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CV II Exam 2 > Thrombosis I > Flashcards

Thrombosis I Flashcards

1
Q

primary hemostasis

A

platelet plug formation

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2
Q

secondary hemostasis

A

coagulation cascade

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3
Q

hemostasis sequence

A

endo injury/dysfunction - vasoconstriction

primary hemostasis

secondary hemostasis

antithrombotic activity

fibrinolysis

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4
Q

virchows triad

A

1 endo injury
2 prothrombotic state
3 abnormal flow

contribute to thrombosis
-endo most important - can cause other 2

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5
Q

economy class syndrome

A

stasis

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6
Q

hypercoagulability

A

antithrombin, protein C, protein S deficiency

protein C resistance - factor V leiden

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7
Q

Gp1b

A

platelets bind to vWF on endo via this receptor

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8
Q

GpIIbIIIa

A

platelets aggregate to one another by this receptor to fibrinogen

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9
Q

favor platelet aggregation

A

ADP and TxA2

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10
Q

factor XIII

A

important for cross linking of fibrin

-makes final clot strong

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11
Q

PGI2

A

inhibit platelet aggregation

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12
Q

protein C pathway

A

inhibit coagulation

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13
Q

heparin and antithrombin III

A

inhibit coagulation

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14
Q

tPA

A

finbrinolysis

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15
Q

plasmin

A

fibrinolysis

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16
Q

plasminogen activator inhibitor

A

inhibit fibrinolysis

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17
Q

alpha-2 antiplasmin

A

inhibit fibrinolysis

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18
Q

alpha-2 macroglobulin

A

inhibit fibrinolysis

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19
Q

vWF

A

binds GpIb

but also can bind GpIIbIIIa (bridge platelets)

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20
Q

intrinsic clotting pathway

A

XII > XIIa
XIIa: PK to K and XI > XIa
XIa: IX > IXa

IXa and VIIIa with Ca and phospholipid**
-results in X >Xa (to common pathway)

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21
Q

kallikrein

A

feedback to more XII > XIIa

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22
Q

extrinsic clotting pathway

A

Tissue factor + VII > VIIa

VIIa with calcium: X >Xa (to common pathway)

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23
Q

common clotting pathway

A

Xa, Va, calcium, and phospholipid
-results in II > IIa (prothrombin > thrombin)

IIa:many effects of thrombin

  • XI >XIa (intrinsic)
  • VIII > VIIIa (intrinsic)
  • V > Va (common)
  • XIII > XIIIa - with calcium
  • fibrinogen > fibrin - with calcium
24
Q

XIIIa

A

cross-linking of fibrin

25
Q

TFPI

A

inhibit TF:VIIa complex from:

  • IX > IXa (extrinsic)
  • X > Xa (Ca dependent)
26
Q

thrombin activity through PAR

A

PAR = protease activated receptor

  • induces TxA2 - platelet aggregation
  • activated endo cells
  • activates leukocytes
27
Q

aPTT

A

measure of intrinsic pathway

-citrated plasma, Ca, phospholipid, activating surface (glass bead or kaolin)

28
Q

PT

A

measure of extrinsic pathway

-citrated plasma, Ca, phospholipid, tissue factor

29
Q

intrinsic tenase complex

A

on phospholipid surface

  • VIIIa and IXa
  • convert X > Xa
30
Q

extrinsic tenase complex

A

on phospholipid surface

  • VIIa, TF, and Ca
  • convert X > Xa
31
Q

prothrombinase complex

A

on phospholipid surface

  • Va and Xa
  • convert prothrombin > thrombin (II > IIa)
32
Q

VIII

A

complexe with vWF in circulation

33
Q

hageman factor

A

XII

34
Q

christmas factor

A

IX

35
Q

stuart-prower factor

A

X

36
Q

labile factor

A

V

37
Q

fibrinogen

A

I

38
Q

fibrin

A

Ia

39
Q

TT

A

thrombin time

  • measure of citrated plasma and thrombin
  • if think pt has fibrinogen problem
40
Q

tissue factor

A

III

41
Q

calcium

A

IV

42
Q

factor VI

A

activated factor V

43
Q

Vit K dependent factors

A

II, VII, IX, X

-no activated carboxylase groups

44
Q

warfarin

A

affects Vit K dependent factors

2, 7, 9, 10

45
Q

unfractionated heparin

A

affects 12, 11, 9, 7, 10, 2

46
Q

low MW heparin

A

fractionate

-affects only Xa

47
Q

antithrombin

A

works on activated factors

IIa, Xa, VIIa, IXa, XIa, XIIa

48
Q

Vit K

A

works on factor synthesis

2, 7, 9, 10

49
Q

factor VII deficiency

A

pro-thrombotic state

-problem with thrombosis

50
Q

protein C and S

A

block amplification

51
Q

clotting cascade in vivo

A

TF, Ca, VIIa - convert IX > IXa
IXa and VIIIa: X > Xa
Xa and Va: prothrombin > thrombin
thrombin: fibrinogen > fibrin

52
Q

thrombin effects

A 
VIII > VIIIa
XI > XIa
V > Va
fibrinogen > fibrin
XIII > XIIIa
53
Q

thrombomodulin

A

binds thrombin

  • which goes and activates protein C
  • active protein C and protein S result in proteolysis of factors Va and VIIIa
54
Q

proteolysis of factors Va and VIIIa

A

end result of thrombomodulin

55
Q

heparin like molecules

A

with antithrombin III _ inactivate thrombin and Xa and IXa

56
Q

thrombin receptor

A

on endo cells
-binds thrombin

  • causes endo release of PGI2, NO, adenosine diphosphatase - inhibitors of platelet aggregation
  • also cause release of tPA - initiate fibrinolysis

CV II Exam 2 (18 decks)

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