Normal Hemostasis Pursuit

Question 1

What inhibitor forms an irreversible complex with factors IIa, IXa, Xa, XIa, XIIa and
plasmin to slowly neutralize them

Answer 1

Antithrombin

Question 2

What are the labile factors of the coagulation cascade and what gives them that name

Answer 2

V/VIII - short half lives

Question 3

How is Tissue Plasminogen Activator (TPA) released?

Answer 3

APC causes it to be relased from endothelial cells

Question 4

how is protein C activated?

Answer 4

thrombin-thrombomodulin complex

Question 5

Bill and Joe stole some prescription drugs from their grandmother’s bathroom medicine
cabinet. Thinking the drug warfarin had a rocking name, they took a large dose at the
Slayer concert later that night. At the concert, a glass bottle was broken over Joe’s head
that caused severe lacerations which began bleeding profusely without any sign of
stopping. What could potentially counteract the warfarin and bleeding, at least
theoretically?

Answer 5

large doses of vitamin K, but it woudlnt work immediately

Question 6

What is the only contact factor deficiency that causes bleeding?

Answer 6

XI

Question 7

Bill was roughhousing with Joe and his arm was chopped off accidentally. Joe, being a
quick wit noticed a bottle of sodium citrate and remembering his hemostasis course
quickly dumped it on the wound. Was Joe a genius or a fool and why?

Answer 7

sodium citrate will bind calcium and act as an anticoag

Question 8

When is it necessary to adjust the ratio of blood to anticoagulant and what type of
adjustment is needed?

Answer 8

when HCT is >55% less anticoag is needed

Low HCT more anticoag is needed

Question 9

3 functions of plasmin

Answer 9

breakdown fibrin and fibrinogen
inactivate V/VIII
degrade XII

Question 10

What is the substance needed to convert fibrinogen to fibrin and how does it work to
form a clot?

Answer 10

Thrombin cuts off fibrinopeptides A and B from the end of two polypeptide
chains. The remaining molecule is a fibrin monomer. These monomers will attach end
to end, polymerizing resulting in a fibrin clot

Question 11

name two ways IX can be activated

Answer 11

XIa intrinsic / VIIa, TFIII and calcium (extrinsic)

Question 12

What are the four components of the Intrinsic Tenase Complex?

Answer 12

VIII, IXa, calcium and PF3

Question 13

What are the three components of the Extrinsic Tenase Complex?

Answer 13

TF3, VIIa, calcium

Question 14

Name two roles of the thrombin-thrombomodulin complex

Answer 14

activate protein c and release TAFI

Question 15

How does Tissue Factor Pathway Inhibitor work

Answer 15

inhibits extrinsic path VII/TIII complex

Question 16

Plasmin can lyse both fibrin and fibrinogen; fibrinogenolysis is usually harder to achieve,
why?

Answer 16

antiplasmins will destroy most plasmin that escapes the clot

Question 17

What are the six things activated by Factor IIa?

Answer 17

I, V, VIII, XIII, XI, Protein C

Question 18

Which regulatory substance alters the fibrin clot thus inhibiting fibrinolysis?

Answer 18

Thrombin
Activatable Fibrinolytic Inhibitor (TAFI)

Question 19

What mediates the activation of Factor VI

Answer 19

doesnt exist

Question 20

Which normal inhibitor degrades factor Xa and Factor XI?

Answer 20

ZPI

Question 21

Name the coagulation factor that plays a role in both the cascade and platelet
aggregation.

Answer 21

Fibrinogen (I)

Question 22

What substance serves as a plasmin inhibitor only when Alpha2 anti-plasmin is
depleted?

Answer 22

alpha 2 macroglob

Question 23

What substance is released from injured endothelial cells and activated platelets and
functions to neutralize TPA

Answer 23

PAI - 1 and 2 (1 is most important)

Question 24

Name 7 substances that Factor II acts upon

Answer 24

I, V, VIII, XI, XIII, TAFI, Protein C

Question 25

Name at least 2exogenous plasminogen activators

Answer 25

Tpa, Urokinase, streptokinase

Question 26

How are Factor V and VIII affected if thrombin fails to act upon them?

Answer 26

slow but still work in the coag process

Question 27

Thrombin enhances which coag factors?

Answer 27

V/VIII

Question 28

A patient with a bleeding disorder was found to have the following screening test
results: PT-normal and APTT- prolonged. What are the possible factor deficiences?

Answer 28

XI, IX, VIII (bleeding)

Question 29

What may happen to coagulation test results if the sodium citrate tube has a short
draw?

Answer 29

prolonged clot based tests, may neutralize calcium in the test reagent

Question 30

Is Christmas magic?

Answer 30

IX is apart of the magic 4, yes

Question 31

What are 3 shared traits among the magic 4 coagulation factors

Answer 31

vit K dependent
made in the liver
all depleated by oral anticoags

Question 32

Which coagulation factor plays a role in clot formation as well as clot dissolution?

Answer 32

XII