Bleeding & Thrombosis

Question 1

Describe the clotting process

Good luck bro

Answer 1

Vessel damage exposes collagen and releases Physiological activator

Platelets adhere to the site of damage

A platelet homeostatic plug forms

Fibrin forms on the clot

Natural anticoagulants keep the clot in the same place

Fibrinolysis breaks the clot down over time

Question 2

What activator is subsequently released by Physiological activator after vessel damage?

Answer 2

Tissue activator

Question 3

After vessel damage occurs, why do platelets adhere to the site of injury?

Answer 3

As collagen is exposed which is sticky

Question 4

What are the 3 components of clot formation?

Answer 4

Coagulation factors
Platelets
Von Willebrand Factor (VWF)

Question 5

I’m the dotting process, what ensures that the clot stays in the correct place?

Answer 5

Natural anticoagulants

Question 6

What agents eventually break down the fibrin clot?

Answer 6

Fibrinolytic

Question 7

In a normal blood vessel, are clotting factors present?

Answer 7

Yes, but they’re inactive bro

Question 8

What 2 things prevents things from sticking to the endothelium of normal blood vessels?

Answer 8

Prostaglandins

Nitrous oxide

Question 9

What cells to platelets differentiate from?

Answer 9

Megakaryocytes

Which differentiate from common myeloid progenitors

Question 10

What 2 things are present on the surface of platelets?

Answer 10

Receptors

Glycoproteins

Question 11

What is the function of the glycoproteins that are present on the surface of platelets?

Answer 11

Allow the platelet to bind once a receptor is activated

Question 12

What are the 3 different types of receptors found on platelets?

Answer 12

Thrombin receptor
ADP receptor
Adrenaline receptor

Question 13

What is contained within platelets?

Answer 13

Granules

Question 14

What are the 3 functions of a platelets?

AAA

Answer 14

Adhering
Activating
Aggregating

Question 15

What allows platelets to carry out their adhering function?

Answer 15

Glycoproteins

Question 16

What allows platelets to carry out their activating function?

Answer 16

ADP
Adrenaline
Cycloxygenase (COX)

Question 17

What allows platelets to carry out their aggregating function?

Answer 17

Arachidonic acid
Scramblase

They both make the platelets extra sticky so platelets can adhere to them

Question 18

What forms arachidonic acid, which is responsible for platelet aggregation, and what is the catalyst?

Answer 18

ADP and adrenaline

Catalysed by Cycloxygenase (COX)

Question 19

What regulates the production of platelets?

Answer 19

Thrombopoietein

Question 20

Thrombopoietein regulates the production of platelets, which organ produces it?

Answer 20

The liver

Question 21

What factor number does Von Willebrand factor (VWF) have a receptor for?

Answer 21

8

Question 22

What factor deficiency is the most common bleeding disorder?

Answer 22

VWF

Question 23

What are the 6 steps of the coagulation pathway?

Answer 23

1. Tissue factor binds to F7
2. F7 is activated, forming F7a
3. F7a binds to F10
4. F10 is activated, forming F10a
5. F10a coverages prothrombin into thrombin
6. Thrombin converts fibrinogen into fibrin

Question 24

What 5 factors are involved in the coagulation pathway?

Answer 24

Tissue factor
F7 and F7a
F10 and F10a

Question 25

In the clotting pathway, what factor converters prothrombin into thrombin?

Answer 25

F10a

Question 26

If natural anticoagulants are absent, what is the patient at an increased risk of?

Answer 26

VTE (PE and DVT) As blood clots to easily bro and can break off and fly awayyyy

Question 27

What are the 3 main examples of natural anticoagulants?

Answer 27

Tissue Factor Pathway Inhibitor (TFPI) Proteins C and S Anti-thrombin

Question 28

What 2 factors does the natural anticoagulant Tissue Factor Pathway Inhibitor (TFPI) bind to?

Answer 28

F7 | F10a

Question 29

What 2 factors does the natural anticoagulants Proteins C and S bind to?

Answer 29

F5 | F8

Question 30

What 2 factors does the natural anticoagulant Anti-thrombin bind to?

Answer 30

F10a | Thrombin

Question 31

What type of bleeding involves mucous membranes?

Answer 31

Platelet type

Question 32

What are the 2 main types of bleeding?

Answer 32

Platelet type | Clotting factor type

Question 33

What type of bleeding involves deep haematomas?

Answer 33

Clotting factor type

Question 34

What type of bleeding involves petechial rashes?

Answer 34

Platelet type

Question 35

What are some of the causes of platelet type bleeding?

Answer 35

Von Willebrands disease Immune thrombocytopenic purpura (ITP) Haemolytic uremic syndrome Thrombocytopenia

Question 36

What is a cause of clotting factor type bleeding?

Answer 36

Haemophilia

Question 37

When taking a history, what questions do you need to ask about regarding bleeding?

Answer 37

History of bleeding Severity Bleeding pattern Previous surgeries

Question 38

What coagulation factors are dependent on Vit. K?

Answer 38

2, 7, 9 and 10

Question 39

Apart from it's adhering, aggregating and activating (3 As) functions, what other function does platelets have?

Answer 39

Maintains vascular integrity

Question 40

Do platelets have a role in maintaining vascular integrity

Answer 40

Yeah