Platelets, coagulation and bleeding Flashcards

1
Q

What are the components primary hemostasis?

A

-Platelets

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2
Q

What are the components of secondary hemostasis?

A

-Coagulation cascade-fibrin formation

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3
Q

What converts fibrinogen (Soluble) to fibrin (insoluble)?

A

-Thrombin

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4
Q

What is the intrinsic pathway measured by?

A

-PTT (Patrial thromboplastin time)

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5
Q

What are vitamin K-dependent factors?

A
  • II
  • VII
  • XI
  • X
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6
Q

What is a normal PTT?

A

25-35 seconds

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7
Q

What does PT (Prothrombin Time) measure?

A

-Extrinsic pathway

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8
Q

What is a normal PT?

A

11-13.5 seconds

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9
Q

What are the features of platelets?

A
  • Anucleated
  • 10 day lifespan
  • Circulating platelets do not adhere it is during stasis adhesion occurs
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10
Q

How id primary hemostasis initiated?

A

-Injury

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11
Q

In primary hemostasis adherence to subendothelium occurs by interaction with what?

A

-Von Willebrand factor (Carrier for factor VIII)

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12
Q

Secondary hemostasis factors are mostly from where?

A

-Liver

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13
Q

What are the factors in the intrinsic pathway?

A
  • XII
  • XI
  • IX
  • VII
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14
Q

What are extrinsic pathway factors?

A
  • VII

- IX

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15
Q

What are common pathway factors?

A
  • X
  • V
  • II
  • Fibrin production
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16
Q

What tests are used to measure the common pathway?

A

PT and PTT

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17
Q

What do fibrin and platelet aggregates form?

A

-Stable clot

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18
Q

What are the vitamin K dependent factors necessary for?

A

-Calcium binding sites activating coagulation cascade

19
Q

What are natural anticoagulants?

A

-Protein C

20
Q

What is Fibrinolysis?

A

-Break down clot

21
Q

What do you do when assessing hemostasis?

A
  • Platelet count
  • Coagulation cascade
  • Prolonged coagulation tests
22
Q

What causes Thrombotic disorders?

A

-Virchow’s triad

23
Q

What is Virchow’s triad?

A
  • Endothelial injury
  • Abnormal blood flow
  • Hypercoagulability
24
Q

What are some causes of bleeding disorders?

A
  • Abnormal vessels
  • Decreased platelets/dysfunction
  • Abnormal factors
25
Q

What is mucocutaneous bleeding?

A

-Petechiae on mucosal surfaces (Platelet type bleeding)

26
Q

What are causes of platelet type bleeding?

A
  • Thrombocytopenia

- Von Willebrand disease (helps with adhesion)

27
Q

What are the causes of Thrombocytopenia?

A
  • Decreased bone marrow production
  • Hemodilution due to multiple transfusion
  • Immune reaction due to platelet autoantibodies directed at platelet surface proteins
28
Q

What are the clinical presentations of thrombocytopenia?

A
  • Platelet counts lower than 10-20,000 (result in spontaneous bleeding)
  • Anti-platelet drugs such as aspirin
29
Q

What does Thrombocytopenia purpura include?

A
  • Fever
  • Renal failure
  • Transient neurological deficits
  • Microangiopathetic hemolytic anemia
30
Q

What is the most common of the inherited blood-clotting disorders?

A

-Von Willebrand

31
Q

What does Von Willebrand factor not bind properly to in VWD?

A

-factor VIII

32
Q

If vWF doesn’t bind properly to factor VIII what occurs?

A

-Platelet adhesion doesn’t work very good

33
Q

What is Hemophilia A?

A

-Deficient factor VIII

34
Q

Who is hemophilia B more likely in?

A

Males under 25 because of X linked recessive trait

35
Q

What are some acquired abnormalities in coagulation factors?

A
  • Liver disease

- Vitamin K deficiency

36
Q

What does liver disease and Vitamin K deficiency do to the PT and PTT?

A

-Increase both

37
Q

What is a generalized secondary activation of clotting due to disseminated factors such as toxins, inflammation, and cancers?

A

-Disseminated Intravascular Coagulation

38
Q

What can Disseminated Intravascular Coagulation cause?

A

-Both ischemia because of increased clotting as well as bleeding due to increased activation of fibrolysis

39
Q

What is the pathologic counterpart of hemostasis?

A

-Thrombosis

40
Q

What are acquired hypercoagulable states?

A
  • Surgery/trauma
  • Limb immobilization
  • Bedridden
  • Long-distance air travel
  • Pregnancy
  • Oral contraceptives
41
Q

What is an example of genetic thrombotic disorder?

A

-Factor V Leiden

42
Q

What is the most common inherited thrombophilia and is associated with increased fibrin formation?

A

-Factor V Leiden

43
Q

What is Caisson disease caused by?

A

-Air embolism blocking blood flow