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Coagulation > Test 1 > Flashcards

Test 1 Flashcards

0
Q

What is the basic hemostasis sequence after a cut?

A
  1. ) Vasoconstriction (blood vessels diameter decreases)
  2. ) Formation of platelet plug at damaged site
  3. ) Platelet - Plasma Proteins - Vasculature interactions
  4. ) Fibrin clot Formation
  5. ) Clot Removal (fibrinolysis)
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1
Q

What are the four components of the Hemostasis system?

A

Vasculature
Thrombocytes (Platelets)
Plasma Coagulation Proteins
Fibrinolytic System (Inhibits/Removes Clots)

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2
Q

What do arteries do?

A

Transport oxygenated blood away from the heart

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3
Q

What do veins do?

A

Transport de-oxygenated blood back to the heart.

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4
Q

What is the tunica intima?

A

Innermost, single endothelial cell layer in contact with blood

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5
Q

What is the tunica media?

A

Middle layer of smooth muscle and elastic tissue

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6
Q

What is the tunica adventia?

A

outer layer, connective tissue, nerve endings, and vas vasorm

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7
Q

What do prostacyclins do?

A

Inhibit platelet aggregation and adhesion

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8
Q

What do plasminogen activators do?

A

clot dissolution

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9
Q

What is Von Wilebrand Factor?

A

Platelet adhesion protein

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10
Q

What is the glycocalyx in a platelet?

A

Fluffy outer coat, regulates shape, platelet adhesion and aggregation

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11
Q

What are the Platelet Alpha Granules?

A 
Von Willebrand Factor
Thrombospondin
Fibronectin
Platelet Fibrinogen 
Platelet Factor IV
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12
Q

What are the platelet Denes Granules?

A

ADP and Serotonin (Vasoconstriction)

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13
Q

Where are most blood (plasma) coagulation proteins synthesized?

A

Liver

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14
Q

What leads to the formation of the fibrin clot at the site of the injured blood vessel?

A

A cascading domino sequence of chemical interactions between the proteins, tissue substances, and calcium leads to the formation of an insoluble protein (fibrin clot)?

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15
Q

What gets the Roman numerals in the plasma factors?

A

Only proteins

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16
Q

What factors are in group 1 and what is the name of group 1?

A

Fibrinogen group

Factors I, V, VIII, XIII (1,5,8,13)

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17
Q

Is group one in serum?

A

No, it’s absent in serum because it’s consumed in clotting.

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18
Q

What is group II called and what’s in it?

A

Prothrombin group.

Factors II, VII, IX, X (2,7,9,10)

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19
Q

Is group 2 present in serum?

A

Yes except II, it is not consumed during clotting.

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20
Q

What is group III called and what factors are in this group?

A

Contact group

Factors XI, XII, Fletcher, Fitzgerald

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21
Q

Is group three consumed during clotting?

A

No

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22
Q

Is group three in serum?

A

Yes

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23
Q

What group is Vitamin K dependent?

A

Prothrombin II

24
Q

What is factor II called and what group is it in?

A

Prothrombin

Group II Prothrombin

25
Q

What are all the factors in Group I Fibrinogen?

A

Factor I - Fibrinogen
Factor V - Proaccelerin
Factor VIII - Anti-hemophilic Factor
Factor XIII - Fibrin Stabilizing Factor

26
Q

What factors are in Group II Prothrombin?

A

Factor II - Prothrombin
Factor VII - Proconvertin
Factor IX - Plasma Thromboplastin Component
Factor X - Stuart Factor

27
Q

Which groups of proteins are stored in plasma?

A

Groups II and III

28
Q

Which groups of proteins are consumed in the clot?

A

Group I

29
Q

When is the extrinsic pathway activated?

A

By contact with tissue phospholipids (Thromboplastins) following endothelial damage.

30
Q

What factors are in Group III (Contact)?

