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HEM Exam 1 > Hemostasis and Thrombosis > Flashcards

Hemostasis and Thrombosis Flashcards

1
Q

purpose of hemostatic system

A
  • helps to ensure that blood is confined to and flows freely within the circulatory system
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2
Q

how the normal hemostatic system limits blood loss

A
  • precisely regulated interactions between components of vessel wall, circulating blood platelets, and plasma proteins
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3
Q

common clinical manifestations of many diseases

A
  • hemorrhage
  • intravascular thrombosis
  • embolism
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4
Q

the two mechanisms underlying the arrest of bleeding

A
  • vasoconstriction

- formation of a hemostatic plug

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5
Q

vasoconstriction

A
  • narrowing of blood vessels to help prevent further blood loss
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6
Q

formation of a hemostatic plug

derived from

A
  • thrombus or clot

- derived from platelets and fibrin strands in which RBCs and WBCs are trapped

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7
Q

hemostasis is

A
  • the arrest of bleeding following vascular injury
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8
Q

hemostasis is dependent on interactions between

A
  • platelet adhesion and aggregation
  • endothelial cell function
  • blood coagulation system
  • clot lysis (fibrinolysis) system
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9
Q

primary hemostasis
secondary hemostasis
tertiary hemostasis

A
  • aggregation/endothelium
  • coagulation
  • fibrinolysis
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10
Q

components of primary hemostasis

A
  • blood vessels

- platelets

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11
Q

blood vessels designed for

A
  • smooth movement of blood from the heart to the tissues and back
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12
Q

the surface of blood vessels is considered to be

A
  • an anticoagulant surface
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13
Q

the purpose of blood vessels being an anticoagulant surface

A
  • prevents a clot from forming on their surface
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14
Q

platelets help to

A
  • maintain the integrity of the vessel lining

- plug any rupture in the circulatory vessels

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15
Q

normal intimae that suppress hemostasis

A
  • prostacyclin
  • heparan sulfate
  • tissue factor pathway inhibitor
  • nitric oxide
  • thrombomodulin

to suppress hemostasis you need Pretty Huge TNT

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16
Q

platelets are formed from

A
  • the cytoplasm of bone marrow megakaryocytes
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17
Q

size of platelets

A
  • smallest of the blood cells
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18
Q

normal platelet count

A
  • 150-450x10^9 per liter
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19
Q

normal platelet lifespan

A

7-10 days

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20
Q

shape of platelets

A
  • disc shaped
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21
Q

structure of platelets

that reflects?

A
  • complex internal structure

- reflects the specific hemostatic functions of the platelet

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22
Q

flow of hemostasis

A
  • vascular integrity breached
  • procoagulation (initiate)
  • anticoagulation (stop)
  • fibrinolysis (clear out)
  • vascular integrity restored
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23
Q

consequences of either abnormal or uncontrolled hemostasis

A
  • bleeding (hemorrhage)

- thrombosis (venous or arterial)

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24
Q

blood coagulation system composed of

and they are called

A
  • a series of specific plasma proteins

- coagulation factors

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25
Q

how coagulation factors interact

A
  • in a highly ordered sequence
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26
Q

ultimate object of coagulation factors

A
  • convert soluble fibrinogen into insoluble fibrin

- stabilize primary hemostatic plug

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27
Q

coagulation factors referred to by

A
  • Roman numerals
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28
Q

coagulation factors named by

A
  • order of discovery
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29
Q

coagulation factor 1

A
  • fibrinogen

FOOLISH

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30
Q

coagulation factor 2

A
  • prothrombin

PEOPLE

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31
Q

coagulation factor 3

A
  • tissue thromboplastin (factor)

TRY

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32
Q

coagulation factor 4

A
  • calcium

CLIMBING

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33
Q

coagulation factor 5

A
  • labile factor

LONG

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34
Q

coagulation factor 6

A
  • not used
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35
Q

coagulation factor 7

A
  • stable factor

SLOPES

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36
Q

coagulation factor 8

A
  • anti hemophilic factor

AFTER

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37
Q

coagulation factor 9

A
  • Christmas factor

CHRISTMAS

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38
Q

coagulation factor 10

A
  • stuart factor

SOME

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39
Q

coagulation factor 11

A
  • anti hemophilic factor C

AWFUL HUMANS

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40
Q

coagulation factor 12

A
  • hageman factor

HAVE

41
Q

coagulation factor 13

A
  • fibrin stabilizing factor

FALLEN

42
Q

secondary hemostasis composed of

A
  • zymogens/active enzymes
  • cofactors
  • non-protein cofactors
  • fibrinogen and factor XIII
43
Q

