bleeding and thrombosis Flashcards

1
Q

what happens as a result of blood vessel damage

A

normal flow is altered
collagen is exposed
blood vessel releases TF
adrenaline is released

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2
Q

function of platelets in blood vessel damage

A

detect abnormal surface (collagen)
become activated
have glycoproteins that bind to clotting factors

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3
Q

how do platelets stick to collagen

A

via glycoproteins on their cell surface

von willebrand factor is important for platelet adhesion

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4
Q

what is aggregation

A

when the phospholipids on the internal surface of the platelet move to the external surface

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5
Q

what enzyme is involved in aggregation

A

scramblase

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6
Q

what is the purpose of aggregation

A

creates a site for coagulation reactions

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7
Q

how does a primary platelet clot form

A

platelets all stick together via glycoproteins

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8
Q

how is fibrin produced

A

thrombin binds to fibrinogen and cleaves it producing fibrin

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9
Q

what is fibrinogen

A

precursor of fibrin

requires all the clotting agents to be working for it to become cleaved

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10
Q

how is thrombin formed

A

factor X cleaves prothrombin into thrombin

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11
Q

what is a clot made up of

A

platelets and fibrin mesh

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12
Q

what is t-PA and u-PA

A

molecules released by endothelial cells that cleave plasminogen to male plasmin

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13
Q

what does plasmin do

A

breaks down fibrin clot

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14
Q

plasminogen inhibitors

A

PAI-1

PAI-2

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15
Q

what is the main source of PAI-1

A

adipose tissue

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16
Q

what are d-dimers

A

fibrogen degeneration products

raised if there has been thrombosis

17
Q

what is TFPI

A

natural anticoagulant

18
Q

how does TFPI work

A

inhibits factors 7 and 10

this means less thrombin will be produced

19
Q

what is protein C

A

natural anti-coagulant

20
Q

function of protein C

A

binds to it’s cofactor protein S and switches off factors 8 and 5

21
Q

what can deficiencies in natural anticoagulants lead to

A

coagulopathies like DVT

22
Q

what is vitamin K needed for

A

post translational modification of factors 2,7,9,10

23
Q

how does aspirin work as an anti-coagulant

A

blocks COX pathway

this prevents aggregation

24
Q

how does Clopidogrel work

A

block ADP on platelets to prevent activation

25
Q

what drugs block GP 2/3

A

abciximab
tirofiban
eptifibatide

26
Q

how does warfarin work

A

blocks factor 10, 9, 7

27
Q

how do heparins work

A

bind to anti-thrombin and allow it to cleave thrombin faster

28
Q

what drugs bind to factor 10

A

rivaroxaban
edoxaban
apixaban

29
Q

what drugs are direct thrombin inhibitors

A

dabigatran

bivalirudin