A

XI - Plasma Thromboplastin Anticedent
XII - Hangeman Factor
Fletcher
Fitzgerald

31
Q

When is the intrinsic pathway activated?

A

By contact with negatively charged solid surfaces (collagen, glass)

32
Q

What are the three steps of fibrin formation?

A

Proteolysis
Polymerization
Stabilization

33
Q

What does the first process ( proteolysis) of the fibrin formation do?

A

Thrombin splits fibrinogen into smaller parts (fibrin monomers)

34
Q

What halogens in the second step (polymerization) of the fibrin formation?

A

Monomers polymerize using weak hydrogen bonds.

35
Q

What happens in the third step (stabilization) of the fibrin formation?

A

Factor XIII promotes stronger covalent bonding between monomer, forming a strong fibrin polymer.

36
Q

What is the end result of the fibrin formation?

A

Platelets trapped in fibrin extend pseudopods to fibrin strands and pull the steams together - the clot retracts and becomes stronger.

37
Q

What is plasmin?

A

An enzyme that breaks fibrin and fibrinogen into small pieces.

38
Q

When plasmin breaks fibrin and fibrinogen into small pieces, what are the pieces called?

A

FDP - fibrin degradation products (fragments X, Y, D, E)

39
Q

What do FDPs do?

A

Inhibit platelet aggregation, fibrin polymerization, and thrombin.

40
Q

What do plasminogen activators do?

A

Activate plasminogen into plasmin

41
Q

What can plasminogen activators be used for?

A

Treat AMIs (heart attack), pulmonary embolism, and other vascular occlusions.

42
Q

What is ATIII (Anti - Thrombin III)?

A

Most active natural anticoagulant. Inhibits thrombin (also factors IX, X, XI, XII). Synthesized by liver, platelets, and endothelium.

43
Q

What is protein C?

A

Natural anticoagulant that inhibits factor V and VIII. Synthesized in liver and vitamin K dependent.

44
Q

What is the protein C - protein S pathway?

A

Major system involved in the regulation of blood coagulation and in the protection against thrombotic diseases.

45
Q

What does the common pathway represent?

A

The merging of the extrinsic and intrinsic pathways.

46
Q

What are some other names for Warfarin?

A

Coumarin or Coumadin

47
Q

What is Warfarin and what does it do?

A

An oral anticoagulant which inhibits Vitamin K synthesis in the liver. This makes it hard for body to make Group II

48
Q

How long does Warfarin last and how long does it take before it starts working?

A

8-12 hours before effects.

Last 72 hours.

49
Q

What is Warfarin measured with?

A

Prothrombin Time

50
Q

What are some natural coumarin sources?

A

Tonka beans, lavender, licorice, strawberries, apricots, cherries, cinnamon, sweet clover

51
Q

Why must Warfarin limit their sources of Vitamin K (kale, broccoli, okra)?

A

Because Warfarin inhibits Vitamin K, and if you have too much Vitamin K, you do not have enough Warfarin to inhibit all of it which could lead to you producing more clots.

52
Q

What is Heparin and what does it do?

A

An IV anti-coagulant that inhibits thrombin by enhancing anti-thrombin III and inactivating factors IIa and Xa.

53
Q

How long does Heparin usually last and how long does it take to take affect?

A

Effective within minutes after IV dosage and has short duration (half-life = 1 hr)

54
Q

What is Heparin measured by?

A

PTT test.

Partial Thromboplastin Test

55
Q

There are 2 forms of heparin, what are they and where do they come from?

A

UFH (unfractioned) from beef lung and pig intestines.

LMWH (low molecular weight) from purified form of UFH.

56
Q

What is factor V Leiden?

A

A Factor V mutation that results in prolonged survival of thrombotic activated factor V, following stimulation of the coagulation cascade, and increases risk of thrombosis.

57
Q

What is TPA?

A

Tissue plasminogen activator

Coagulation (2 decks)

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