1 - Hemostasis and Coagulation Flashcards

(97 cards)

1
Q

Timing of Hemostasis:

Vasoconstriction (immediately)
Platelet adhesion
Platelet aggregation

A

Primary Hemostasis

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2
Q

Timing of Hemostasis:

Activation of clotting factors
Fibrin formation

A

Secondary hemostasis

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3
Q

Timing of Hemostasis:

Activation of fibrinolytic factors
Clot lysis

A

Fibrinolysis

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4
Q

Key players of Primary Hemostasis

A

Platelet
Blood vessels

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5
Q

Endpoint of primary hemostasis

A

Platelet plug

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6
Q

Key players of secondary hemostasis

A

Coagulation system
Enzymes
Cofactors
Platelets

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7
Q

End product of Secondary hemostasis

A

Stabilized fibrin clot

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8
Q

Key players of fibrinolysis

A

Fibrinolytic system

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9
Q

End product of fibrinolysis

A

Dissolution of fibrin clot (Healing)

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10
Q

Anticoagulant properties of Intact Vascular Intime

A
  1. Prostacyclin
  2. Nitric oxide
  3. Tissue Factor Pathway Inhibitor
  4. Thrombomodulin
  5. Heparan sulfate
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11
Q

providing a smooth inner surface of the blood vessel that prevents harmful turbulence that otherwise may activate platelets and coagulation enzymes

A

Rhomboid and contiguous ECs

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12
Q

separating procoagulant proteins and platelets in blood from collagen & tissue factor in fibroblasts and smooth muscle cells

A

ECs as a physical barrier

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13
Q

Platelet inhibitor and a vasodilator

A

Prostacyclin

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14
Q

induces smooth muscle relaxation and subsequent vasodilation, inhibits platelet activation, and promotes angiogenesis

A

Nitric oxide

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15
Q

Eicosanoid platelet inhibitor

A

Prostacyclin

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16
Q

vascular “relaxing” factor

A

nitric oxide

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17
Q

coagulation extrinsic pathway regulator

A

tissue factor pathway inhibitor

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18
Q

a protein C coagulation control system activator

A

thrombomodulin

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19
Q

Procoagulant properties of Damage Vascular Intima:

A
  1. Vasoconstriction
  2. Collagen
  3. von Willebrand factor
  4. ADAMTS-13
  5. P-selectin
  6. Intercellular adhesion molecules (ICAMs)
  7. Platelet endothelial cell adhesion molecules (PECAMs)
  8. Smooth muscle cells and fibroblasts
  9. Tissue factor
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20
Q

necessary for platelet adhesion to collagen

A

von Willebrand factor

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21
Q

promotes platelet leukocyte binding

A

P-selectin
ICAMs (Intercellular adhesion molecules)
PECAMs (Platelet endothelial cell adhesion molecules)

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22
Q

3 fibrinolytic properties:

A
  1. Tissue plasminogen activator (TPA)
  2. Plasminogen activator inhibitor-1 (PAI-1)
  3. Thrombin-activatable Fibrinolysis Inhibitor (TAFI)
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23
Q

A serine protease, activates fibrinolysis by converting plasminogen to plasmin

A

Tissue plasminogen activator (TPA)

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24
Q

TPA control protein that inhibits plasmin generation and fibrinolysis

A

Plasminogen activator inhibitor-1 (PAI-1)

