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Hemostasis > Hemostasis Exam 2: Electric Boogaloo > Flashcards

Hemostasis Exam 2: Electric Boogaloo Flashcards

1
Q

Surface damage activates _____ of the _____ pathway.

This factor activates _____, then _____, then _____.

Trauma activates _____ of the _____ pathway. This factor activates _____.

A

Factor XII (converted to XIIa), Intrinsic

Factor XI, Factor IX, Factor X

Factor VII, Extrinsic, Factor X

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2
Q

Which pathway do Factors XII, XI, IX, X belong?

Which pathway do Factors VII and X belong

A 
Intrinsic pathway (contact activation)
Extrinsic pathway (trauma)
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3
Q

_____, _____, and _____ –> Active Protein C

Active Protein C halts the reaction _____.

A

Protein C
Thrombomodulin
Protein S

V –> Va

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4
Q

Upon activation of X to Xa, prothrombin can be converted to _____.

Another factor that can perform this reaction is Factor _____.

A

Thrombin

Va

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5
Q

Thrombin activates Factors _____, _____, and _____ and also activates _____.

A

V, VIII, XIII, platelets

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6
Q

Thrombin converts _____ to _____.

This forms a _____.

A

Fibrinogen to fibrin.

Cross-linked fibrin clot.

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7
Q

Antithrombin prevents two conversion reactions. What are these reactions

A

X –> Xa

I –> Ia

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8
Q

TFPI prevents _____ from becoming _____.

A

VII, VIIa

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9
Q

Serine proteases

A

All activated factors except factor XIIIa

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10
Q

Transaminases

A

only XIIIa

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11
Q

Fitzgerald factor

A

HMWK

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12
Q

Fletcher factor

A

Prekallikrein

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13
Q

Contact Proteins

Protein C and S are _____.

A

XII, XI, Prekallikrein, HMWK

Inhibitors

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14
Q

Vitamin K Dependent Factors

Which of these has the shortest 1/2-life

A

2, 7, 9, 10

7 has shortest 1/2-life

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15
Q

Coumarin, Coumadin, and Warfarin inhibit

A

Vitamin K-dependent factors

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16
Q

What test monitors Coumadin (oral coagulant) therapy?

A

PT

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17
Q

Fibrinogen or thrombin sensitive proteins

A

I, V, VIII:C, XIII

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18
Q

Which factors does PT measure?

A

I, II, V, VII, X

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19
Q

What factors are measured in the APTT test?

A

Intrinsic: VIII, IX, XI, XII
extrinsic: I, II, V, X

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20
Q

How is fibrinogen measured?

A

With thrombin agent

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21
Q

Intrinsic pathway factors

A

8, 9, 11, 12

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22
Q

Extrinsic pathway factors

A

7

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23
Q

Common pathway factors

A

1, 2, 5, 10 (and 13 too, aka, Fibrin stabilizing factor)

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24
Q

APTT is used to monitor

A

heparin therapy

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25
Q

Serum factors

A

7, 9, 10, 11, 12
Intrinsic + Extrinsic + Common (10)
Fibrinogen has been exhausted

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26
Q

Adsorbed serum

A

1, 5, 8, 11, 12

Missing 9

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27
Q

Which factor is missing from stored plasma?

A

Factor V
Labile Factor
Accelerin

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28
Q

What are the factors in stored plasma?

A

1, 2, 7, 9, 10, 11, 12

Includes all the “important” ones

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29
Q

Adsorbed serum contains

A

11, 12

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30
Q

Fibrinogen reference range

A

150-400 mg/dL

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31
Q

PT reference range

A

11.5-14.0 seconds

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32
Q

APTT reference range

A

20-45 seconds

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33
Q

Affected by tissue factor

A

Factor VII

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34
Q

Activation of Factor II creates positive feedback for which factor in which pathway?

A

Factor XI of the intrinsic pathway

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35
Q

Factor _____ is needed for for IX to activate X

A

Factor VIII

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36
Q

Extrinsic pathway activation involves what two factors?

A

III (TF) and VII (Stable factor)

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37
Q

What reagents are used to test the extrinsic pathway?

A

Ca++ and thromboplastin

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38
Q

How does TF begin the extrinsic pathway?

A

TF provides a phospholipid surface for activation

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39
Q

What is the key enzyme in fibrinolysis?

A

Plasmin – breaks polymer bonds & releases FDP’s

40
Q

How is plasmin activated?

A

Results from the cleavage of inactive form (zymogen) - plasminogen by either of two pathways: Extrinsic pathway activation: TF3 and fibrin as cofactor. Intrinsic pathway activation: involves Factors XIIa, kallikrein, or HMWK

41
Q

Are plasminogen activators exogenous or endogenous and where are they found?

A

Endogenous.

It’s present in the blood & other tissues. Primary source of activators are in the blood vessel endothelium.

42
Q

Primary activator of plasminogen in the genitourinary system?

A

Urokinase

43
Q

If a patient shows no increase in t-PA, what are they at an increased risk for?

A

DVT

44
Q

Where are the coagulation factors active/inactive and what is their overall purpose?

A

Blood – inactive state
Once activated – interact to form fibrin clot
Purpose – reinforces platelet plug

45
Q

Where are the coagulation factors produced?

A

Liver

46
Q

Factor I is also called

Factor II is also called

A

Fibrinogen

Prothrombin

47
Q

Factor III

A

Tissue factor or tissue thromboplastin

48
Q

What is the name for factor IV?

A

Ionized calcium

49
Q

Factor V

A

Labile factor or proaccelerin

50
Q

Factor VI

A

Clearly the most important factor.

