intro. to secondary hemostasis

Question 1

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

Answer 1

Coagulation proteins (Factors)

• Blood – inactive state
• Once activated – interact to form fibrin clot
• Purpose – to reinforce the plt plug

Question 2

Where are the coagulation factors produced?

Answer 2

All factors are produced in the liver

Question 3

What is the name for factor I?

Answer 3

Fibrinogen

Question 4

What is the name for factor II?

Answer 4

prothrombin

Question 5

What is the name for factor III?

Answer 5

Tissue factor or tissue thromboplastin

Question 6

What is the name for factor IV?

Answer 6

Ionized calcium

Question 7

What is the name for factor V?

Answer 7

Labile factor or proaccelerin

Question 8

What is the name for factor VII?

Answer 8

• stable factor (Serum prothrombin conversion accelerator SPCA),
• proconvertin

Question 9

What is the name for factor VIII?

Answer 9

antihemophilic factor

Question 10

What is the name for factor IX?

Answer 10

Christmas factor, plasma thromboplastin component, or antihemophilia factor B

Question 11

What is the name for factor X?

Answer 11

Stuart-Prower factor

Question 12

What is the name of factor XI?

Answer 12

plasma thromboplastin antecedent

Question 13

What is the name of factor XII?

Answer 13

hageman factor or contact factor

Question 14

What is the name of factor XIII?

Answer 14

fibrin stabilizing factor

Question 15

What is another name for Fitzgerald factor?

Answer 15

high molecular weight kinogen

Question 16

What is another name for Fletcher factor?

Answer 16

prekalikrein

Question 17

Which factor is the main substrate?

Answer 17

Fibrinogen

Question 18

Which factors are cofactors?

Answer 18

• Factor V (labile factor)

- VIII:C (antihemophilic factor (AHF))

Question 19

Which factors are serine proteases?

Answer 19

Serine proteases – cut peptide bonds

Includes all except XIII (IIa,VIIa, IXa, Xa, XIa, XIIa, prekallikrein)

Question 20

Which factor is a transaminase?

Answer 20

XIIIa-creates cross-links to stabilize clots

Question 21

Which factors are contact proteins?

Answer 21

XII – Hageman factor
XI – plasma thromboplastin antecedent
Prekallikrein – Fletcher factor
High-molecular weight kininogen (HMWK) – Fitzgerald factor

Question 22

Which factors are vitamin k dependent?

Answer 22

2, 7, 9, 10

Question 23

Which vitamin k dependent factor has the shortest half life?

Answer 23

7 & is most sensitive levels of coumarin therapy

Question 24

What are the vit. K dep. Inhibitors?

Answer 24

Prot. C & S

Question 25

what do Vit K deficient patients-have decreased production of ?

Answer 25

functional prothrombin proteins | & inhibitors

Question 26

what do Coumarin, Coumadin, Warfarin inhibit?

Answer 26

Vit. K reduction yielding inactive factors

Question 27

what test monitors coumadin therapy?

Answer 27

pt

Question 28

what are Acquired Vit K deficiencies – common, seen in ?

Answer 28

- post surgical procedures - high dose antibiotic use - liver disease

Question 29

which factors are Fibrinogen or Thrombin sensitive proteins

Answer 29

I V VIII:C XIII

Question 30

Which group does thrombin act on?

Answer 30

all the factors in the fibrinogen group - Enhances activity of factors V & VIII:C - Activates factor XIII - Converts fibrinogen to fibrin

Question 31

what are the Procoagulant effects of Thrombin ?

Answer 31

- + feedback: Factor V & VIII - Converts Factor I to soluble fibrin monomer (cleaves fibrinopeptides A & B) - Activates XIII (cross-links fibrin monomers) - Induces plt activation & aggregation by promoting ---secretion of serotonin & TXA2

Question 32

what are the Coagulation inhibitor effects of thrombin?

Answer 32

- Binds to Antithrombin (AT), If heparin present AT enhanced 200x ‘s - Promotes release of t-PA (Tissue Plasminogen Activator) - Binds to thrombomodulin – activates Protein C (neg. feedback on Va & VIIIa)

Question 33

how does Thrombin Initiates Tissue Repair?

Answer 33

- Induces chemotaxis | - Stimulates proliferation of smooth muscle & endothelial cells