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Blood and Lymph Mine > Unit 3 Coagulation > Flashcards

Unit 3 Coagulation Flashcards

1
Q

Factors that require vitamin K:

A 
Vitamin K activates clotting and fibrinolysis factors
factor II
factor VII
factor IX
factor X 
protein C 
protein S
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2
Q

PT/INR

A

-measures extrinsic pathway

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3
Q

aPTT

A
  • take out tissue factor
  • just have phospholipid
  • measures intrinsic pathway
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4
Q

Hemophilia A

A
  • deficiency in factor 8
  • inc aPTT
  • muscle bleeding, bruising
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5
Q

Hemophilia B

A
  • deficiency in factor 9
  • inc. aPTT
  • muscle bleeding, bruising
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6
Q

Factor 5 Leiden

A
  • mutation in factor 5 that inhibits it from getting inactivated by protein C
  • inc. clotting
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7
Q

Von Willebrand Disease

A

-most common bleeding disorder
-VW factor stored in weibel pilate bodies
-treated with desmopressin (DDAVP) before procedures (only works type 1)
-Type 1- low amounts
-Type 2- nonfunctional
Type 3- not present at all

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8
Q

Bernard-Soulier

A

-deficiency of GP1B

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9
Q

Immune Thrombocytopenic Purpura (ITP)

A
  • antibodies attack platelets
  • acute and chronic
  • tx: steroids, IVIG (overwhelms immune system), rituximab (lowers B cells), splenectomy
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10
Q

Bleeding Time Test

A

-does not diagnose factor deficiencies

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11
Q

Primary Hemostasis

A
  • platelet plug formation
  • measure with bleeding time or PFA100
  • defects lead to mucocutaneous bleeding
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12
Q

prothrombin G20210A

A

x

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13
Q

Plasmin

A

The key enzyme responsible for clot digestion (fibrinolysis).
-plasminogen is incorporated into clots and is activated by tPA and uPA, and it becomes plasmin

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14
Q

D-Dimer Test

A

x

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15
Q

Glycoprotein 2b3a

A

x

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16
Q

Heparin

A
  • cofactor for antithrombin which greatly increases its ability to inactivate thrombin
  • works in intrinsic pathway
  • effects are immediate
  • safe in pregnancy
  • protamine reverses unfractionated heparin
  • unfractionated heparin inactivates thormbin and factor 10 (IV)
  • low molecular weight heparin also possible- inactivates factor 10 (injection)
  • can be reversed with protamine sulfate (opposite charge of heparin) (hep is -)
  • heparin induced thrombcytopenia- antibodies attack platelet factor 4-heparin complexes- tx in future with argatroban or leparudin
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17
Q

Warfarin

A
  • works on extrinsic pathway
  • takes a while for effects to begin (4 or 5 days)
  • teratodenic- do not use in pregnant people
  • oral
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18
Q

Desmopressin

A
  • DDAVP
  • stimulates VWF
  • temporarily stop sx of VW disease
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19
Q

Argatroban

A

-drug that would be given if heparin is not working

20
Q

mucocutaneous bleeding

A

-associated with platelets, VWF, and adherance

21
Q

Idiopathic Thrombocytopenic Purpura

A

-antibody mediated destruction of platelets

22
Q

TTP

A

ADAM

23
Q

lupus anticoagulant

A
  • antibodies mess up aPTT making it appear long
  • pt is actually at risk for clots
  • do mixing tests to confirm
24
Q

citrate in blood tests

A
  • chelates calcium

- add calcium when ready to run test

25
Q

intrinsic tenase complex

A
  • factors 8, 9, 10

- activates factor 10

26
Q

extrinsic tenase complex

A
  • TF and factor 7

- activates factor 10

27
Q

prothrombinase

A

-factor 5, factor 10, prothrombin (factor 2)

28
Q

factor 13

A
  • covalently binds fibrins together in clot

- measuring of D-dimer is measurement of two fibrins between crosslink

29
Q

central enzyme in blood coagulation

A

-thrombin

30
Q

protein C

A
  • protein S is cofactor
  • activated by thrombin thrombomodulin to APC
  • secondarily activated by vitamin K
31
Q

tissue factor pathway inhibitor

A
  • binds to 10a and then can bind to factor 7 and TF

- inhibits extrinsic pathway

32
Q

plasminogen activation inhibitor 1 (PAI-1),

A
  • inhibits fibrinolysis

- inhibits plasminogen activation by inibiting tPA and uPA

33
Q

alpha2-antiplasmin

A
  • inhibits fibrinolysis

- inhibits plasmin directly

34
Q

thrombin-activatable fibrinolysis inhibitor (TAFI)

A

-activated by thrombo-thrombomodulin (which also activates protein C

35
Q

endothelial lining prevention of clots

A
  • makes heparin
  • expressed thrombomodulin
  • makes tPA and uPA
  • vasodilates
36
Q

secondary hemostasis

A

-coagulation cascade arm of hemostasis

37
Q

3 Functions of Platelets

A
  • adhere to endothelium and release granules
  • aggregate and form plug
  • provide phospholipid surface to support coag cascade
38
Q

lupus anticoagulant

A
  • have high aPTT but pt presents with clot
  • antiphospholipid antibody
  • causes clotting
  • associated with lupus
  • inc. risk of arterial and venous clotting
39
Q

thrombin time (TT) test

A
  • add thrombin to plasma

- if inc. it indicates problem with fibrinogen

40
Q

DIC

A

-associated with ebola and APML

41
Q

Mixing Studies

A
  • mix pt plasma and normal plasma

- determines inhibitor vs. deficiency in clotting factors

42
Q

Test for Hypercoagulability

A

-factor assay

43
Q

Tissue Plasminogen Activator

A
  • activates plasminogen to plasmin
  • fibrinolytic agent
  • use only in emergencies
  • give at high dose compared to amount in body
44
Q

Fibrinolytic Drugs

A
  • break down fibrin
  • break clots that are already there
  • tissue plasminogen activator
45
Q

Anti Platelet Drugs

A
  • aspirin- prevents formation of thromboxane
  • prevent clots from forming
  • GP2B3A inhibitors
  • ADP receptor blockers (plavix)
  • works in arterial clots best

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