51
Q

Factor VII

A

Stable factor (Serum prothrombin conversion accelerator SPCA). Proconvertin

52
Q

Factor VIII

A

Antihemophilic factor

53
Q

Factor IX

A

Christmas factor
Plasma thromboplastin component
Antihemophilia factor B

54
Q

Factor X

A

Stuart-Prower factor

55
Q

Factor XI

A

Plasma thromboplastin antecedent

56
Q

Factor XII

A

Hageman factor

Contact factor

57
Q

Factor XIII

A

Fibrin stabilizing factor

58
Q

Main substrate

A

Fibrinogen

59
Q

Which factors are cofactors?

A
  • Factor V (labile factor)

- VIII:C (antihemophilic factor (AHF))

60
Q

What measures prothrombin activity in serum following coagulation?

A

Prothrombin consumption

61
Q

A screen for all types of circulating anticoagulants based on the ability of normal plasma to correct an abnormal clotting time with a factor deficiency

A

Mixing studies

62
Q

commercially prepared concentrate to the vitamin K dependent factors in lyophilized form, used to treat some hemorrhagic disorders

A

Prothrombin complex

63
Q

Inherited deficiency of factor VIII:C

A

Hemophilia A

64
Q

VIII:C

A

procoagulant portion of factor VIII complex

65
Q

Stypven time

A

Test used to distinguish between factor VII and factor X deficiency

66
Q

Substance used to delay or prevent clotting

A

Anticoagulant

67
Q

system that contains factors XII, XI, IX, and VIII, leads to the common pathway and is surface (contact) activated

A

Intrinsic

68
Q

Factor IX deficiency

A

Hemophilia B

69
Q

Single donor therapeutic plasma product containing all clotting factors

A

Fresh frozen plasma

70
Q

Acquired inhibitors of normal coagulation, directed against a specific factor or a complex of factors

A

Circulating anticoagulant

71
Q

Factor VIII:C

A

Antihemophiliac factor

72
Q

Factor V deficiency

A

parahemophilia

73
Q

“Easy” bleeder, mostly men

A

Hemophiliac

74
Q

Process of stopping blood flow from a wound

A

Coagulation

75
Q

Trait with moderate bleeding diathesis in which PT is normal, APTT is slightly prolonged and is not corrected by incubation and levels of all known coagulation factors are normal

A

Passovoy

76
Q

Factor that stabilizes the soluble fibrin gel

A

FSF

77
Q

Deficiency of this, primarily found in Ashkenazi Jews and sonsanguineous relationships, causes hemophilia C

A

PTA

78
Q

Process by which body controls clotting and bleeding

A

Hemostasis

79
Q

Measures intrinsic system activity, examples are Lee-White and Hemochron

A

Whole blood clotting time

80
Q

Substance which, in the presence of ionized calcium, converts factor VII to VIIa

A

Tissue thromboplastin

81
Q

Disorder in which fibrinogen is qualitatively abnormal

A

Dysfibrinogenemia

82
Q

Factors II, VII, IX, and X are dependent on sufficient quantities of this for production in the liver

A

Vitamin K

83
Q

disorder manifesting decreased levels of fibrinogen

A

Hypofibrinogenemia

84
Q

presence of this may lead to thrombosis

A

Lupus anticoagulant

85
Q

Test monitoring the extrinsic system

A

PT

86
Q

substance extracted from the venom of a snake Bothrops atrox; used in coagulation procedure to resolve discrepant results when the thrombin time is prolonged due to heparin

A

Reptilase

87
Q

Thrombin time

A

Test that monitors the conversion of fibrinogen to fibrin

88
Q

Fletcher factor

A

Prekallikrein

89
Q

Substance used as a surface activator in APTT testing

A

Kaolin

90
Q

Substance that acts as a contact activator causing the release of PF3 and the activation of the intrinsic system

A

Celite

91
Q

What are the general characteristics of Plasminogen Activator Inhibitor – 1?

A
  • Synthesized by blood vessel endothelium & released in an inactive state
  • An acute phase reactant
  • Primary substrate is t-PA = thus regulation of fibrinolysis is dependent on the interaction of t-PA w/ PAI-1
  • Excess of this inhibitor associated with thrombotic disease
92
Q

How does plasmin limit the coagulation process?

A

Limits coag process by cleaving & rendering inactive FV & FVIII, XII & GPIb (vWF receptor)

93
Q

What is the primary plasmin inhibitor and what is its overall effect?

A
  • alpha 2-antiplasmin inhibitor

- Overall effect – plasmin activity is limited to area of fibrin deposition

94
Q

What are the indications for fresh frozen plasma use?

A
  • Significant coagulopathy
  • A significant coagulopathy results when the PT > 3 sec., INR >1.5 sec. And the patient has
  • An active bleed
  • Anticipated invasive procedure
95
Q

What is cryoprecipitate?

A

Cryoprecipitate:
Is prepared by taking FFP and thawing it slowly between 1-6oC. The white
precipitate that forms at the bottom of the bag is the cryoprecipitate… so it
is the cold, insoluble portion of plasma.

96
Q

What are the indication of use for cryoprecipitate?

A

Control bleeding associated with a deficiency of FI or FXIII
2nd choice therapy for management of Hemophilia A & vWD (when FVIII concentrates are not available)
Source of surgical fibrin sealant

97
Q

What are the adverse effects of cryoprecipitate?

A

Hemolytic or febrile transfusion reactions are possible because this is a human product
Allergic reactions
Septic reactions

Hemostasis (1 decks)

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