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Lab Med > Hemostasis & Thrombosis > Flashcards

Hemostasis & Thrombosis Flashcards

1
Q

cessation of blood flow from an injured blood vessel; maintaining blood in a fluid state

A

hemostasis

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2
Q

what are the 2 parts of primary hemostasis?

A

vasoconstriction
platelet activation

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3
Q

what are the 2 parts of secondary hemostasis?

A

coagulation cascade
antithrombotic control mechanisms

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4
Q

what occurs in primary hemostasis?

A

platelet plug formation

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5
Q

what occurs in secondary hemostasis?

A

formation of fibrin clot (thrombus)

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6
Q

what occurs during fibrinolysis of the hemostasis process?

A

plasmin breaks down fibrin clot, limits the size of the clot so it becomes normal tissue

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7
Q

what process is caused by proteins from activated PLTs and injured endothelial cells?

A

vasoconstriction

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8
Q

during primary hemostasis, damaged endothelial cells produce vWF, tissue factor, expose collagen, secrete plt-activating factor, and release plasminogen activator inhibitor to inhibit fibrinolysis. what is this process called?

A

thrombogenesis

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9
Q

what produces platelets?

A

megakaryocytes in bone marrow

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10
Q

what is the lifespan of platelets?

A

7-10 days

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11
Q

what are the 3 roles of platelets in primary hemostasis? (AAA)

A

adhesion
activation
aggregation

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12
Q

what acts as the glue for optimal platelet-collagen binding?

A

von Willebrand factor

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13
Q

how long does aspirin inhibit platelet function?

A

life of platelet

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14
Q

platelet recruiting and attachment to adjacent platelets to form a mesh network

A

aggregation

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15
Q

the PLT-PLT cross linkage is stabilized by what?

A

thrombospondin

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16
Q

in the coagulation cascade, which pathway overrides?

A

intrinsic pathway

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17
Q

anticoagulant protein that inhibits early phases of extrinsic response to neutralize factor VIIa

A

tissue factor pathway inhibitor (TFPI)

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18
Q

serine protease inhibitor made by the liver that binds thrombin and factor Xa, neutralizing their activity

A

anti-thrombin

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19
Q

what enhances anti-thrombin activity?

A

heparin released by endothelial cells

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20
Q

serine protease produced by the liver that degrades factors Va and VIIa

A

protein C

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21
Q

what does protein C depend on?

A

vitamin K

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22
Q

protein made by the liver, endothelial cells, and PLTs that serves as a cofactor to protein C activity to neutralize factors Va and VIIa

A

protein S

23
Q

what does d-dimer find?

A

fibrin degradation products (FDP) that are still attached to factor XIII

24
Q

what do defects in hemostasis result in?

A

abnormal bleeding or clotting

25
Q

what are some examples of conditions that present with thrombocytosis? (5) HIMMS

A

Hemorrhage
Infection
Myeloproliferative disorder (MPD)
Malignancy
Splenectomy

26
Q

what are some conditions that present with thrombocytopenia? (3) BAL

A

Bone marrow disorders
Autoimmune disease
Liver disease

27
Q

pinpoint, flat and small, purplish spots

A

petechiae

28
Q

red, dark blue localized to one area; do not blanch with pressure

A

purpura

29
Q

what does generalized purpura indicate?

A

systemic problem (meningitis, lupus)

30
Q

deep collections of blood under the skin that changes color

A

ecchymosis

31
Q

what is the most common reason platelet function changes?

A

medications (aspirin or clopidogrel)

32
Q

time required to build a stable platelet plug and obtain full occlusion, reported in seconds

A

closure time

33
Q

when could closure time be abnormal?

A

if PLT count or HCT is low

34
Q

measurement of PLT aggregation to various activators in vitro; recorded by a light transmission aggregometer

A

PLT aggregation studies

35
Q

what is the gold standard in PLT function testing?

A

platelet aggregation studies

36
Q

two incisions made and the time for clotting to occur is recorded

A

bleeding time

37
Q

measures extrinsic and common pathways to evaluate liver function

A

prothrombin time (PT)

38
Q

what is the method of choice to monitor coumadin (warfarin) therapy?

A

INR

39
Q

what does an increase in INR indicate?

A

increased anticoagulation

40
Q

measures intrinsic and common pathways to monitor heparin therapy and evaluate liver function

A

activated partial thromboplastin time (APTT)

41
Q

measures conversion of fibrinogen to fibrin in common pathway and is sensitive to circulating anticoagulants like heparin

A

thrombin time (TT)

42
Q

measures protein concentration, and is used in the diagnosis of hypo or dysfibrinogenemia, disseminated intravascular coagulation (DIC), and primary fibrinolysis

A

fibrinogen

43
Q

what assay is most commonly performed for fibrinogen?

A

clauss assay

44
Q

what do FDP cause in thrombin time test?

A

visible agglutination

45
Q

what does a positive D-dimer indicate?

A

clot has formed and is breaking down

46
Q

what are 4 conditions that cause high D-dimer levels? PMSH

A

pregnancy
surgery
malignancy
heart disease

47
Q

inhibits carboxylation of vitamin K dependent coagulation factors (II, VII, IX, X)

A

MOA for warfarin

48
Q

how long does warfarin take to reach therapeutic levels?

A

4-5 days

49
Q

what do we use to monitor warfarin?

A

PT/INR

50
Q

inhibits thrombin activation of platelets (thrombin, V, VIII, IXa, and Xa)

A

MOA of heparin

51
Q

what do we use to monitor heparin?

A

APTT

52
Q

what is a complication of heparin?

A

heparin-induced thrombocytopenia (HIT)

53
Q

inactivates Xa but less effective in inactivating thrombin

A

LMW Heparin

54
Q

what do we use to monitor LMWH?

A

factor Xa inhibition assay

Lab Med (19 decks)

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