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AU2017 Gen Path Exam 2 > Lecture 3- Coagulation > Flashcards

Lecture 3- Coagulation Flashcards

1
Q

Primary hemostasis is … … formation

A

platelet plug

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2
Q

Seconday hemostasis is … … formation

A

fibrin clot

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3
Q

Response sequence of platelets

A

adhesion
activation
aggregation

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4
Q

Platelet adhesion involves membrane receptor …. and the adhesive protein…. and the appropriate surface ….

A

Glycoprotein Ib

von Willebrand Factor (vWF)

Subendothelial matrix (collagen)

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5
Q

In platelet activation, they secrete …. that brings fibrinogen and … which provide ionized calcium and ADP

A

alpha-granules

dense bodies

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6
Q

Platelet leads to activation of …. receptor and … reorganization and the platelet …. changes

A

GP IIb/IIIa

phospholipid

shape (rounded discs to flat planes- increased surface area)

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7
Q

3 molecules that counter primary hemostasis (platelets)

A

NO
Prostacyclin (PGI2)
ADPase

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8
Q

3 molecules that counter secondary hemostasis (coag pathways)

A

Serine protease inhibitors (antithrombin)

Protein C pathway (controls Va and VIIIa)

Fibrinolytic system (removes excess clot)

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9
Q

Activated … plus …. serve to inactivate factors Va and VIIIa

A

Protein C (APC)

Protein S

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10
Q

Protein C or Protein S deficiencies result in …

A

hypercoagulable states

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11
Q

Factor V Leiden mutation promotes…. because of resistance to enzymatic inactivation by the Protein C/S complex

A

coagulation

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12
Q

In the presence of heparin, ATIII will bind and inactivate….

A

thrombin (IIa)

and other serine proteases:
IXa, Xa, XIa, XIIa

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13
Q

Regulation of coag:

Antithrombin inhibits….

Protein C inhibits….

Plasmin removes…

A

serine proteases

cofactors (Va, VIIIa)

excess clot

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14
Q

In the presence of fibrin, … can bind to plasminogen and convert it to plasmin to break down previously cross-linked fibrin monomers into FDP

A

tPA (tissue plasminogen activator)

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15
Q

Prothrombin time (PT) screens for activity of proteins in the … pathway ( factors 5,7,2,10 and fibrinogen)

A

extrinsic

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16
Q

In a PT test, … and … are added to patients plasma with…

A

phospholipid
tissue factor
calcium

17
Q

PT time is time it takes to form a clot which should be …

A

11-13 seconds

18
Q

PT forms the basis of …

which should have a value of … if normal

A

INR (International Normalized Ratio) patient/control

0.8-1.2

19
Q

INR is used to monitor patients on…

A

warfarin

20
Q

Partial thromboplastin time (PTT) screens for activity within the … pathway (5, 2, 9, 10, 11, 12 and fibrinogen)

A

intrinsic

21
Q

PTT often used to monitor patients on…

A

heparin

22
Q

In a PTT test, addition of … to patient serum together with calcium

A

negatively charged activator of Factor XII (kaolin)

23
Q

In a PTT test, clot is formed after … seconds

A

28-35

24
Q

The 3 classifications of vWD are

A

type 1: quantitative deficiency (partial)

type 2: qualitative deficiency

type 3: quantitative deficiency (total)

25
Q

Hemophilia is a … … disorder and is a deficiency of …

symptoms are recurrent soft tissue bleeding and symptoms that start in early childhood

A

X-linked recessive

factor VIII

26
Q

lab abnormalities in hemophilia A

A

prolonged PTT

decreased factor VIII

27
Q

… is a disorder characterized by immune-mediated destruction of platelets.

What are the common targets?

A

Immune Thrombocytopenic Purpura (ITP)

GPIb/IX and IIb/IIIa

28
Q

bone marrow and blood findings in ITP

A

megakaryocytes normal to increased

no microangiopathic changes on blood smear review

29
Q

ITP therapy (4)

A

corticosteroids
IV Ig
Immunosuppression
splenectomy

30
Q

… acute disorder is characterized by intravascular platelet activation with formation of platelet-rich microthrombi throughout the circulation.

A

Thrombotic Thrombocytopenic Purpura (TTP)

31
Q

TTP is due to deficiency of… which is a … that normally degrades very high MW vWF

A

ADAMTS 13

metalloproteinase

AU2017 Gen Path Exam 2 (9 decks)

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