Module 3: Mechanisms of Normal Hemostasis (from review sheet) Flashcards
Hemostasis
prevention and arrest of bleeding by rapid repair of nay ruptures in blood vessels
5 components of hemostasis
vascular platelet coagulation system fibrinolytic system natural anticoagulants and inhibitors
3 things secreted by endothelial cells that make them thromboresistant
heparin sulfate
Prostacyclin
nitrous oxide
2 types of vasoconstriction after injury
muscular humoral (delayed due to release of endothelin)
endothelin
secreted by endothelial cells
induces smooth muscle contraction for vasoconstriction
2 things released by injured tissue
Tissue thromboplastin (III) Tissue Plasminogen Activator (TPA)
Tests for vascular response (3)
bleeding time
closure test
capillary fragility test
why is Thrombopoiesis different from other cells (2)
megakaryocytic get bigger as they mature
no cellular division
platelet lifespan in blood
8-10 days
3 zones of platelet
peripheral
sol gel
organelle
peripheral zone
plasma membrane
outer coating
glycocalyx
Important for adhesion and aggregation
Sol gel zone
cytoskeleton with contractile proteins thrombosthenin and actomyosin
importnat in plt retraction, shape changes, viscous metamophosis in secondary aggregation
Organelle zone
canicular system, dense bodies, alpha granules (PF3, fibrinogen, thrombospondin, PF4), dense tubular system (stores Ca2+)
Important in plt retraction and prostaglandin synthesis
% of platelets in circulation
70%
% of platelets in spleen
17%
% of platelets in liver, lungs, bone marrow
13%
Platelet factor
substance absorbed onto the plt membrane or carried in the plt granules that are released during the release reaction and that influence homeostasis
PF1
absorbed coagulation factor V
PF2
fibrinogen activating factor
PF3
platelet phospholipid
acts as organization surface to bring required factors into close proximity and facilitate reaction
PF4
anti-heparin factor
glycoprotein that inhibits the reaction of heparin
Platelet functions (2)
hemostatic functions (plug, adhesion, aggregation and retraction) Thromboplastic (actual clot, plt releases chemicals that reinforce vasoconstriction, aggregation and coagulation reactions that promote growth and healing)
platelet adhesion requires (2)
GPIb
vwF
Primary aggregation requires (4) - reversible
ADP
GIIb/IIIa
Ca2+
Fibrinogen
secondary aggregation requires (2) - irreversible
ADP and thrombin
Result of secondary aggregation (3)
induce prosaglandin synthesis
activate enzymes that hydrolyse plt membrane phospholipids
Arachidonic acid used by cyclooxyrgenase to produce PGH2 and then the enzyme TxA2 syntheses changes PGH2 into TxA2
Thromboxane A2 functions (3)
release calcium
lowers camp levels
vasoconstrictor
Contractile protein involved in plt retraction
Thrombosthenin
Inhibitors of plt aggregation will increase CAMP levels by
activating adenylcyclase or inhibiting phosphodiesterase
Aggregation agents will decrease CAMP levels by
inhibiting adenycyclase or activating phosphodiesterase
Chelating agents inhibit plt aggregation by
removing Ca2+
Heparin inhibits
thrombin
Aspirin inhibits plt aggregation by
inhibiting TxA2 synthesis in plts
Screening test for plts (4)
plt count
bleeding time
closure time
capillary fragility
Function tests for plt adhesion, aggregation, retraction (5)
plt adhesion tests plt aggregation tests prothrombin consumption time PF3 availability clot retraction
Tests for cause of low plt (3)
bone marrow examination
tests for anti-plt antibody
Plt survival studies
All activated enzymes are _____ except XIIIa
serine proteases
XIIIa
transamidase
Factor that is never “activated”
I
Factor VIII made up of 2 components
antihemophilic
VWF
Contact group key words
His private parts hurt
HMWK, PTA, PK, Hageman
Prothrombin group key words
Presents save christmas Santa
Prothrombin, stuart-prower, christmas, stable
Fibrinogen group key words
Fancy ladies acquire funds
Fibrinogen, Labile, antihemophilic, fibrinase
Intrinsic group key words (APTT)
Horny prostitutes have coitus and spread legs for precious pennies
HMWK, Prothrombin, hageman, christmas, antihemophilic, stuart power, labile, fibrinogen, pta, pk
extrinsic group key words (PT)
Silly sluts love pillow fights
Stuart prower, stable, labile, prothrombin, fibrinogen
Factors key words
French I Fibrinogen prostitutes II Prothrombin tell III Tissue factor clients IV Ca2+ loves V Labile stupid VII Stable anyways VIII Antihemophilic children IX Christmas spend X Stuart-prower pennies XI PTA hella XII Hageman fast XIII Fibrinase
Thrombin major functions (4)
converts fibrinogen to fibrin
activates factor XIII
enhances factor V and VIII
induces plt aggregation
How does factor XIII stabilize fibrin clot
catalyzing formation of strong covalent bonds between amino acids of fibrin monomers in different polymers
Localization and control of hemostasis (5)
inhibition of hemostasis by products of coagulation
concentration of coagulation factors by their adoption onto plt surface
Natural antithrombins in plasma (pinocytosis)
Tissue damage starts fibrinolytic system
Thrombomodulin binds to thrombin and activates protein C (destroys V and VIII)
most significan antithrombin
antithrombin III
activated by heparin
Inhibits: II, VII, IX, X, XI, XII
2 ways plasminogen activated plasmin
tpa secreted by injury
weakly activated by thrombin
accelerated by XII, HMWK, PK
5 actions of plasmin
digest/destroy structure of fibrinogen/fibrin produces FDP destroys V, VIII, IX, XI activates complement enhances XII and PK
FDP roles (3)
inhibit thrombin
inhibit fibrin polymerization
increase vascular permeability
tests for fibrinolysis (2)
D Dimer (increased; secondary fibrinolysis) Fibrinogen assay (decreased)
Groups consumed during coagulation
fibrinogen group
XI from contact group
II from prothrombin group
Groups present in serum (after clotting)
contact and prothrombin (except factor II)
groups Present in plasma
contact, prothrombin and fibrinogen (except I, XIII)
Groups absorbed by BaSO4
prothrombin group
Groups Present in absorbed plasma
contact and fibrinogen
Groups dependent on Vit K
Prothrombin
Groups synthesized in liver
Prothrombin and fibrinogen (except VIII)