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Lab Diagnosis 1 > Hemostasis, Thrombosis, and Fibrinolysis (final) > Flashcards

Hemostasis, Thrombosis, and Fibrinolysis (final) Flashcards

1
Q

-the process that stops bleeding at the site of an injury
-maintains blood in a fluid, clot free state in normal vessels while inducing rapid formation of a localized platelet plug at the site of vascular injury

A

hemostasis

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2
Q

What are the 3 primary steps of hemostasis?

A

1) vascular spasm/ vasoconstriction
2) platelet plug formation/ primary hemostasis
3) coagulation/ blood clotting

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3
Q

When a blood vessel is injured, the vessel constricts to reduce blood flow to the area and limit blood loss. ____________ and the subendothelium are exposed at the site of injury and promotes platelet adhesion. ____________ tissue factor is released and activates the extrinsic pathway of coagulation

A

Collagen, Factor 3

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4
Q

Platelet plug formation, also known as ____________________ is a part of the body’s response to blood vessel injury. It involves the accumulation and aggregation of platelets at the site of a damaged blood vessel to form a temporary plug that helps stop bleeding.

A

primary hemostasis

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5
Q

What is this process called?
-exposure of collagen in vessel wall
-platelet adhesion/binding (exposed collagen and vWF promotes adherence of platelets to subendothelium through receptors on their surface

A

platelet adhesion

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6
Q

What promotes adherence of platelets to subendothelium through receptors on their surface?

A

exposed collagen and vWF

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7
Q

What is this process called?
-once bound, platelets undergo a shape change increasing their surface area
-activated platelets release the contents of their granules, including ADP, thromboxane A2, actin, myosin, and serotonin
-these substances promote further platelet activation and vasoconstriction

A

platelet activation

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8
Q

What substances are inside platelet granules?

A

-ADP
-thromboxane A2
-actin
-myosin
-serotonin

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9
Q

What is this process called?
-ADP and thromboxane A2 stimulates other platelets to aggregate at the site of binding to fibrinogen and von Willebrand factor (vWF) which acts as a bridge between platelets
-the accumulating platelet forms a temporary platelet plug that seals the wound and prevents further blood loss

A

platelet aggregation and fibrinogen bridging

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10
Q

How long do platelets normally live for?

A

9 days

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11
Q

What meds inhibit TXA2 synthesis and prevent aggregation of platelets?

A

aspirin and NSAIDs

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12
Q

What medication irreversibly binds to receptor on platelets preventing ADP from activating platelets?

A

plavix

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13
Q

What is this process called?
-process of converting fibrinogen into fibrin and that forms a meshwork around the platelet plug
-the fibrin mesh stabilizes the platelet plug, creating a solid blood clot that seals the wound
-cascade of enzymatic reactions involving clotting factors (proteins in the blood) culminating in the activation of thrombin, which converts fibrinogen to fibrin

A

coagulation (blood clotting)

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14
Q

What converts fibrinogen to fibrin?

A

thrombin

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15
Q

What is the required electrolyte for coagulation?

A

calcium

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16
Q

What is another name for factor 1?

A

fibrinogen

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17
Q

What is another name for factor 3?

A

tissue thromboplastin/ tissue factor

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18
Q

What factor activates extrinsic pathway?

A

factor 3/tissue thromboplastin/tissue factor

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19
Q

What is another name for factor 8?

A

anti hemophiliac factor

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20
Q

_______ is a carrier for factor 8

A

vWF

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21
Q

What is another name for factor 9?

A

Christmas factor

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22
Q

What is another name for factor 12

A

contact factor/hageman factor

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23
Q

What factor activates intrinsic pathway?

A

contact factor/hageman factor

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24
Q

Some coagulation factors are dependent on what vitamin?

