Hemostasis and Related Disorders

Question 1

Release of urokinase activates plasmin

Answer 1

Radical prostectomy

Question 2

Reduced production of @2-antiplasmin

Answer 2

Cirrhosis of liver

Question 3

Disruption in blood flow, Endothelial cell damage, Hypercoagulable state

Answer 3

Virchow Triad

Question 4

Blocks exposure to subendothelial collagen and underlying tissue factor

Answer 4

Endothelial cells

Question 5

Produces PGI2 and NO

Answer 5

Endothelial cells

Question 6

Secretes heparin-like molecules

Answer 6

Endothelial cells

Question 7

Heparin-like molecules

Answer 7

augment ATIII, which inactivates thrombin and coagulation factors

Question 8

Secretes tPA

Answer 8

Endothelial cells

Question 9

tPA

Answer 9

converts plasminogen to plasmin

Question 10

Plasmin

Answer 10

cleaves fibrin and serum fibrinogen, destroys coagulation factors, blocks platelet aggregation

Question 11

Secretes thrombomodulin

Answer 11

Endothelial cells

Question 12

Thrombomodulin

Answer 12

REDIRECTS thrombin to activate protein C

Question 13

Protein C

Answer 13

inactivates FV and FVIII

Question 14

high homocysteine levels with homocystinuria, vessel thrombosis, mental retardation, lens dislocation, long slender fingers

Answer 14

Cystathionine Beta Synthase Deficiency. Converts homocysteine to cystathionine, without it you get homocysteine build-up.

Question 15

recurrent DVTs or DVTs at a young age

Answer 15

Hypercoagulable state

Question 16

mutated form of factor V that lacks the cleavage site for deactivation by protein C and S

Answer 16

Factor V leiden

Question 17

inherited point mutation in prothrombin that results in increased gene expression

Answer 17

Prothrombin 2010A; excess production of thrombin. Promotes thrombin formation

Question 18

PTT does NOT rise with standard heparin dosing

Answer 18

ATIII deficiency (need HIGH doses to activated limited ATIII; coumadin then given to maintain anticoag state).

Question 19

estrogen induces increased production of coagulation factors

Answer 19

Oral Contraceptives

Question 20

cholesterol clefts in embolus

Answer 20

Atherosclerotic plaque

Question 21

dyspnea with petechiae on skin overlying chest

Answer 21

Fat embolus

Question 22

multifocal ischemic necrosis of bone due to nitrogen gas

Answer 22

Caisson Disease (chronic form of decompression sickness: joint and muscle pain ‘bends’ and respiratory symptoms ‘chokes’ due to Nitrogen gas that precipitates out of blood due to rapid ascent by diver.)

Question 23

Labor or delivery, SOB, neurological sxs, DIC

Answer 23

Amniotic fluid embolus: characterized by squamous cells and keratin debris; tissue thromboplastin in amniotic fluid activates coagulation cascade in mother.

Question 24

PE in patient with preexsiting cardiopulmonary compromise

Answer 24

Pulmonary infarction (V/Q lung scan shows mismatch where perfusion is abnormal; elevated D-dimer). Hemorrhagic wedge-shaped infarct on gross examination.

Question 25

Electromechanical dissocation

Answer 25

Sudden death b/c heart pumps but blood supply is totally blocked (e.g. large saddle embolus)

Question 26

Thromboembolus that occludes most commonly lower extremeties and flow to organs

Answer 26

Systemic embolism (usually arise from left heart)

Question 27

activates FVII (extrinsic coagulation pathway)

Answer 27

tissue thromboplastin

Question 28

activates FXII (intrinsic coagulation pathway)

Answer 28

subendothelial collagen

Question 29

induces platelet agglutination by causing vWF to bind platelet GpIb

Answer 29

Ristocetin

Question 30

factor not made by the liver

Answer 30

FVIII

Question 31

activates vitamin K

Answer 31

epoxide reductase (liver)

Question 32

IgG autoantibody against Platelet Factor 4+Heparin

Answer 32

HIT (IgG autoantibody)

Question 33

increased fibrinogen split products without d-dimers

Answer 33

disorder of fibrinolysis; serum fibrinogen is lysed, however d-dimers are not formed because fibrin thrombi are absent

Question 34

blocks activation of plasminogen

Answer 34

aminocaproic acid

Question 35

high homocysteine levels with homocystinuria; vessel thrombosis, mental retardation, lens dislocation, long slender fingers

Answer 35

cystathionine beta synthase deficiency