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Heme > Principles of coagulation > Flashcards

Principles of coagulation Flashcards

1
Q

When there is injury to a blood vessel what happens before the formation of the primary hemostatic plug?

A

vasoconstriction

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2
Q

Why does a blood vessel constrict immediately after injury?

A

to slow down the blood and allows all the coagulation factors time to interact

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3
Q

What clotting factor deficiency does a pt possibly have if s/he has:

normal PT and prolong PTT

A

8, 9, 11, 12, prekalikrein, HMWK

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4
Q

What clotting factor deficieincy does a pt possibly have if s/he has:

normal PT and prolong PTT and is bleeding

A

8, 9, 11 (or vWF)

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5
Q

What clotting factor deficieincy does a pt possibly have if s/he has:

normal PT and prolong PTT, is bleeding, low factor VIII

A

hemophilia or vWF deficiency

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6
Q

What clotting factor deficieincy does a pt possibly have if s/he has:

normal PT and prolong PTT, is bleeding, low factor VIII, low vWF

A

vWF deficiency

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7
Q

What clotting factor deficieincy does a pt possibly have if s/he has:

normal PT and prolong PTT, is bleeding, low factor VIII, normal vWF

A

hemophilia

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8
Q

What clotting factor deficieincy does a pt possibly have if s/he has:

normal PT and normal PTT and pt is still bleeding

A

factor XIII deficiency

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9
Q

What clotting factor deficieincy does a pt possibly have if s/he has:

prolong PT and normal PTT

A

7 deficiency

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10
Q

What factors are measured with PT?

A

7, 5, 10, prothrombin (2), fibrinogen

  • extrinsic pathway
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11
Q

What factors are measured with PTT?

A

everything but 7 (and 13)

*intrinsic

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12
Q

What clotting factor deficiency does a pt possibly have if s/he has:

prolong PT and prolong PTT

A

10, 5, prothrombin (is this right?)

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13
Q

T or F: antithrombic counter regulation occurs only after the formation on the secondary hemostatic clot

A

F: it occurs the entire time a clot is forming

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14
Q

What clotting factors are serine proteases?

A

11, 9, 7, prothrombin (2)

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15
Q

What clotting factors are cofactors?

A

12, 8, 5, tissue factor (3)

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16
Q

What are the vitamin K dependent clotting factors?

A

2, 7, 9, 10

protein S and C

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17
Q

What is the role of vitamin K in the activity of some of the clotting factors?

A

it is needed for the carboxylation of glutamic acid residues. Without the carboxylation, these clotting factors canot adhere to the a phospholipid membrane

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18
Q

Elevated F1.2 indicates….

A

elevated thrombin (bc active thrombin makes F1.2)

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19
Q

What does von Willebrand’s disease and hemophilia have in common?

A

low factor 8

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20
Q

Where is factor 8 made? What is it bound to?

A

made in the liver

bound to vWF

21
Q

If a pt does not have vWF, they will have (high, low) factor 8

A

low

22
Q

What molecule antagonizes thrombin?

A

anti-thrombin 3

23
Q

How does heparin effect anti-thrombin 3?

A

changes the shape of anti-thrombin 3 so that it binds up/inhibits thrombin

24
Q

What does active protein C do?

A 
inactivates 5a and 8a (stops clot formation)
inactivates tPAi (enhances fibrinolysis)
25
Q

How does protein C become active?

A

thrombin binds thromodulin on endothelial surface. This interaction activates protein C (which was bound to a receptor on endothelial surface and released upon activation)

26
Q

What does thrombin cleave off of fibrinogen to make fibrin?

A

fibrinopeptide A and B

27
Q

What is a D dimer?

A

product of fibrin cleavage by plasmin

fibrin degradation product

28
Q

T or F: a fibrin degradation product can still form a weak clot

A

T (fragment Y)

29
Q

T or F: a fibrin degredation product has the ability to negatively regulates clot formation

A

T: fragment D can inhibit platelets bc they bind it thinking it is fibrin

30
Q

What holds a fibrin polymer together?

A

Hydrogen bonds

31
Q

What activates factor 13?

A

thrombin

32
Q

What is the role of clotting factor 13?

A

crosslinks fibrin polymers with transaminase bonding

33
Q

T or F: Plasmin is circulating freely in our blood

A

F: it if formed on a fibrin clot

34
Q

How is plasminogen converted to plasmin?

A

Tissue Plasminogen Activator (TPA) is a serine protease that binds fibrin to activate plasmin locally at the clot

35
Q

What is the role of alpha-2 plasmin inhibitor?

A

inhibits any local free plasmin (keeps it from getting into circulation)

36
Q

What are the factors involved in the intrinsic activation of plasminogen to plasmin?

A

12a and Kallikrein

37
Q

What are the factors involved in the extrinsic activation of plasminogen to plasmin?

A

tPA

urokinase-like A

38
Q

What is streptokinase?

A

bacterial agent/peptide that complexes with plasminogen which converts other molecules to plasmin

39
Q

What does tissue factor do?

A

initiate coagulation (extrinsic)

40
Q

What does PGI2 (prostacyclin) do?

A

vasodilation and inhibit platelet aggregation (activates adenylate cyclase to inc cAMP)

41
Q

What does vWF do?

A

platelet-collagen adhesion

carriage of factor 8

42
Q

What does protein C and S do?>

A

inhib coag

43
Q

WHat does TPA do?

A

fibrinolysis

44
Q

What does alpha1-protease inhibitor act on?

A

factor 11a to prevent activation of 9

45
Q

What does antithrombin/heparin act on?

A

9a to prevent formation of Xa

46
Q

What does TFPI-Xa act on?

A

TF-7a to inhibit Xa and 9a formation

47
Q

What does alpha2-macroglobulin act on?

A

thrombin

48
Q

What does heparin cofactor II act on?

A

thrombin

Heme (38 decks)

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