A

vit K

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25
All factors are made in liver except
factor 3/tissue factor/tissue thromboplastin
26
What is another name for the extrinsic pathway?
tissue factor pathway
27
Which pathway is this? -tissue factor/factor 3 exposed at the injury site binds with factor 7, activating factor 7 -the tissue factor-factor 7 complex activates factor 10 in the common pathway
extrinsic pathway
28
What is another name for intrinsic pathway?
contact activation pathway
29
What pathway is this? -factor 12 is activated by contact with the exposed sub-endothelial collagen, which then activates factor 11 -factor 11 activates factor 9, which with the help of factor 8 activates factor 10
intrinsic pathway /contact activation pathway
30
What factor is activated by contact with exposed sub-endothelial collagen in the intrinsic pathway?
factor 12
31
What pathway is this? -activated factor 10, along with factor 5, forms a complex, which converts prothrombin to thrombin -thrombin converts fibrinogen to fibrin and activates factor 13, which cross links fibrin strands, stabilizing the clot
common pathway
32
Activated factor _____, along with factor ______, forms a complex, which converts prothrombin to thrombin
10, 5
33
Thrombin converts fibrinogen to fibrin and activates factor ______, which cross links fibrin strands, stabilizing the clot
13
34
Which lab test is looking at the intrinsic pathway?
APTT (activated partial thromboplastin time)
35
What lab test is looking at the extrinsic pathway?
Pt/INR (prothrombin time and international normalized ratio)
36
Heparin blocks which coagulation pathway?
intrinsic
37
What 2 things promote formation of platelet plug during aggregation?
vWF and fibrinogen
38
Secondary hemostasis consists of what pathways?
intrinsic and extrinsic and then common pathway
39
What 2 pathways promote cascade reactions and activate factor 10 and common pathway?
intrinsic and extrinsic pathway
40
What activates prothrombin activator?
-factor 10 -calcium -factor 5 -platelet factor 3
41
thrombin cleaves fibrinogen to
fibrin
42
-a process that occurs 30-60 min after the initial formation of a blood clot -it involves the shrinking or consolidation of the clot, which helps stabilize the clot and reduce bleeding by closing the wound more effectively -this process is driven by platelets, which contract via actin and myosin filaments, similar to muscle cells -the platelets interact with the fibrin mesh within the clost, pulling the edges of the wound toegther
clot retraction
43
-formation of a blood clot inside a blood vessel which can obstruct blood flow -can occur in veins or arteries
thrombosis
44
What are the 2 types of thrombosis?
arterial and venous
45
MI is what type of thrombosis?
arterial
46
A stroke is what type of thrombosis?
arterial
47
-the process by which the body breaks down clots after they have fulfilled their purpose of stopping bleeding -it ensures that blood vessels remain open, and blood flow is restored after healing
fibrinolytic system
48
What are the 3 main components of the fibrinolytic system?
1) activation of plasminogen 2) protein c and s 3) antithrombin
49
Plasminogen is an inactive protein incorporated into the clot as it forms. Plasminogen is activated to form __________, an enzyme that can digest __________
plasmin, fibrin
50
What are the key regulators of the coagulation cascade and help prevent excessive clotting?
protein C and S
51
____________ def can lead to an increased risk of venous thromboembolism, including deep vein thrombosis and pulmonary embolism
Protein C
52
_____________ def increases the risk of developing abnormal blood clots and it can be genetic or acquired
Protein S
53
Small proteins that inactivate several enzymes in the coagulation system and inhibits thrombin formation
antithrombin
54
__________ degrades fibrin into soluble fragments, effectively dissolving the clot
Plasmin
55
What are the breakdown products of fibrin?
D dimers and fibrin split/degradation products
56
What can be measured in the blood as fibrinolytic activity?
D dimers and fibrin split/degradation products
57
prevents bleeding and is activated quickly after injury
hemostasis
58
What lab test is this? -part of cbc -gives us the number of platelets in a volume of blood
platelet count
59
What lab test is this? -group of assays that measure the ability of platelets to aggregate in a sample of blood -variety of tests available, but no one test that identifies all problems with platelet function
platelet function testing
60
Which lab test is this? -measures extrinsic factor pathway and common pathway -can be used to regulate Coumadin and warfarin anticoagulants
PT and INR
61
Which lab test is this? -measures intrinsic pathway and common pathway -can be used to regulate heparin anticoagulant
APTT
62
Which lab test is this? -used to determine the likelihood of a clot present -helps to rule out DVT, pulmonary embolism, or stroke
D dimer
63
Which lab test is this? -indicates the level of activity of the fibrinolytic system
fibrin split products/degradation products
64
high levels of fibrin split products indicates
fibrinolysis
65
increased fibrin split products indicates
DIC
66
-decreased platelet count -inherited or acquired
thrombocytopenia
67
Thrombocytopenia causes __________ destruction, __________ production, and ____________ sequestration (ex: spleen)
increased, decreased, increased
68
What pathology is this? -autoimmune mechanism: the body produces autoantibodies against platelets -these abs mark the platelets for destruction, primarily in the spleen -immune mediated disorder -acute (most common) or chronic (6+ months)
immune thrombocytopenia (ITP)
69
What are the signs and symptoms of ITP?
-ecchymoses, petechiae, nosebleeds -easy bruising -melena -hematuria -menorrhagia
70
What pathology would have these lab findings? -decreased platelet count -anti platelet ab test
immune thrombocytopenia (ITP)
71
What pathology is this? -microangiopathic hemolytic anemia and consumptive thrombocytopenia with deposition of hyaline thrombi in terminal arterioles and capillaries leading to multiorgan damage
thrombotic thrombocytopenic purpura (TTP)
72
This is the hallmark of what? -hyaline microthrombi of platelets and fibrin occluding arterioles and capillaries in many organs and localized fibrinolysis is absent
thrombotic thrombocytopenic purpura (TTP)
73
What are the signs and symptoms of thrombotic thrombocytopenic purpura (TTP)?
-ecchymoses, petechiae, nosebleeds -easy bruising -melena -hematuria -jaundice due to hemolysis
74
What pathology has this presentation? -fever -hemolytic anemia -thrombocytopenia -renal and neurological dysfunction
thrombotic thrombocytopenic purpura (TTP)
75
What pathology has these lab findings? -decreased hemoglobin -decreased platelets -schistocytes on peripheral smear -increased bilirubin
thrombotic thrombocytopenic purpura (TTP)
76
What is this pathology? -characterized by widespread activation of the coagulation cascade, leading to the formation of blood clots throughout the body -can cause severe bleeding due to the consumption of clotting factors and platelets -secondary condition -involves both excessive clotting (thrombosis) and bleeding (hemorrhage) due to the over-activation of the body's clotting mechanisms and subsequent depletion of clotting factors and platelets -a thrombo-hemorrhagic disorder
disseminated intravascular coagulation (DIC)
77
What are the common triggers for disseminated intravascular coagulation (DIC)?
-sepsis -trauma -ob complications -malignancies -liver disease
78
What pathology has these lab findings? -decreased platelet count -increased PT/INR -increased APTT -increased FDP/FSP -increased D dimer
disseminated intravascular coagulation (DIC)
79
too many platelets=
thrombocytosis
80
vWF is what type of protein?
glycoprotein
81
What protein is in charge of platelet adhesion and stabilization of clotting factor 8?
vWF
82

Lab Diagnosis 1 (11 decks)

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