Section 11: Fibrinolytic/Thrombic Disorders

Question 1

Fibrinolytic Disorders

Answer 1

increased plasmin activity
bleeding

Question 2

Function of plasmin

Answer 2

lyses fibrin/fibrinogen
inactivates Va VIIIa

degrades XIIa

Question 3

Fibrinogenolysis - primary fibrinolysis

Answer 3

Always pathological

overactivation of plasmin and or overwhelms plasmin inhibitors

Question 4

Fibrinolysis - secondary

Answer 4

normal

pathological = overactivation of plasmin and or overwhelms plasmin inhibitors

Question 5

Liver disease
overactivation of?
decreased
increased
decreased a

Answer 5

overactivation of plasmin

decreased inhibitors

increased fibrinolysis

decreased alpha 2 antiplasmin

Question 6

Exogenous activators

Answer 6

overactivation of plasmin

strepto/urokinase, tPA

Question 7

Factors in thrombosis
major
o
comp
oral

Answer 7

major tissue/surgery/trauma

obesity
complications of pregnancy
oral contreceptives

Question 8

Anti Thrombin Deficiency

Answer 8

hered dom or co dom
thrombosis
family hxt of pathological thomboli/emboli

Question 9

Protein C and S deficiency

Answer 9

thrombosis
Factors V VIII inactivation

Question 10

Protein Z and ZPI deficiency
what factors?

causes?

Answer 10

thrombosis
Xa

ZPI = XIa

Question 11

Heparin cofactor II

Answer 11

neutralizes thrombin

Question 12

Activated Protein C resistance (APC-R)
also called?
mutation of?

causes?

Answer 12

FVL

mutation of V gene, resistant to lysis of APC

thrombosis

Question 13

Factor V leiden (APC resistance)

lab tests

Answer 13

PT normal
APTT normal

doesnt affect clot lysis

Question 14

Clot based assay - APC resistance
what rgnt + …. + depleated

what range indicates…

APC will inactivate?

Answer 14

APTT rgnt + pt plasma + V depleated plasma

<1.8 indicates Factor V leiden

APC will inactivate normal V

Question 15

XII deficiency
needed for?

doesnt cause?

Answer 15

needed for activation of plasminogen to plasmin

DOESNT CAUSE BLEEDING

Question 16

XI deficiency

Answer 16

bleeding, doesnt cause thrombosis

Question 17

PK/HMWK deficiency

Answer 17

asymptomatic, may have thrombosis

Question 18

Dysfibrinogenemia
mostly?
may be resistant to? clot resistant to? causes?

can also be?

Answer 18

mostly asympt

may be resistant to fibrinogenolysis/ clot is resistant to fibrinolysis = thrombosis

can also be a bleeding disorder

Question 19

Plasminogen deficiency
ty 1
ty 2

Answer 19

Type 1 - decrease in activity/ Ag deficiencies

Type 2 - dysfunctional thrombosis

Question 20

tPA deficiency
decreased
causes?

Answer 20

decreased plasminogen to plasmin

thrombosis

Question 21

Prothrombin Mutation

Answer 21

increased prothrombin levels
gene mutation/single point

thrombosis

Question 22

Homocystine

Answer 22

defect in metabolism of homocytine

increased levels

thrombosis

damage to endothelial cells

Question 23

Ebola

Answer 23

thrombocytopenia bone marrow supression

Plt dysfunction

DIC

hepatic Coagulopathy

Question 24

Covid 19

Answer 24

lymphopenia indicator that its getting worse

reactive lymphs abnormal morphology

hypercoagulopathy

stasis - decreased blood flow

Question 25

Hypercoagulopathy state

Answer 25

in covid 19

Question 26

Covid lab results
PT/APTT
PLTs
Fibrinogen
D dimer
monitor for?

Answer 26

PT/APTT norm or prolonged

Plt norm or increased

Fibrinogen increased

D dimer increased

monitor for renal impairment

Question 27

Distinction of DIC from covid

Answer 27

Covid thrombosis rare bleeding
increased fibrinogen
VIII increased

DIC bleeding
decreased fibrinogen
Low VIII