MTAP W4 (Hematology: Checkpoint notes: Hemostasis) Flashcards

1
Q
  • process of forming barrier to blood loss and maintain blood in fluid state

when out of balance:
1. hemorrhage
2. thrombosis

A

hemostasis

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2
Q

formation of primary hemostatic plug or platelet plug

A

primary hemostasis

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3
Q

components:
1. vascular system
2. platelets

A

primary hemostasis

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4
Q

events include: vasoconstriction, platelet adhesion, platelet aggregation=initial plug

A

primary hemostasis

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5
Q

formation of stable fibrin clot

A

secondary hemostasis

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6
Q

components: coagulation factors

A

secondary hemostasis

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7
Q

events include: fibrin stabilization by factor XIII, coag factors interact on platelet surface to produce FIBRIN

A

secondary hemostasis

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8
Q

secondary hemostasis
fibrin stabilization by factor -

A

factor XIII/13

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9
Q

physiologic process that removes insoluble fibrin deposits by enzymatic digestion of stabilized fibrin polymers

A

fibrinolysis

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10
Q

gradual digestion and removal of fibrin clot as healing occurs

A

fibrinolysis

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11
Q

release of tissue plasminogen activator, conversion of plasminogen to plasmin, conversion of fibrin to fibrin degradation products

A

fibrinolysis

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12
Q

Primary hemostasis: Component

consist of ENDOTHELIAL CELLS, basement membrane and subendothelial connective tissue

A

tunica intima

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13
Q

Primary hemostasis: Component

thicker in arteries than in veins, contains smooth muscle cells which contract and expand

A

tunica media

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14
Q

Primary hemostasis: Component

thicker in veins than in arteries

A

tunica adventitia/externa

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15
Q

Primary hemostasis: Component

lines the blood vessels

A

endothelium

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16
Q

Primary hemostasis: Anticoagulant Properties

eicosonaid platelet inhibitor and vasodilator

A

prostacyclin

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17
Q

Primary hemostasis: Anticoagulant Properties

vascular ‘relaxing’ factor

A

nitric oxide

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18
Q

Primary hemostasis: Anticoagulant Properties

glycosaminoglycan that enhances antithrombin activity

A

heparan sulfate

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19
Q

Primary hemostasis: Anticoagulant Properties

extrinsic pathway regulator

A

tissue factor pathway inhibitor

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20
Q

Primary hemostasis: Anticoagulant Properties

endothelial surface receptor for thrombin

A

thrombomodulin

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21
Q

Primary hemostasis: Anticoagulant Properties

activating fibrinolysis

A

tissue plasminogen activator

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22
Q

protein C pathway is catalyzed by

A

thrombomodulin

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23
Q

downregulates coagulation by digesting activated factors V and VIII, thereby inhibiting thrombin formation

A

protein C pathway

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24
Q

Primary hemostasis: Procoagulant Properties

smooth muscle cells in arterioles and arteries induce -

A

vasoconstriction

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25
Q

Primary hemostasis: Procoagulant Properties

exposed subendothelial - bind VWF and platelets

A

collagen

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26
Q

Primary hemostasis: Procoagulant Properties

damaged/activated ECs secrete - and adhesion molecules

A

vWF

27
Q

Primary hemostasis: Fibrinolytic Properties

activates fibrinolysis

A

tissue plasminogen activator

28
Q

production is influenced by THROMBOPOIETIN prdocued in the liver or kidney

secretes coagulation factors stored in their granules

A

platelets

29
Q

first response to injured vessel

A

vasoconstriction

30
Q

vasoconstriction is initiated by - and - derived from platelets and endothelial cells

A

Serotonin
Thromboxane A

31
Q

attachment of platelets to collagen and other components

A

adhesion

32
Q

adhesion: collagen

A

in vivo

33
Q

adhesion: glass

A

in vitro

34
Q

Primary hemostasis

at HIGH SHEAR rates, platelet adhesion requires presence of both - and receptor -

