Week 7

Question 1

action of clotting factor

Answer 1

prothrombin to thrombin

Question 2

effect of thrombin

Answer 2

fibrinogen to fibrin (insoluble keeps clot)

Question 3

waht is a platelets action

Answer 3

adhere to each other to form a clot paltelets red blood cesll held together by fibrin

Question 4

What is in dense granules of platelet

Answer 4

small molecules driving activating)

Question 5

waht is in alpha granules of platelets

Answer 5

contain secreted prtteins such as clotting factors and PDGF-

Question 6

thrombopoeisis pathway

Answer 6

Hemocytoblast- stem cells
Promegakaryocyte
Megakaryocyte- release platelets

Question 7

what is thrombocytosis and what this does

Answer 7

high platelet count

unwanted clotting- occlusion and ischemia

Question 8

what causes thrombocytosis

Answer 8

splenectomy, after hemorrhage, myloproliferative disorders such as CML

Question 9

what is Thrombocytopenia

Answer 9

paltelets below 150,000 mm3

Question 10

waht causes Thrombocytopenia

Answer 10

Idiopathic thrombocytopenis perpura (ITP)
Bleeding disorder in which immune system destroys platelets
Leukemia, infections

Question 11

what causes platelet aggregation

Answer 11

Fibers of collagen not usually exposed to the bloodstream but damage such as atherosclerosis causes collagen to be exposed and recognized by
GP1b complex recognizes VMF then GPVI is activated so granules are released

Question 12

aggregates released by platelets

Answer 12

Thromboxane A2 (TXA2) and ADP

Question 13

action of clopidogril

Answer 13

inhibits ADP binding with P2Y12- so the level of cAMP increases in the patlet which inhibits it – prevents unwanted clotting

Question 14

where is clopidogril metabolised

Answer 14

liver to active metabolites

Question 15

what is clopidogril

Answer 15

Oral anti-platelet- often used to treat coronary artery disease, reduce risk of stroke

Question 16

what causes low bioaviability of clopidorgil

Answer 16

85% iof drug is immediately eliminated by esterases

Question 17

waht happens toa ctive metabolites

Answer 17

15% enters 2-OXO-clopidogrel and then second step to ctive metabolite

Question 18

limitations of clopidorgril

Answer 18

Low efficiency-
Reliance on hepative processing casues interindividual variability
compelx determination

Question 19

gene involved in metabolizing clopdogril

Answer 19

CYP2C19

Question 20

alternatives to clopidogrel

Answer 20

Prasugrel- simimpler convertion- faster action and elss resistance as not reliant upon hepatic system
Ticagrelor- no conversion/ faster action
Cangrelor- no conversion/ less resistance

Question 21

poor metaboliser of clopidogrel

Answer 21

not likely to receive full benefit- increased risk for heart attack (3%)

Question 22

intermediate metaboliser of clopidogrel

Answer 22

may not receive fill benefit- possible increased risk for ehart attacka dn stroke (20%)

Question 23

extensive metaboliser of clopidogrel

Answer 23

expected to benefit from standard clopidogrel dose (38%)

Question 24

ultra rapid metaboliser of clopidogrel

Answer 24

expected to process medication more quick;y- possible increased benefit possible increased risk for bleeding (32%)

Question 25

Drugs effecting clopidogrel

Answer 25

NSAIDS- GI bleeding

proton pump inhibitors - less liely to prevent clots