Used to dissolve a thrombus
-Converts plasminogen to plasmin enabling dissolution of clots.

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6
Q

Test to detect the von Willebrand disease

A

Ristocetin cofactor assay which determines reduced platelet aggregation in von Willebrand disease

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7
Q

Test to determine which type of platelet glycoprotein disease

A

Flow cytometry to distinguish Bernard-Soulier syndrome vs. Glanzmann thrombasthenia

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8
Q

Disorders of the clotting pathway (coagulation cascade) include:

A

1) Hemophilia A and B
2) Vitamin K deficiency

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9
Q

Disorders caused by defects in platelet plug formation:

A

1) Von Willebrand disease
2) Platelet defects: Thrombocytopenia, Bernard-Soulier syndrome, Glanzmann thrombasthenia

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10
Q

Tests for primary hemostasis/platelet plug formation:

A

Bleeding time
Platelet count
vWF levels
Platelet aggregation studies (ADP, thrombin, ristocetin)
Flow Cytometry

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11
Q

Tests for secondary hemostasis/clotting cascade:

A

Prothombin time (PT/INR)
APTT

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12
Q

Function of Endothelial PGI2 (prostacyclin) and nitric oxide:

A

Prevent platelet aggregation

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13
Q

Function of PGI2:

A

Increases platelet cAMP levels and inhibits activation (Thromboxane antagonist)

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14
Q

Function of Antithrombin III

A

-Inactivates thrombin and factor Xa and prevents clotting

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15
Q

Which molecule activates Antithrombin-III?

A

Heparin (glycosaminoglycan)

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16
Q

Which vitamin is Protein C and S dependent on?

A

Vitamin K

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17
Q

What activates protein C and protein S?

A

Binding of thrombomodulin to thrombin

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18
Q

Function of proteins C and S

A

Inactivation of Va and VIIIa of the coagulation cascade

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19
Q

Elevated levels of what indicates a high risk for pulmonary embolism?

A

Highly elevated D-dimer levels

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20
Q

Primary hemostasis

A

Platelet plug formation

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21
Q

Secondary hemostasis

A

Blood coagulation

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22
Q

Steps in Hemostasis

A
  1. Vascular spasm/vasoconstriction
  2. Platelet plug formation/primary hemostasis
  3. Blood coagulation/secondary hemostasis
  4. Clot stabilization and resorption
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23
Q

Defect is which protein causes Bernard-Soulier syndrome?

A

Platelet receptor Gp1b: this binds collagen which allows adhesion of von Willebrand factor biding to allow for adhesion to the subendothelial collagen layer

24
Q

Factor [ ] levels are low in hemophilia A

A

Factor VIII

25
Q

Factor [ ] levels are low in hemophilia B

A

Factor IX

26
Q

Disease characterized by: instability of Factor VIII
-Increased mucosal bleeding
-Easy bruising
-Epistaxis
-Increased post-operative bleeding
-Prolonged bleeding following tooth extraction

A

von Willebrand Disease

27
Q

Abnormal lab findings in von Willebrand Disease

A
  1. Primary hemostasis: prolonged bleeding time, abnormal Ristocetin assay
  2. Secondary hemostasis: prolonged APTT
28
Q

Features of Thrombocytopenia

A

Increased bleeding time and low platelet count

29
Q

Disease that is due to GpIIb/IIIa defect

A

Glanzmann Thrombasthenia

30
Q

EDTA (in-vitro)

A

Calcium chelator

31
Q

Warfarin (Coumadin)

A

Inhibits gamma-carboxylation of vitamin K dependent clotting factors; Inhibits regeneration of vitamin K; inhibits vitamin K epoxide reductase

32
Q

Erythropoietin (EPO)

A

Produced by the kidneys to increase erythrocyte precursors.

33
Q

Thrombopoietin (TPO)

A

Hormone from liver stimulates thrombocyte formation

34
Q

Cytokines

A

Local hormones of bone marrow

35
Q

Which factors stimulate leukocyte production?

A

Colony-stimulating factor (CSF) and interleukin

36
Q

Life span of Erythrocytes

A

120 days (removed by spleen macrophages)

37
Q

Individuals that express N-acetylgalactosamine transferase have which blood group?

A

A

38
Q

Individuals that express galactose transferase have which blood group?

A

B

39
Q

For individuals that express the necessary enzymes within the blood have which blood group?

A

O

40
Q

What is the main stimulus for erythropoiesis?

A

Hypoxia

41
Q

Poikilocytosis

A

The presence of poikilocytes in the blood: RBCs of distorted shape
-Various shapes can be due to membrane abnormalities or due to traumatic conditions

42
Q

Anisocytosis

A

Blood abnormality where the RBCs are of unequal sizes
-Can be detected in peripheral smears
-Can signify conditions such as anemia and thalassemia

43
Q

Hereditary spherocytosis

A

Caused by molecular defects in genes that code for spectrin, ankyrin, band 3 and band 4 proteins. This results in a spherical shape of RBC than the biconcave nature of it.

44
Q

The shape of RBCs in patients with beta-Thalassemia:

A

Target cells

45
Q

Beta-thalassemia

A

Indicates decreased or absent beta chains. Hereditary hypochromic anemia

46
Q

Sickle cell anemia

A

Genetic defect in hemoglobin molecule (Hb-S) where a single point mutation causes hydrophobic glutamic acid replaced by hydrophobic valine at point 6 in the beta chain

47
Q

T cells

A

Cell mediated immunity: differentiate in the thymus
-Long life span
-Attack viruses, fungi, transplanted organs, cancer cells and some bacteria

48
Q

B cells

A

First recognized in the bone marrow:
-Production of antibodies
-Destroy bacteria and their toxins
-Turn into plasma cells that produces antibodies
-Variable life span

49
Q

Natural killer cells (NK): programmed during development

A

-Attack many different microbes and some tumor cells
-Destroy foreign invaders by direct attack

50
Q

Redness following injury site such as wound or cut is due to:

A

Hyperemia: increased diameter of vessels at the site

51
Q

Pain following inflammation of injury site is due to:

A

The release of bradykinin and PGE2

52
Q

Which mediators of acute inflammation cause vasodilation?

A

Prostaglandins, nitric oxide, histamine

53
Q

Which mediators of acute inflammation cause increased vascular permeability?

A

Histamine, serotonin, bradykinin, leukotrienes

54
Q

Which mediators of acute inflammation cause fever?

A

Cytokines (IL-1, TNF), prostaglandins

55
Q

What increases the production of free radicals (Reactive oxygen species)?

A

Oxidant drugs (Sulfa drugs/Primaquine) or infection or fava beans
-Defect in the pentose phosphate pathway leads to the accumulation of hydrogen peroxide accumulation that damage RBC membrane that leads to hemolysis

56
Q

G6PD deficiency results in the formation of:

A

Heinz bodies (denatured insoluble proteins) due to the inappropriate disulfide bond formation

Term 1 MD (54 decks)

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