A

vWF and GPIB/IX/V

35
Q

Primary hemostasis

at LOW SHEAR rates - receptors mediate direct collagen binding

A

GPIaIIa and GPVI

36
Q

Primary hemostasis

occurs within 1-2mins after a break
PASSIVE< non-energy-requiring process and potentially reversinle

A

vasoconstriction

37
Q

multimeric protein that contains binding sites for both GP1b and IX

A

vWF

38
Q

synthesized by ENDOTHELIAL CELLS and MEGAKARYOCYTES

A

vWF

39
Q

vWF; stored in intracellular granules and secreted into the plasma

  • in endothelial cells
A

weibel palade bodies

40
Q

vWF; stored in intracellular granules and secreted into the plasma

  • in platelets
A

alpha granules

41
Q

stimulate platelets and activate them

A

platelet agonists

42
Q
  • agonists

1.ADP
2.PAF/platelet-activating factor
3.serotonin
4. thromboxane A

‘STAP’

A

platelet-derived agonist

43
Q
  • agonists

1.collagen
2. thrombin
3. epinephrine

‘CET’

A

non-platelet-derived agonist

44
Q

strong agonist does not require - activity

A

cyclooxygenase

45
Q

the most potent activator of platelets in vivo

A

thrombin

46
Q

during platelet activation, PHOPHOLIPASE A2 converts phospholipid to -

A

arachidonic acid

47
Q

ARACHIDONIC acid is converted to prostaglandin endoperoxidase by -

A

cyclooxygenase

48
Q

causes release of ca which promotes platelet aggregation and vasoconstriction

A

TXA2

49
Q

potent agonist and can stimulate platelet activation and secretion

A

TXA2

50
Q

permanently blocks the action of cyclooxygenase-1 and TXA2 synthesis, impairing plt function

A

aspirin/acetylsalisylic acid

51
Q

Platelet DENSE BODIES-small molecules

component: -

agonist for platelets

A

ADP

52
Q

Platelet DENSE BODIES-small molecules

component: -

agonist for cells other than platelets; activates ca influx channel in outer membrane

A

ATP

53
Q

Platelet DENSE BODIES-small molecules

component: -

platelet activation

A

calcium

54
Q

Platelet DENSE BODIES-small molecules

component: -

vasoconstriction, platelet antagonist

A

serotonin

55
Q

strong agonist does not require - activity

A

cyclooxygenase

56
Q
  • stimulation results in increased cytoplasmic calcium, more plt release and the appearance of active fibrinogen receptors
A

ADP

57
Q

PLATELET ALPHA GRANULES- LARGE GRANULES

GROUP 1-HEMOSTATIC PROTEINS

platelet aggregation; conversion to fibrin

A

fibrinogen

58
Q

PLATELET ALPHA GRANULES- LARGE GRANULES

GROUP 1-HEMOSTATIC PROTEINS

fibrin formation

A

Factor V, XI

59
Q

PLATELET ALPHA GRANULES- LARGE GRANULES

GROUP 1-HEMOSTATIC PROTEINS

plt adhesion; carries FVIII in plasma

A

VWF

60
Q

PLATELET ALPHA GRANULES- LARGE GRANULES

GROUP 1-HEMOSTATIC PROTEINS

fibrinolysis

A

plasminogen

61
Q

PLATELET ALPHA GRANULES- LARGE GRANULES

GROUP 1-HEMOSTATIC PROTEINS

when released from activated plt, protect newly formed clots from lysis

A

PAI-a, a2-antiplasmin

62
Q

PLATELET ALPHA GRANULES- LARGE GRANULES

GROUP 2-NONHEMOSTATIC PROTEINS
PLATELET SPECIFIC

chemoattractant for neutrophils, fibroblast

neutralizes heparin

A

b-thromboglobulin

63
Q

PLATELET ALPHA GRANULES- LARGE GRANULES

GROUP 2-NONHEMOSTATIC PROTEINS
PLATELET SPECIFIC

weak chemoattractant for neutrophils, fibroblasts

neutralizes heparin

A

platelet factor 4