Pathology-Hemostasis Flashcards

1
Q

What three main factors affect the formation of a thrombus?

A

Vascular wall, platelets, coagulation cascade

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2
Q

Describe vasoconstriction during normal hemostasis

A

Neurologic reflect causes vasoconstriction and is amplified by endothelin

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3
Q

What does endothelin do

A

increases vasoconstriction

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4
Q

Describe what happens during primary hemostasis

A
  1. wall expose so endothelium lays down vWF
  2. GF1b on platelets binds vWF
  3. Platelets release ADP and TXA2
  4. Granules recruit more platelets
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5
Q

What does vWF do

A

causes platelet adhesion

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6
Q

What does GF1b do

A

binds vWF

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7
Q

Dense granules

A

ADP, calcium, serotonin, histamine, epinephrine

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8
Q

Alpha granules

A

V, VIII, protein s, fibrinogen

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9
Q

What happens during secondary hemostasis?

A
  1. Tissue factor is synthesized
  2. Tissue factor and secreted platelet granules activate coagulation cascade
  3. Activates thrombin that cleaves fibrinogen to fibrin to form secondary plug
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10
Q

What does fibrinogen do?

A

Allows platelets to aggregate; forms dimers once cleaved

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11
Q

5 steps of primary hemostasis

A
  1. vasoconstriction
  2. platelet adhesion
  3. platelet activation and secretion
  4. platelet aggregation
  5. primary platelet plug
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12
Q

What types of things activate the endothelium?

A

Infectious agents, hemodynamic factors, plasma mediators, most importantly cytokines

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13
Q

How do PGI-2 and NO prevent thrombi formation

A

vasodilation

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14
Q

Anticoagulant effects of endothelium

A

Heparin like molecules interact with antithrombin III, causing an inactivation of coat factors

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15
Q

Antithrombin III

A

Inactivates thrombin so it cannot cleave fibrinogen

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16
Q

Thrombomodulin

A

binds to thrombin and makes it activate C protein instead of cleaving fibrinogen

17
Q

Tissue-type plasminogen activator (TPA)

A

cleaves fibrin dimers so that it can clear a clot

18
Q

Plaminogen activator inhibitors (PAIs)

A

stop fibrinolysis

19
Q

How does vWF stay attached?

A

Via collagen

20
Q

Protein C and S

A

Vitamin K dependent proteins that activate V and VIII and cause anticoagulation

21
Q

Fibrinolysis

A

break down of fibrin into d-dimers

22
Q

Plasmin

A

derived from plasminogen; plays role in cleavage of fibrin

23
Q

Prostacylcin

A

made via arachidonic acid metabolism; causes vasodilation and inhibits coagulation