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HEMATOLOGY 2 > INHIBITORS & FIBRINOLYSIS > Flashcards

INHIBITORS & FIBRINOLYSIS Flashcards

1
Q

TWO major anticoagulant systems in the body

A

Protein C/Protein S System
Plasma serine protease inhibitors (SERPIN) system

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2
Q

Activated by thrombin bound to thrombomodulin

A

Protein C

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3
Q

Inactivates factors Va and VIIIa

A

Activated Protein C

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4
Q

Cofactor of protein C

A

Protein S

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5
Q

The main the serine protease inhibitor

A

Antithrombin (formerly antithrombin III)

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6
Q

Antithrombin inhibits

A

IXa, Xa, XIa, Kallikerein, XIIa

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7
Q

Acquired inhibitors of coagulation

A

Circulating inhibitors

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8
Q

Usually detected by the prolongation of the PT and APTT which is NOT CORRECTED by the addition of normal (Fresh) plasma

A

Circulating inhibitors (circulating anticoagulant)

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9
Q

Antibodies against specific coagulation factors ; associated with bleeding ; antibodies to factors VIII and IX (most common)

A

Specific inhibitors

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10
Q

Lupus anticoagulant

A

IgA, IgM, IgG

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11
Q

Found in 10% of SLE patients

A

LUPUS ANTICOAGULANT

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12
Q

Directed against phospholipid and are generally not associated with bleeding ; normal or slight INCREASED PT and INCREASED APTT

A

Lupus anticoagulant

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13
Q

Tests for lupus anticoagulant

A

Substitution test
Platelet neutralization test
dRVVT

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14
Q

Examples of specific inhibitors

A

Antibodies to factors VIII and IX

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15
Q

Examples of non specific inhibitors

A

Lupus anticoagulant
Paraproteins
Fibrinogen degradation products

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16
Q

Final stage of coagulation and is the dissolution of the formed clot

A

Fibrinolysis

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17
Q

Two activators of fibrinolysis that are released in response to inflammation and coagulation

A

Tissue plasminogen activator
Urokinase plasminogen activator

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18
Q

A stored and transported in eosinophils

A

Plasminogen

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19
Q

Rapidly binds and inactivates any free Plasmin in the circulation

A

A2-antiplasmin

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20
Q

Serine protease secreted by activated endothelium activates plasminogen

A

Tissue plasminogen activator

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21
Q

It is bound to inhibitors such as PAI-1 and is cleared from plasma

A

Tissue plasminogen activator

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22
Q

Another intrinsic plasminogen activator ; secreted by urinary tract epithelial cells, monocytes and macrophages ; does not bind firmly to fibrin and has a relatively minor physiologic effect

A

Urokinase plasminogen activator

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23
Q

Principal inhibitor of plasminogen activation

A

Plasminogen activator inhibitor - 1 (PAI-1)

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24
Q

Primary inhibitor of free Plasmin

A

A2-antiplasmin

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25
Activated _____ functions as an antifibrinolytic enzyme
TAFI (Thrombin-activatable fibrinolysis inhibitor)
26
Plasmin lyses the fibrin and produces FDP that contain the portion called _____
D-diner
27
It’s presence indicates that a stable fibrin clot has been lysed
D-dimer
28
Proteins that precipitate when plasma is diluted with water and acidified ( 1% acetic acid)
Euglobulin lysis time
29
Induce plasminogen, Plasmin, fibrinogen, and plasminogen activators
Euglobulins
30
Euglobulin lysis’s time is typically longer than __ hours
2 hours
31
Lysis in less than 2 hours indicates
Increased fibrinolytic activity
32
Aka guanine nucleotide-binding proteins
G proteins
33
G proteins stimulate the two other platelets pathways :
Eicosanoid synthesis pathway and IPD3-DAG pathway
34
Aka prostaglandin, Cyclooxygenase, or Thromboxane pathway
Eicosanoid synthesis pathway
35
A mediator derived from the 20-carbon atom arachidonic acid
Eicosanoid
36
It SUPRESSES adenylate Cyclase and REDUCES cyclic AMP concentration ; allows the RELEASE of ionic calcium from the DTS
Thromboxane A2
37
This allows the release of the ionic calcium from the DTS
TXA2
38
This supports the contraction of actin microfilaments, activating the platelet
Ionic calcium
39
It ACCELERATES adenylate cyclase, INCREASING cyclic AMP and SEQUESTERS ionic calcium to the DTS
Prostacyclin
40
The endothelial cell eicosanoid pathway suppresses platelet activation through the mechanism stated above
Intact blood vessels
41
Activates Phospholipase C
G protein
42
Phospholipase C cleaves membrane Phosphatidylinositol 4,5-biphosphate to form _____ and _____
IP3 and DAG
43
Activates a multistep process: activation of Phospholipase C (which triggers phosphorylation of the protein pleckstrin (which regulates actin microfilament contraction)
DAG
44
Regulates actin microfilament contraction
Pleckstrin
45
Processes involved in platelet activation
Blood vessel injury: Exposes collagen Releases vWF Releases tissue factor
46
Platelets adhering to a foreign surface
Adhesion
47
Damaged endothelial cells vWF from cytoplasmic _______
Storage organelles
48
VWF____ (similar to a carpet) and adheres to the injured site
Unrolls
49
VWF exposes sites that partially bind the _____ portion of the platelet _____; A reversible binding process that “tethers” or decelerates the platelet
GPIba ; GP Ib/IX/V
50
The VWF-GP Iba tethering reaction is temporary, and the platelet rolls along the surface ___ __ ___ come into contact with exposed ____
Unless GP VI ; collagen
51
When collagen bind to platelets GP VI, it activates internal platelet activation pathways, releasing _____ and ____
TX2 and ADP (agonists)
52
TXA2 binds
TPa and TPb
53
ADP binds to
P2Y1 and P2Y12
54
Trigger a reaction that increases the affinity of a2b1
(GP Ia/IIa) for collagen
55
Provide inside-out-activation of alpha IIbB3 (GP IIb/IIIa), which assists in platelet aggregation
TXA2 and ADP
56
Platelets adhering to other platelets
Aggregation
57
Triggers the generation of thrombin which reacts with platelet PAR1 and PAR4
Tissue factor
58
Collagen and thrombin activated
COAT platelet
59
Binds fibrinogen and vWF and supports platelet-to-platelet aggregation
GP IIb/IIIa
60
Is the phospholipid on which two coagulation pathway complexes assemble : Tenase and prothrombinase
Phosphatidylserine
61
Coagulation pathway complexes Both supported by ionic calcium
Tenase and prothrombinase
62
Alpha granules contents and lysosomes contents flow through the
Surface-connected canaliculi system
63
A screening test for detecting disorders
Bleeding time
64
A screening test for detecting disorders
Normal value of Duke method
65
This method uses sphygmomanometer inflated at 40 mmHg
Ivy method
66
Template bleeding time reference range
2 to 9 mins
67
A modification of the original ivy bleeding time test
Template bleeding time
68
An example of a capillary fragility test (particularly a tourniquet test)
Rumble-Leede Test
69
A contractile protein important for CR
Thrombosthenin
70
Normal clot retraction requires:
Normal level of fibrinogen Normal level of functioning platelets Calcium ATP
71
CASTOR OIL METHOD
Hirschboeck method
72
Hirschboeck/castor oil method normal value
15 to 45 mins
73
Mc Farlane method normal value
44 to 67%

HEMATOLOGY 2 (7 decks)

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