bleeding and thrmobosis

Question 1

balance between pro-coagulant and anti coagulant forces

Answer 1

human hemostatic system

Question 2

regulated to promote blood flow and will have blood clot rapidly to stop and prevent excanguination

Answer 2

hemostasis

Question 3

platelet adhesion is mediated by a multimeric protein called?

Answer 3

VWF (Von Willebrand Factor)

Question 4

the major plasma inhibitor of thrombin and the other cloting factors in coagulation

Answer 4

antithrombin

Question 5

is a plasma glycoprotein became an anticoagulant when it is activated by thrombin with the presence of thrombomodulin which is a trans membrane proteoglycan binding site for thrombin on endothelial cells surface

Answer 5

protein C

Question 6

once protein C is activated it acts as an anticoagulant by cleaving and inactivating activated factor V and VIII, which accelerated by co-factor ___

Answer 6

protein S

Question 7

deficiency of protein C will lead to?

Answer 7

hypercoagulable state

Question 8

is a plasma protease inhibitor that regulates the TF induced extrinsic pathway of coagulation

Answer 8

tissue factor pathway inhibitor

Question 9

where does tissue factor pathway inhibitor bounds to ?

Answer 9

lipoprotein and can also be released by heparin from endothelial cells which is bound to glycosaminoglycan and from platelets

Question 10

major protease enzyme of fibrinolytic system

Answer 10

PLASMIN

Question 11

markers use to exclude the diagnosis of DVT and pulmonary embolism

Answer 11

D-Dimer assays

Question 12

defects in platelet adhesion

Answer 12

von willebrand diseaes
bernard-soulier syndrome

Question 13

defects of platelet agg

Answer 13

glanzmann thrombasthenia
afibrinogenemia

Question 14

defects of platelet secretion

Answer 14

disease COX activity
granule storage pool defects
nonspecific inherited secretory defects
nonspecific drug disease
uremia
platelet coating

Question 15

defect of platelet coag

Answer 15

scott’s syndrome

Question 16

some risk factors of thrombosis (venous inherited)

Answer 16

factor V leiden
prothrombin G20210A
antithrombin deficiency
Protein C deficiency
Protein S deficiency

Question 17

some risk factors for thrombosis (venous acquired)

Answer 17

age
previous thrombosis
immobilization
major surgery
pregnancy and puerperium
hospitalization
obesity
infection
smoking

Question 18

prolonged prothombin time lab eval

Answer 18

factor vii deficiency
factor k deficient
warfarin anticoagulation
direct Xa inhibitors

Question 19

prolonged pTT and PT disorders

Answer 19

factor 2, 5 ,10 or fibrinogen deficiency
vitamin K defiiency - late
direct thrombin inhibitors

Question 20

deals with the preservation of blood fluidity and to limit blood clotting under normal condition in focal sites of vascular injury

Answer 20

antithrombic mechanism

Question 21

what does tissue factor pathway inhibitor INHIBITS?

Answer 21

TF/Factor VIIa/Factor Xa complex

Question 22

physiologic regulation of fibrnolysis in 3 levels

Answer 22

1. plasminogens activates inhibitors
2. thrombin-activatable fibrinolysis inhibitor
3. A2 - asntplasmin inhibits plasmin

Question 23

herbs with potential antiplatelet activity

Answer 23

gingko
garlic
bilberry
ginger
dong quai
feverfew
asian ginseng
american ginseng

Question 24

coumarin containing herbs

Answer 24

motherwort
chamomile
horse chestnut
red clover
fenugreek

Question 25

abnormalities of prolonged activated partial thromboplastin time aPTT

Answer 25

no bleeding - decrease factor XII, high molecular weight kininogen variable, mild bleeding - decrease factor X1, mild decrease factor VIII and factor IX frequent, severe bleeding - severe deficiency of factors VIII and IX heparin and direct thrombin inhibitors

Question 26

abrnomalities of prolonged prothrombin time (PT)

Answer 26

factor VII deficiency vitamin K deficiency - early warfarin anticoagulation direct Xa inhibitors

Question 27

abnormalities of prolonged aPTT and PT

Answer 27

factor II, V, X or fibrinogen deficiency Viramin K deficiency - late direct thrombin inhibitors

Question 28

abnormalities of prolonged thrombin time

Answer 28

heparin or heparin like inhibitors direct thrombin inhibitors mild or no bleeding - dysfibrinogenemia frequent, severe bleeding - afibrinogenemia

Question 29

abnormalities of prolonged PT and.or aPTT not corrected with mixing with normal plasma

Answer 29

bleeding lupus anticoagulant disseminated intravascular coagulation heparin or direct thrombin inhibitors

Question 30

abnormalities of abnormal clot solubility

Answer 30

factor XIII deficiency inhibitors or defective cross linking

Question 31

abnormalities of rapid clot lysis

Answer 31

deficiency of a2- antiplasmin or plasminogen activator inhibitor 1 treatment with fibrinolytic therapy