Thrombophilia

Question 1

Discuss the mechanism by which coagulation is inhibited by tissue factor pathway inhibitor (TFPI)

Answer 1

Inhibits the TF pathway by inactivating Factor VIIa

Due to the action of TFPI: TF-VIIa is short lived and coagulation amplification occurs primarily through XI

Question 2

The origin of Protein C (and Protein S)

Answer 2

synthesized in the liver

Question 3

What are protein C, and S dependent upon?

Answer 3

Vitamin K

Question 4

What is the principle of Protein C & S by which coagulation is inhibited and affected factors?

Answer 4

It inactivates Va and VIIIa and may cause recurrent thromboses (blood clot)

Question 5

State the condition that is responsible for the most commonly inherited cause of thrombophilia

Answer 5

Activated Protein C resistance (APCR)–Called Factor V Leiden mutation

Question 6

The origin of antithrombin.

Answer 6

Liver

Question 7

Is antithrombin dependent upon Vitamin K?

Answer 7

No

Question 8

Principle of Antithrombin (AT) by which coagulation is inhibited, including affected factors.

Answer 8

Serine protease inhibitor (SERPIN)

Irreversibly binds & neutralizes the serine proteases in the intrinsic pathways: XIIa, XIa, IXa, Xa, Thrombin (IIa);

Question 9

In the Antithrombin, When no heparin is present, AT’s binding with the serine proteases is a __________ reaction

Answer 9

Slow progressive reactions

Question 10

When either endothelial cell heparan or exogenously administered ____is present, _____ binding with the serine proteases is _____ and enhanced 1,000-fold!!

Answer 10

Heparin is present; AT’s binding; Immediate

Question 11

The effect of deficiency states of Antithrombin (AT) and protein C (protein S)

Answer 11

May cause recurrent thromboses

Question 12

List eight factors that predispose a person to thrombosis.

Answer 12

Age, Hereditary, Immobilization/stasis, smoking, malignancy, injury to vessels (trauma, surgery), Elevated estrogens (Low Protein S, C, AT), Inflammation, Anti-phospholipid syndrome

Question 13

State three types of thromboses.

Answer 13

Arterial thromboses
Microcirculatory (TTP, HUS, DIC)
Venous thromboses

Question 14

What is the process by which arterial thrombosis are formed?

Answer 14

Result of a disease process which causes major damage in a vessel wall: Myocardial infract and Arteriosclerosis

Question 15

Major component of Arterial thrombosis.

Answer 15

Platelets

Question 16

Treatment for arterial thrombosis

Answer 16

anti-platelet drugs: Aspirin, Plavix

Question 17

What is the process by which venous thrombosis are formed?

Answer 17

Result of a major stasis in blood flow: DVT, Pulmonary embolus

Question 18

Major component of venous thrombosis.

Answer 18

Fibrin

Question 19

Treatment for venous thrombosis.

Answer 19

Anti-fibrin drugs: Heparin, Coumadin

Question 20

Defined as predisposition of thrombosis secondary to a congenital or acquired disorder

Answer 20

Thrombophilia

Question 21

Defined as inappropriate formation of platelet or fibrin clots that obstruct vessels.

Answer 21

Thrombosis

Question 22

Defined as any foreign object in the bloodstream such as air, bullet, clot.

Answer 22

Embolus