W11 P: Molecular background of acquired thrombophilia. Fibrin stabilization and the study of soluble fibrin monomers

Question 1

Name 2 proteases that has the function of a procoagulant

Answer 1

Thrombin
FVIIa

Question 2

Name 2 cofactors that has the function of a procoagulant

Answer 2

FVa
FVIIIa

Question 3

What happen if there is hyperactivity in anticoagulants?

Answer 3

Causing thrombophilias

Question 4

Name 3 procoagulants (except proteases and co-factors)

Answer 4

1. Tissue factor (TF)
2. Fibrin
3. Platelets

Question 5

What happens if there is a dysfunction in procoagulants?

Answer 5

Coagulopathy

Question 6

2 types of coagulopathy

Answer 6

1. congenital (hemophilias)
2. acquired

Question 7

What happen if there is hyperactivity in procoagulants?

Answer 7

Leading to Thrombophilias

Question 8

What are the symptoms of thrombophilias?

Answer 8

1. congenital
2. acquired

Question 9

Name anticoagulants (6)

Answer 9

1. Antithrombin
2. Protein C and S
3. TF pathway inhibitor
4. Fibrinolytic system
5. Endothelial cells

Question 10

Name the enzymes

Answer 10

Question 11

name the inhibitors

Answer 11

Question 12

APC resistance is the main pathway of ___

Answer 12

membrane bound FVa inactivation

Question 13

Consequences of Leiden mutation?

Answer 13

Increase of lifetime of prothrombinase and tenase complexes
-> Thrombophilia

Question 14

Do Coagulation complexes need phospholipids?

Answer 14

yes!

Question 15

Name 2 experiments for Detection of APC resistance

Answer 15

-Functional assay of APC resistance (by APTT reagent)
-PCR: detection of FVR506Q point mutation

Question 16

Activated Partial Thromboplastin Time (APTT)
-> Steps of intrinsic pathways

Answer 16

Question 17

Example of Therapy of APC resistance

Answer 17

Chronic oral anticoagulation with coumarin-derivatives

Question 18

An example of Therapy of APC resistance is “Chronic oral anticoagulation with coumarin-derivatives”
-> What is the mechanism for this?

Answer 18

Coumarin
-> inhibited vit K reductaseno vit K cofactor
-> no Gla synthesis
-> no clotting complexes
-> longer clotting time/no thrombosis

Question 19

Functional assay of APC resistance
-> What does it mean when we have normal Activated Partial Thromboplastin Time (APTT)?

Answer 19

No coagulation factor deficiency in APC resistance

Question 20

Functional assay of APC resistance
-> What happen if we add APC to normal plasma?

Answer 20

APTT will elongate more than 2x

Question 21

Functional assay of APC resistance
-> What happen if we add APC to FV Leiden plasma?

Answer 21

APTT will slightly elongate

Question 22

Prothrombin time (PT)
-> Steps of extrinsic pathway

Answer 22