BL- COAG 2 Flashcards Preview

BL/DD USMLE and Basics > BL- COAG 2 > Flashcards

Flashcards in BL- COAG 2 Deck (49):
1

Antithrombin: A serpin

serine protease inhibitor
inhibits coagulation

2

Does antithrombin only inhibit thrombin?

NO
2a and 10a also

3

A highly sulfated glycosaminoglycan

A commonly used anticoagulant

Acts as a cofactor for antithrombin


Heparin

Heparan sulfate, a related compound, produced by endothelial cells (masts and basos)

4

Another Vitamin K-dependent serine protease

Activated by thrombin

Inactivates Factor Va and Factor VIIIa

Protein S is a cofactor

Protein C

5

Factor V Leiden: A mutation of factor V that makes it resistant to ________ by protein C

inactivation

*“APC resistance.”

6

a small protein molecule that inactivates several enzymes of the coagulation system.

Antithrombin

7

Protein C inactivates

Factor Va and Factor VIIIa

8

performs these operations primarily by proteolytically inactivating proteins Factor Va and Factor VIIIa.

Protein C

9

Common risk factor for venous thromboembolism

Factor V Leiden

A mutation of factor V
*“APC resistance.”

10

A proteinase inhibitor
Constitutively expressed by endothelial cells

Inhibits extrinsic tenase by binding and inactivating the complex

Tissue Factor Pathway Inhibitor (TFPI)

11

Anticoagulation mechanisms

-Antithrombin
-Tissue Factor Pathway Inhibitor (TFPI)
-Factor V Leiden
-Protein C
-Heparin

12

genetically inherited disorder of blood clotting. ___________ is a variant of human factor V that causes an increase in blood clotting (hypercoagulability)

Factor V Leiden

13

a single-chain polypeptide which can reversibly inhibit Factor Xa (Xa).

Tissue Factor Pathway Inhibitor (TFPI)

14

a process that prevents blood clots from growing and becoming problematic.[1] This process has two types

Fibrinolysis- Key enzyme: Plasmin

15

Plasmin

Derived from plasminogen through cleavage by tissue plasminogen activator (t-PA) or urokinase (u-PA)

16

Plasminogen Activator Inhibitor-1 (PAI-1)

Binds to t-PA and u-PA and inactivates them

17

an important enzyme present in blood that degrades many blood plasma proteins, including fibrin clots.

Plasmin

18

serpin that functions as the principal inhibitor of tissue plasminogen activator (tPA) and urokinase (uPA), the activators of plasminogen and hence fibrinolysis (the physiological breakdown of blood clots).

Plasminogen Activator Inhibitor-1 (PAI-1)

19

important fibrin degreadation products

D Dimer

20

Inhibition of Fibrinolysis

Plasminogen Activator Inhibitor-1 (PAI-1)

a2- antiplasmin

thrombin- activatable fibrinolysis inhibitor

21

a serine protease inhibitor (serpin) responsible for inactivating plasmin, an important enzyme that participates in fibrinolysis and degradation of various other proteins.

Alpha 2-antiplasmin

22

An exopeptidase involved in Inhibition of Fibrinolysis

Thrombin-Activatable Fibrinolysis Inhibitor (TAFI)

23

a fibrin degradation product (or FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis.

D Dimer

24

α2-Antiplasmin

Another serpin
Binds to plasmin and inactivates it

25

____ is used in some cases of diseases that feature blood clots, such as pulmonary embolism, myocardial infarction, and stroke, in a medical treatment called thrombolysis

Therapeutic tPA

26

In resting state, _______tends to prevent clotting

Endothelium

27

Produces heparan sulfate

Endothelium Resting state

28

Endothelium Exposure of tissue factor

With vessel damage, promotes clot formation

29

Expresses thrombomodulin → protein C activation

Endothelium Resting state

30

With vessel damage, _______promotes clot formation

Endothelium

31

Release of von Willebrand factor from Weibel-Palade bodies of the endothelial cells

With vessel damage, endothilum promotes clot formation

32

Expresses TFPI

Endothelium Resting state

33

von Willebrand factor

a blood glycoprotein involved in hemostasis

primary function is binding to other proteins, in particular factor VIII, and it is important in platelet adhesion to wound sites

34

Exposure of subendothelium, leading to platelet adhesion and activation

With vessel damage, endothilum promotes clot formation

35

Binds to subendothelium via collagen, von Willebrand factor, and other proteins

Role of the platelet

36

Forms a platelet plug at the site of injury

Role of the platelet

37


Synthesizes t-PA and u-PA

Endothelium Resting state

38

Release of substances that cause vasoconstriction

With vessel damage, endothilum promotes clot formation

39

With activation, exposes anionic phospholipids that act as a surface for coagulation to take place

Role of the platelet

40


Synthesizes PGI2 (prostacyclin) and nitric oxide → vasodilitation

Endothelium Resting state

41

Releases multiple substrates for coagulation

Role of the platelet

42


Metabolizes ADP (platelet agonist) to AMP + adenosine (platelet inhibitor)

Endothelium Resting state

43

a blood glycoprotein involved in hemostasis

primary function is binding to other proteins, in particular factor VIII, and it is important in platelet adhesion to wound sites

Von Willebrand factor's

44

is Von Willebrand factor's an enzyme?

No- It is NOT an enzyme and, thus, has no catalytic activity.

45

dRVVT

good if prolonged aPTT
activates factor 10
if SLE (antiphoslipid) this test wont change

46

APS
Antiphospholipid SLE

must ave positive AB panal 6 weeks apart in setting of miscarriage or thrombosis

47

Labs for DIC

Fibrinogen
D-Dimer
CBC
PT
aPTT

48

How do you ALWAYS treat DIC

Treat the underlying disorder

49

Prolonged PT
Greatly prolonged PTT
Prolonged thrombin time
Low platelet count
Low fibrinogen level
Increased fibrin split products
Increased D-dimer

Labs for DIC