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Blood coagulation Flashcards

(47 cards)

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1
Q

What is blood coagulation?

A

Forming a tough protein ‘coagulum’ of fibrin

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2
Q

How does vasoconstriction occur?

A

Neural sympathetic input

Myogenic response

Endothelin

Platelet TXA2 + serotonin

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3
Q

What produces endothelin?

A

Damaged endothelium

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4
Q

Which usually keeps blood from coagulating?

A

NO, prostacycline, antithrombin, protein C + S

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5
Q

Which factors does antithrombin inhibit?

A

2, 9 , 10

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6
Q

Which factors does protein C inhibit?

A

5 and 8

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7
Q

What is von willebrand factor?

A

Released from endothelial cells when they are injured

Binds to other platelets

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8
Q

What platelet receptor binds vWF?

A

glycoprotein1b

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9
Q

Which is released with platelet granule release + functions (hint 3)?

A

ADP
TXA2
Serotonin

First two - activate more platelets
Last two - vasoconstrict

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10
Q

How do platelets bind together?

A

Via their GpIIb/IIIa receptors, which are branched by fibrinogen/vWF

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11
Q

What are the five steps of stopping bleeding?

A

1) vascular spasm
2) Platelet plug
3) Coagulation cascade
4) Retraction + repair
5) Fibrinolysis

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12
Q

What does heparin do do?

A

Acts to activate antithrombin, which inhibits factors 2 (thrombin), 9, 10

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13
Q

What does clopidergral do?

A

ADP receptor inhibitor

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14
Q

What does aspirin do?

A

blocks TXA2 production (both activates other platelets + vasoconstrictor)

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15
Q

What does factor 13 do?

A

Crosslinks fibrin via transamidation, creating a fibrin mesh which overlays the platelet plug

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16
Q

How does dabigatrin work?

A

Direct thrombin inhibitor (factor II)

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17
Q

What are the other names for factor 1, 2 ,3

A

1= fibrinogen/fibrin
2 = prothrombin/thrombin
3= tissue factor

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18
Q

Are the extrinsic + intrinsic pathways really seperate?

A

No.. the factors IRL interact lots like 3 helps activate 9… common pathway

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19
Q

What are the steps of clot retraction + repair?

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A

1) platelet contraction via myosin + actin
2) Secretion of platelet-derived growth factor (works on smooth muscle + connective tissue)
3) VEGF - helps grow back the endothelium

20
Q

What does plasminogen do?

Study These Flashcards
A

Breaks down fibrin into FDPs (back to fibrinogen, D dimer)

21
Q

Which are the VitK dependent factors

Study These Flashcards
A

2, 7, 9, 10, c + s

22
Q

What does warfarin do?

Study These Flashcards
A

inhibition of vitamin K epoxide reductase, blocks the synthesis of the vitK dependant factors

23
Q

T or F The main physiological process for
activating coagulation requires
activation of FXII & FXI.

Study These Flashcards
A

F, just XI to get to common pathway. 12 is slow asf

24
Q

What happens to clotting tests if vit k is low?

Study These Flashcards
A

Both PT and APTT prolonged

25
What drug can TCT measure?
Dabigatrin, a direct thrombin inhibitor
26
What is DIC?
pathological process in which **tissue factor** is released into blood vessels. --> platelets, fibrinogen will be used up, FDPs increases. PT/APTT could increase as factors used up.
27
What is the most common cause of DIC?
Gram negative sepsis (E coli, Pseudomonas aeruginosa, Klebsiella)
28
What is PFA-100?
A platelet function test, assesses aggregation. Often not needed, can use bleeding time
29
What are some causes of thrombocytopenia?
Reduced production Reduced survival Haemodilutation after haemorrhage Splenic sequestration
30
How do NSAIDs work?
COX-1 inhibitors, this enzyme is required for TXA2
31
How is aspirin different to other NSAIDs?
Aspirin permanently inhibits COX-1 enzyme, other NSAIDs just do so temporarily.
32
What is haemophilia A?
Factor 7 deficiency
33
What is haemophilia B?
Factor 9 deficiency
34
What genetic inheritance pattern is vWF disease?
Autosomal dominant
35
What are the two types of vWF disease?
Type I: reduced production of vwF Type II: abnormal protein
36
How do you diagnose vWF disease?
Normal platelet level but function is reduced Factor 8 can also be slightly reduced due to vWF carrying VIII in blood.
37
How to prepare a vWF disease patient for surgery?
Desmopression (temporarily increases synthesis + release of vWF), fibrinolysis inhibitor (tranexamic acid)
38
How to treat vWF patient with heavy periods?
e.g. OCP, Mirena could stop periods Tranexamic acid can help too
39
How does tranexamic acid work?
Binds to plasminogen. *(compare to alteplase, which is tPA which activates plasminogen to plasmin!)*
40
Which chromosome is implicated in Haemophilia disorders?
X chromosome
41
How does haemophilia lead to increased bleeding?
Platelet function is fine but the coagulation pathway is affected --> reduced thrombin burst --> weak fibrin mesh overlaying platelet plug
42
How to treat haemophilia?
Can inject the actual factor that is missing.
43
What is 'acquired haemophilia'? How can it be treated?
Autoantibody reacts with the factor, usually factor 8, and therefore injection of the factor will not help - the body will attack it. Needs intense immunosuppressives!
44
How can we test to differentiate between Inherited Haemophilia A/B(deficiency) vs acquired haemophilia (autoantibody)
Inherited/deficiency - when mix with 1/2 normal plasma, the bleeding time will correct Autoantibody - will not correct!
45
What is the antidote for heparin?
Protamine sulphate, very positive histone protein. Binds to form a stable salt.
46
Which test do we use to monitor heparin?
APTT (PT lower sensitivity) , remember heparin activates antithrombin which inhibits factor 2,9,10 (FACTOR 9-->APTT)
47
What inheritance pattern does haemophilia follow?
Sex-linked (X) recessive

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