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Hematology > Hemostasis, Platelet, Coagulation, Anti-coagulant Drugs (Exam 3) > Flashcards

Hemostasis, Platelet, Coagulation, Anti-coagulant Drugs (Exam 3) Flashcards

1
Q

What is hemostasis?

A

arrest of bleeding by the vasoconstriction and coagulation

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2
Q

What are the 3 functions of platelets?

A

platelet adhesion | release reaction | platelet aggregation

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3
Q

Describe platelet adhesion function of the platelet?

A

after vessel injury = platelets adhere to sub-endothelial connective tissues

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4
Q

What is platelet adhesion dependent on?

A

the presence of factor 8 (VIII) = von-Willebrand factor

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5
Q

What are the 3 molecules found in the granules of platelets?

A

ADP, thromboxane A2, serotonin

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6
Q

Describe the release reaction function of platelets?

A

platelet exposed to collagen = release granule contents

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7
Q

Describe the platelet aggregation function of the platelet?

A

ADP and ThromboxaneA2 release = additional platelets aggregate to injury site = platelets swell = platelets adhere together = aggregation = factor 3 exposed for coagulation protein complex formation

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8
Q

What is the role of ADP?

A

attracts more platelets to the site

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9
Q

What is the role of serotonin?

A

promotes vasoconstriction

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10
Q

What is the role of Thromboxane A2?

A

promotes platelet aggregation, degranulation, and vasoconstriction

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11
Q

Why is vasoconstriction important in blood coagulation?

A

slow blood flow to injury site to plug the hole

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12
Q

What is the protein factor that initiates the coagulation process at the injury site?

A

factor III (factor 3) = platelet thromboplastic factor 3

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13
Q

What is the protein factor that acts as the connecting piece for all of the processes carried out in coagulation?

A

factor XIII (factor 13)

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14
Q

What is blood coagulation?

A

the process of forming a clot

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15
Q

What is the result of blood coagulation?

A

platelets aggregate at site of clot | fibrin ties up platelets to form clot

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16
Q

What are the 3 pathways involved in blood coagulation?

A

intrinsic activation, extrinsic activation, common pathway

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17
Q

What is the end product of the Intrinsic Activation Pathway?

A

Factor IXa (factor 9a)

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18
Q

What is the end product of the Extrinsic Activation Pathway?

A

Factor VIIa (factor 7a)

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19
Q

What are the protein factors and mineral needed to create protein factor Xa (factor 10a)?

A

7a + 9a + Ca2+ = 10a

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20
Q

What is the end product of the common pathway?

A

thrombin

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21
Q

What is the role of factor XIIIa (factor 13a)?

A

converts fibrin into stable form by making covalent bonds

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22
Q

How is fibrin made? What are the factors needed?

A

thrombin drives fibrinogen (with Ca2+) = fibrin

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23
Q

What will happen if one of the protein factors are missing from the blood coagulation process?

A

cause a disease (specific to which factor is missing)

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24
Q

What is the treatment for missing coagulation protein factors?

A

blood transfusions

25
Q

What are the 4 ways coagulation is controlled?

A

factor concentration-dependent | liver | anti-thrombin | plasmin

26
Q

What is significant about factor concentration dependence in order to control coagulation?

A

concentration of protein factors need to be high enough to initiate the hemostasis process

27
Q

How does the liver control coagulation?

A

destroy unused factors in parenchymal cells

28
Q

What is the role of anti-thrombin? What activates it?

A

inactivates thrombin | heparin activates anti-thrombin

29
Q

What does plasmin do?

A

digests fibrin, fibrinogen, factors V and VIII (factors 5 and 8)

30
Q

What is the number one observation on people who suffer from coagulation factor deficiency?

A

hematoma on thigh due to prolonged-sitting

31
Q

What are the 3 lab screening tests used in diagnosing coagulation disorders?

A

prothrombin time (PT) | activated partial thromboplastic time (APTT) | thrombin time (TT)

32
Q

What is the function of the prothrombin time (PT) screen test?

A

tests extrinsic and common pathways

33
Q

What is the function of the activated partial thromboplastic time (APTT) screen test?

A

tests intrinsic and common pathways

34
Q

What is the function of thrombin time (TT) screen test?

A

tests fibrinogen to fibrin conversion

35
Q

What is Hereditary Hemorrhagic Telangiectasis (HHT)?

A

vascular and platelet genetic autosomal dominant trait disorder

36
Q

What are the symptoms of Hereditary Hemorrhagic Telangiectasis (HHT)?

A

abnormal blood vessel formation | skin lesions | a lot of nose bleeds

37
Q

What reduces coagulation in Hereditary Hemorrhagic Telangiectasis (HHT)?

38
Q

What are the 3 causes of thrombocytopenia?

A

failure platelet production | increased destruction of platelets | abnormal distribution of platelets at unnecessary sites

39
Q

What is Hemophilia A?

A

most common coagulation disorder | genetic, found on X-chromosome (sex-linked)

40
Q

What is Hemophilia A due to?

A

absence or low level of factor VIII:C (factor 8) procoagulant activity clotting activity

41
Q

Who are most affected by Hemophilia A? Who are the carriers of Hemophilia A?

A

men | women = carriers

42
Q

What is the characteristic of Hemophilia A?

A

factor VIII:C (factor 8) procoagulant activity deficiency

43
Q

Where are the main sites of hemorrhage for Hemophilia A?

A

muscle, joints, post-trauma or surgery

44
Q

What is the most serious complication for Hemophilia A?

A

antibodies against factor VIII (factor 8)

45
Q

What is the treatment of Hemophilia A?

A

factor VIII (C-antigen) and desmopressin = increase plasma factor VIII (factor 8) production

46
Q

What is Hemophilia B?

A

Similar clinical features as Hemophilia A just with factor IX (factor 9)

47
Q

What is another name for Hemophilia B?

A

Christmas Disease

48
Q

What is the characteristic of Hemophilia B?

A

factor IX (factor 9) deficiency

49
Q

What is the treatment of Hemophilia B?

A

factor IX (factor 9) concentrates

50
Q

What is von-Willebrands disease?

A

SAME as Hemophilia A BUT different = deficient levels if factor VIIIR:AG (factor 8) related antigen

51
Q

What is disseminated intravascular coagulation (DIC)?

A

coagulation happens everywhere in body = exhaust all of available coagulation factors

52
Q

What are the 2 causes of disseminated intravascular coagulation (DIC)?

A

entry of pro-coagulant material from: transfusion, snakebites, premature separation of placenta | widespread endothelial damage and collagen exposure (septecemia, viral infection)

53
Q

What is the treatment for disseminated intravascular coagulation (DIC)?

A

fresh frozen plasma | supportive fibrinogen and platelet

54
Q

What are the 2 anti-coagulant drugs discussed? Which one is the most commonly used one?

A

heparin (most common) | coumarin (warfarin)

55
Q

How is heparin administered and what is its half-life?

A

intravenously | ~1 hour

56
Q

Where was coumarin first found?

57
Q

What is the function of coumarin?

A

(anti-vitamin K) decreases activity of anti-vitamin-K dependent factors 2, 7, 9, 10 (factors II, VII, IX, X)

58
Q

How is coumarin administered?

Hematology (20 decks)

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