Study Guide: Chapter 14

Question 1

To stop bleeding by activating the coagulation system

Answer 1

hemostasis

Question 2

When do you need hemostasis?

Answer 2

To stop bleeding within a few minutes by forming a clot at the injury site.

Question 3

What are the 5 important factors involved in hemostasis?

Answer 3

1) Small blood vessel integrity
2) Enough platelets
3) Normal amounts of coagulation factors
4) Normal amounts of coagulation inhibitors.
5) Sufficient calcium

Question 4

Which phase I coagulation factor is linked to hemophilia A?

Answer 4

factor VIII

Question 5

Which phase 1 coagulation factor is linked to hemophilia B?

Answer 5

factor IX

Question 6

Which phase I coagulation factor is linked with the Leiden mutation?

Answer 6

factor V

Question 7

What are antithrombin and protein C?

Answer 7

Coagulation inhibitors

Question 8

Which coagulation inhibitor inhibits thrombin?

Answer 8

Antithrombin

Question 9

Which coagulation inhibitor inhibits factor V (Leiden) and VIII (hemophilia)?

Answer 9

protein C

Question 10

What is another name for fibrinolysin?

Answer 10

plasmin

Question 11

What plasminogen activator functions as the central coordinator of both coagulation and fibrinolysin processes?

Answer 11

Thrombin

Question 12

Which plasminogen activators can be used clinically to in heart attack patients to dissolve a clot?

Answer 12

tPA and streptokinase

Question 13

Why would it be preferable, if possible, to give a patient anticoagulants than plasminogen activators?

Answer 13

PAs could cause serious bleeding (e.g., stroke)

Question 14

What is the difference between plasminogen activators and anticoagulants?

Answer 14

PAs dissolve fibrin clots; anticoagulants prevent further clotting and let the body’s own fibrinolysin dissolve the clot.

Question 15

When would you give a plasminogen activator to a patient?

Answer 15

In an emergency if a clot needs to be dissolved immediately.

Question 16

Which phase 1 pathway is most important in initiating clotting?

Answer 16

Extrinsic pathway

Question 17

Enzyme needed to produce thrombin in phase II of the coagulation process.

Answer 17

thromboplastin

Question 18

What does prothrombinase (activated thromboplastin) do?

Answer 18

Converts prothrombin to thrombin

Question 19

What is used to convert fibrinogen to fibrin?

Answer 19

thrombin

Question 20

What is the most common clotting disorder?

Answer 20

Thrombocytopenia

Question 21

Too few platelets

Answer 21

thrombocytopenia

Question 22

What is the most common bleeding disorder?

Answer 22

von Willebrand’s Disease

Question 23

What causes vWD?

Answer 23

vWF deficiency

Question 24

True or false: Phase I coagulation disorders are all hereditary.

Answer 24

True

Question 25

Classic anticoagulant that acts rapidly/immediately to bind and enhance antithrombin III
(a natural coagulation inhibitor) activity thereby inhibiting thrombin activity, its production, and the coagulation cascade

Answer 25

Heparin

Question 26

Classic anticoagulant that provides longer term (than heparin) inhibition of all the vitamin K dependent cofactors.

Answer 26

Coumadin (Warfarin)

Question 27

Two examples of newer medications that directly inhibit thrombin activity.

Answer 27

1) Pradaxa

2) Argatroban

Question 28

Two examples of newer anticoagulant medications that inhibit prothrombinase (and therefore thrombin production)

Answer 28

1) Xarelto

2) Eliquis

Question 29

What causes unwanted release of thromboplastic substances into the circulation to (over)stimulate coagulation, including disseminated intravascular coagulation (DIC)?

Answer 29

1) Shock
2) Widespread infections
3) Tissue necrosis

Question 30

What condition is characterized by major hemorrhaging caused by thromboplastic substances being disseminated into the circulation, causing the body to quickly use up its coagulation factors and a surge in clot lysis?

Answer 30

Disseminated intravascular coagulation (DIC)

Question 31

What happens in patients in with thromboplastic materials are slowly released, providing enough time for them to be replaced? What types of patients does this occur in?

Answer 31

Net overall clotting throughout the body; advanced cancer