Hemostasis & Thrombosis Flashcards

1
Q

What are the 4 phases of hemostasis?

A
  1. vasoconstriction
  2. formation of platelet plug at site of injury
  3. cascade of zymogen activation
  4. dissolution of clot by plasmin
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2
Q

What is hemostasis?

A

where blood flow stops

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3
Q

What is the intrinsic pathway in the blood clotting cascade?

A
  • all clotting factors involved
  • damage to endothelium exposes collagen that binds to platelets and initiates clotting
  • factors: 9,8 -> 10
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4
Q

What is the extrinsic pathway in the blood clotting cascade?

A
  • one factor involved comes from outside circulation
  • trauma to blood vessel causes release of factor 3 into blood to initiate clotting
  • factors: 3, 7 -> 10
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5
Q

How is prothrombin (2) turned into thrombin (2a)?

A

factors 10a + 5a + Ca + phospholipids

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6
Q

How is fibrinogen turned into fibrin?

A

cleavage of A and B fibrinopeptides

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7
Q

What does the conversion of glutamate to gamme-carboxyglutamate require?

A

vitamin K & protein carboxylase

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8
Q

What enzyme is responsible for glutamine and lysine forming the fibrin clot?

A

transglutaminase (factor 13a)

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9
Q

What factor plays a role in fibrinogen turning into fibrin?

A

thrombin

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10
Q

What are the inhibitors of clotting?

A
  • vitamin K antagonists -> dicoumarol & warfarin
  • aspirin
  • heparin/antithrombin
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11
Q

What is the process of heparin/antithrombin?

A
  1. antithrombin (+) binds to heparin (-)
  2. thrombin (+) binds to heparin (-)
  3. thrombin & antithrombin come together
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12
Q

In the prothrombinase complex, what factors are involved?

A
  • 10a
  • 5a
  • Ca
  • phospholipids
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13
Q

What is the role of plasmin?

A

breaks down fibrin

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14
Q

What is the role of tPA?

A

activates plasmin

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15
Q

What is the kringle domain?

A

region of tPA binds the fibrin clot

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16
Q

What is the serine protease domain?

A

region of tPA that converts

17
Q

How is plasminogen converted into plasmin?

A

plasminogen activator (tPA)

18
Q

What is hemophilia A?

A

mutation in factor 8 that leads to bleeding

19
Q

What diseases lead to thrombotic states?

A
  • antithrombin deficiency
  • tPA deficiency -> decrease plasmin = decrease brealdown of fibrin clots
20
Q

What are key components of prothrombosis?

A
  • factros 1-13
  • vitamin K
  • protein carboxylase
  • Ca
21
Q

What are key components of antithrombosis?

A
  • vitamin K antagonists
  • warfarin
  • aspirin
  • heparin
  • plasmin
  • tPA
22
Q

Blood clotting cascades are controlled by what activation?

A

zymogen