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General Pathology > Thrombosis and Hemorrhage > Flashcards

Thrombosis and Hemorrhage Flashcards

1
Q

What are the main regulators of hemostasis

A

Anticoagulant proteins
Endothelial cells
Fibrinolysis

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2
Q

Who contributes the most to anticoagulation

A

Antithrombin (80%)

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3
Q

What does antithrombin degrade

A

II, IX, X
plasmin & kallikrein

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4
Q

What stimulates antithrombin

A

Heparin & family

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5
Q

Where does heparin live

A

On the endothelial cells

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6
Q

Protein C contributes to……

A

Anticoagulation

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7
Q

How is protein C activated

A

-Circulating in blood
-Complex between thrombin and thrombomodulin
-Binds to a receptor on the epithelium
-Then activates protein C

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8
Q

How does protein C contribute to anticoagulation

A

Once activated –>
Inactivates V and VIII

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9
Q

How do epithelial cells contribute to anticoagulation

A

HEALTHY endothelial cells release granules that inhibit platelet aggregation
Pro-fibrinolytic ‘carpet’

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10
Q

What enzyme makes fibrinolysis possible

A

plasmin

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11
Q

How is plasmin activated

A

Plasminogen (zymogen) activated by t-PA and u-PA

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12
Q

What makes the vessel itself anticoagulative

A

Glycocalyx ‘carpet’
Sheds when there is an injury to the vessel wall

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13
Q

What determines the severity of a thrombis

A

Alternative routes available
Needs of the cells in the occluded areas
How fast did it happed (was there time for angiogenesis to occur)

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14
Q

How do neutrophils contribute to immunothrombosis

A

Spit out nucleus –> proteins kick off coag cascade
Neutrophil extracellular traps can activate platelets

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15
Q

How do monocytes contribute to immunothrombosis

A

Upregulate tissue factor
Bleb off membranes (high in TF)

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16
Q

Is DIC a primary or secondary process

A

Secondary (always!)

17
Q

What is DIC (generally)

A

disseminated intravascular coagulation
Unregulated, unlocalized, inappropriate clotting

18
Q

Is DIC thrombotic or hemorrhagic

A

Both. Starts as thrombotic, but uses up the platelets so becomes hemorrhagic

19
Q

Why is DIC hard to diagnose

A

Clots can dissolve prior to necropsy because they’re so small
Coag tests are designed to measure a delay in clotting not the other way around

20
Q

How can you diagnose DIC

A

Measure the breakdown products (D-dimer)

21
Q

How are thrombocytopenia and bleeding related

A

A severe thrombocytopenia CAUSES bleeding—not the the other way around

22
Q

How are liver disease/damage and bleeding related

A

Liver not working –> no coag factors being produced or carboxylated

23
Q

What are the general causes of bleeding

A

Defects in primary hemostasis - platelet # or function, vWF issues, drugs, thrombocytopenia

Defects in secondary hemostasis - trauma, toxins, vessel wall damage

General Pathology (19 decks)

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