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25
Thrombin-thrombomodulin complex
Thrombin-activatable Fibrinolysis Inhibitor (TAFI)
26
Activated by thrombin bound to EC membrane thrombomodulin
Thrombin-activatable Fibrinolysis Inhibitor (TAFI)
27
Platelets are produced from the cytoplasm of bone marrow
megakaryocytes
28
Platelets function: Plts roll and cling to non-plt surfaces, reversible
Adhesion
29
Give clinical significance for Adhesion
Bernard-Soulier Syndrome von Willebrand disease
30
Platelets function: Plts adhere to each other; irreversible
Aggregation
31
Give clinical significance for Aggregation
Glanzmann thrombasthenia Afibrinogenemia
32
Platelets function: Plts discharge the contents of their granules; irreversible
Secretion
33
Platelet granule: B-Thromboglobulin
a-granules
34
Platelet granule: Adenosine diphosphate
dense granules
35
Platelet granule: Factor V
a-granules
36
Platelet granule: Adenosine triphosphate
dense granules
37
Platelet granule: protein s
a-granules
38
Platelet granule: calcium
dense granules
39
Platelet granule: fibrinogen
a-granules
40
Platelet granule: serotonin
dense granules
41
Platelet granule: VWF
a-granules
42
Platelet granule: platelet factor 4
a-granules
43
Platelet granule: platelet-derived growth factor
a-granules
44
procoagulant enzymes that are in inactive form
zymogens
45
bind, stabilize, and enhance the activity of enzyme
cofactors
46
examples of zymogens
Factor 7, 9, 10, 11, 12, 13 Prekallikrein Prothrombin
47
examples of cofactors
Factor V, VIII Protein Z HMWK Tissue factor Protein S Thrombomodulin
48
Factor I
Fibrinogen
49
Plasma coagulants: Thrombin substrate, polymerizes to form fibrin
Factor I - Fibrinogen
50
Factor II
Prothrombin
51
Factor III
Tissue factor
52
Factor IV
Ionic calcium
53
Factor V
Proaccelerin
54
Plasma coagulants: Stable factor, Serum prothrombin conversion accelerator, Autoprothrombin I, Cothromboplastin
Factor VII - Proconvertin
55
Factor VIII
Antihemophilic factor
56
Factor IX
Christmas factor
57
Factor X
Stuart-Prower factor
58
Factor XI
Plasma Thromboplastin Antecedent (PTA)
59
Factor XII
Hageman factor
60
Prekallikrein
Fletcher factor, pre-K
61
High molecular weight kininogen
Fitzgerald factor, HMWK
62
Factor XIII
Fibrin-stabilizing factor (FSF)
63
example of control proteins
1. Antithrombin 2. Heparin cofactor II 3. TFPI 4. Protein C 5. a2-macroglobulin 6. a1- antitrypsin 7. ZPI
64
Vitamin K is a quinone found in green leafy vegetables and is produced by the intestinal organisms
Bacteriodes fragilis Escherichia coli
65
3 Groups of coagulation factors
1. Thrombin sensitive group (Factors I, V, VIII, XII) 2. Vitamin K dependent group (Factors II, VII, IX, X, PROTEIN C, S, and Z) 3. Contact group (Factors XI, XII, pre-K, HMWK)
66
Receptor dor FVIIa
Tissue factor
67
Activated by thrombin and inactivated by protein C
Factors V and VIII
68
cofactor to XIIIa and prekallikrein
HMWK
69
coagulation control cofactors
1. Thrombomodulin 2. Protein S 3. Protein Z
70
Thrombin cofactor, fibrinolysis; when bound to thrombin activates protein C and TAFI
Thrombomodulin
71
Cofactor to protein C
Protein S
72
Two phases of Coagulation:
1. Initiation 2. Propagation
73
Two phases of Coagulation: Occurs on tissue-factor bearing cells
Initiation
74
Two phases of Coagulation: Occurring on platelets
Propagation
75
Principal regulators of Coagulation
1. Tissue factor pathway inhibitor (TFPI) 2. Activated protein C (APC) 3. Antithrombin (AT)
76
The final stage of hemostatic activation
Fibrinolysis
77
Binds to the lysine moieties on the fibrin molecule
plasminogen
78
active form of plasminogen
plasmin
79
plasminogen activation:
1. Tissue Plasminogen Activator (TPA) 2. Urokinase Plasminogen Activator (UPA)
80
Control of Fibrinolysis
1. Plasminogen activator inhibitor-1 (PAI-1) 2. Alpha 2-Antiplasmin 3. Thrombin activatable fibrinolysis inhibitor (TAFI)
81
Or soft tissue hemorrhage - a generalized bleeding that is seen in acquired or congenital defects in secondary hemostasis
Anatomic hemorrhage
82
Pattern of inheritance in which the transmission of a dominant allele on an autosome causes a trait to be expressed in heterozygotesv
Autosomal dominant
83
Pattern of inheritance resulting from the transmission of a recessive allele that is not expressed in heterozygotes
Autosomal recessive
84
Hemorrhagic spot, 1 cm or larger in dm, typically forming an irregular blue or purplish patch.
Ecchymoses
85
Nosebleed that requires intervention
Epistaxis
86
Bleeding from multiple sites, spontaneous and recurring bleeds, or hemorrhage that requires physical intervention of transfusion
Generalized hemorrhage
87
Chronic joint bleeds that cause inflammation and immobilization
Hemarthroses
88
Vomiting of bright red blood
Hematemesis
89
Localized collection of extravasated blood, usually clotted, in an organ space or tissue
Hematoma
90
Intact RBCs in the urine
Hematuria
91
Free hemoglobin in the urine
Hemoglobinuria
92
Expectoration of blood secondary to hemorrhage in the larynx, trachea, bronchi and lungs
Hemoptysis
93
Passage of fresh, red blood in your stool
Hematochezia
94
Stool containing dark red or black blood
Melena
95
Abnormally heavy or prolonged menstrual periods
Menorrhagia
96
Pinpoint purple or red spots on the skin or mucous membranes, approx 1 mm in dm
Petechiae
97
Purple skin discoloration, typically rounded with a dm of greater than 3 mm
purpura