zymogens/active enzymes

A
  • vitamin K dependent

- vitamin K independent

44
Q

vitamin K dependent factors

A
  • 2
  • 7
  • 9
  • 10
45
Q

vitamin K independent factors

A
  • 11
  • 12
  • 13
46
Q

cofactors

A
  • factor 5
  • factor 7
  • tissue factor
  • von Willebrand factor
47
Q

non protein factors

A
  • calcium

- phospholipid surfaces

48
Q

calcium found where

A
  • in blood
49
Q

phospholipid surfaces found where

A
  • from cells
50
Q

purpose of thrombin

A
  • fibrinogen -> fibrin
51
Q

purpose of activated factor XIII

A
  • cross link fibrin
52
Q

plasma concentration of factor 7

A

0.5

53
Q

half life of factor 7

A

3-6 hours

54
Q

plasma concentration of factor 8

A

0.1-0.2

55
Q

half life of factor 8

A

8-12 hours

56
Q

trauma to blood vessel exposes

A
  • collagen and tissue factors
57
Q

trauma to blood vessel triggers

A
  • platelet adhesion and aggregation
58
Q

primary hemostasis process

A
  • injury exposes collagen
  • vWF
  • initial hemostatic plug
59
Q

activated platelets release

A
  • granule contents
60
Q

granule contents examples

A
  • ADP

- TXA2

61
Q

purpose of ADP, TxA2

A
  • recruit more platelets

- promote aggregation

62
Q

platelet glycoprotein IIb/IIIa type of receptor

A
  • integrin receptor
63
Q

platelet gycoprotein IIb/IIIa function

A
  • adheres to fibrinogen
  • enhances aggregation
  • stabilizes thrombus
64
Q

activated platelets also release

A
  • coagulation factors

- promote coagulation process

65
Q

growing platelet thrombus stabilized by

A
  • fibrin
66
Q

what is trapped in the thrombus

A
  • RBC/WBC
67
Q

what do endothelial cells release

A
  • prostacyclin

- nitric oxide

68
Q

purpose of releasing prostacyclin and nitric oxide

A
  • inhibit further platelet aggregation
69
Q

critical role of platelets in

A
  • primary hemostasis
70
Q

critical role of blood coagulation proteins

A
  • secondary hemostasis
71
Q

extrinsic pathway of coagulation cascade

A
  • VII activates TF(Tissue Factor)+VIIa
  • TF+VIIa -> X
  • X->Xa+Va
  • Xa+Va activates Prothrombin-> Thrombin
  • Thrombin activates Fibrinogen->Fibrin
72
Q

intrinsic pathway

A
  • XIa activates IXa and VIIIa
  • IXa and Vllla -> Xa+Va
  • Xa+Va activates Prothrombin-> Thrombin
  • Thrombin activates Fibrinogen->Fibrin
73
Q

other part of pathway

A
  • HMWK/Prekallikrein activates XII->XIIa
  • XIIa activates XI->XIa
  • XI activates IX->IXa for intrinsic pathway
74
Q

what activates Va

A
  • V
75
Q

platelets primary stage

A
  • subendothelial collagen
  • vWF -> platelet adhesion
  • platelet adhesion -> platelet activation
  • platelet activation -> platelet aggregation by ADP TxA2
76
Q

Fibrinolysis tertiary pathway

A
  • plasminogen-> plasmin by tPA

- fibrin -> fibrin degradation products by plasmin

77
Q

the end of blood coagulation result

A
  • thrombus (clot)

- “hemostatic plug”

78
Q

thrombus formation following vessel wall injury

A
  • vascular injury
  • platelet activation
  • activation of coagulation
  • thrombin forms thrombus
79
Q

initiation steps

A
  • vascular injury
  • platelet activation
  • activation of coagulation
80
Q

amplification steps

A

Thrombin feedback to amplify and create a lot more thrombin!

81
Q

burst steps

A

Creates massive amount of thrombin to cleave fibrinogen.

82
Q

factor VIII inheritance

A
  • X-linked
83
Q

factor IX inheritance

A
  • X-linked
84
Q

fibrin monomer polymerizes

A
  • end to end
  • side to side
  • in nonenzymatic process
85
Q

stable fibrin clot formed when

A
  • fibrin-stabilizing factor (13) covalently links the adjacent domains of three fibrin monomers through gamma chains
86
Q

what type of molecule is fibrin stabilizing factor

A
  • factor XIII
87
Q

What activates XIII to XIIIa

A
  • Thrombin
88
Q

fibrinogen molecule formed from

A
  • three protein molecules present in the molecule in pairs
89
Q

three protein molecules

A
  • A alpha
  • B beta
  • gamma
90
Q

the central part of the fibrinogen molecule is the

A
  • E domain
91
Q

the distant ends of the fibrinogen molecule are the

A
  • D domain
92
Q

thrombin action on fibrinogen

A
  • cleaves two small activation peptides from fibrinogen to form fibrin
93
Q

what is D dimer

A
  • degradation product of cross linked fibrin
94
Q

what does D dimer reflect

A
  • ongoing activation of the hemostatic system
95
Q

D dimer levels of healthy individuals

A
  • low
96
Q

elevated D dimer levels could indicate

A
  • ongoing activation of hemostatic and thrombolytic system
97
Q

coagulation complex that provides in vivo trigger to initiate blood clotting

A
  • tissue factor/VIIa
98
Q

anticoagulant property of thrombin

A
  • complex with thrombomodulin

HEM Exam 1 (22 decks)

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