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Physiology > Blood Coagulation > Flashcards

Blood Coagulation Flashcards

1
Q

Blood Clotting Process (5):

A
  1. Severed vessel
  2. Platelets agglutinate
  3. Fibrin appears
  4. Fibrin clot forms
  5. Clot retraction occurs
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2
Q

When is primary hemostatic plug formed?

A

When platelets begin to aggregate at the site

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3
Q

When does secondary hemostatic plug form?

A

When fibrin clot forms

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4
Q

What else are platelets known as?

A

Thrombocytes

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5
Q

What two things to platelets bind to when they are exposed upon injury?

A
  1. Sub-endothelial collagen

2. vWF (von Willebrand Factor)

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6
Q

What does aspirin inhibit?

A

Platelets activation

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7
Q

What is needed to activate prothrombin to form thrombin?

A

Development of fibrin network (primary hemostatic plug)

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8
Q

What is needed to activate fibrinogen to form fibrin?

A

Thrombin

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9
Q

T/F: Do both intrinsic and extrinsic pathways occur simultaneously and are interdependent?

A

True

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10
Q

Which factor does vWF bind to?

A

FVIII in serum and stabilizes it.

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11
Q

What other thing does vWF act as?

A

Platelet activator for X

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12
Q

Activated by exposure to highly (-) charged surfaces (collagen and glass)

A

Intrinsic pathway

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13
Q

Activated by release of TF by injured tissue

A

Extrinsic pathway

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14
Q

How are coagulation factors released?

A

As zymogens to the serum

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15
Q

What do Gla proteins require?

A

Ca++ and phospholipids

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16
Q

What steps involve Gla proteins in coagulation cascade?

A

Intrinsic: IX and X
Extrinsic: VII and X
Common: II

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17
Q

What are Gla proteins modified by?

A

Vitamin K-dependent carboxylase

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18
Q

How are g-carboxyglutamyl (Gla) residues formed?

A

Carboxylation at the g carbon of Glu

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19
Q

What does Gla allow?

A
  • charged proteins to interact with - phospholipids
20
Q

How is vitamin K oxidized?

A

During the carboxylation reaction

Reduced by vitamin K epoxied reductase and vitamin K reductase

21
Q

Measures number of platelets in serum; part of routine CBC

A

Platelet count

22
Q

Normal platelet count:

A

150,000-400,000 cells/mL

23
Q

Measures rate of clotting by the extrinsic and common pathways
Determined mainly by the amount of prothrombin in plasma
Oxalated blood is treated with excess Ca++ and tissue factor, and clotting time is measured

A

Prothrombin Time (PT)

24
Q

Normal prothrombin time

A

10-14sec

INR ~ 1.1

25
Q

Measures rate of clotting by the intrinsic and common pathway
Oxalated blood is treated with excess Ca++, phospholipid, and nuclear ink surface (kaolin) and clotting time is measured

A

Partial Thromboplastin Time (PTT aPTT)

26
Q

Normal partial thromboplastin time

A

30-42 sec

27
Q

“Bedside” test of entire clotting process

A

Activated clotting time

28
Q

Which conditions would result in prolonged INR and PTT?

A

Afribrinogenemia

Vitamin K deficiency

29
Q

Which condition would result in prolonged PTT, but a normal INR?

A 
Hemophilia A (FVIII deficiency)
vonWillebrand Disease (vWF deficiency)
30
Q

What does thrombin activate?

A

Factors V, VII, VIII, XI

Stimulate platelet aggregation

31
Q

How is the clotting cascade slowed down?

A
  1. thrombomodulin:thrombin complex activates protein C
  2. Active protein C forms an active complex with protein S
  3. Cleave FVa and FVIIIa
32
Q

Which is a key serpin?

A

Antithrombin III

33
Q

What does serpin stand for?

A

Serine protease inhibitors

34
Q

What does antithrombin III irreversibly inactivated?

A

Thrombin

35
Q

Proteolysis of plasminogen by what produces plasmin?

A

tPA (tissue plasminogen activator)

U-PA (urokinase)

36
Q

What is plasmin?

A

Protease that cleaves fibrin and several clotting factors

37
Q

Hypo-coagulation or hyper coagulation:

Deficiency in FVIII

A

Hypo

38
Q

Hypo-coagulation or hyper coagulation:

Advanced liver disease

A

Hypo

39
Q

Hypo-coagulation or hyper coagulation:

Deficiency in protein C

A

Hyper

40
Q

Hypo-coagulation or hyper coagulation:

Vitamin K deficiency

A

Hypo

41
Q

Hypo-coagulation or hyper coagulation:

Mutation in FV at protein C cleavage site

A

Hyper

42
Q

Hypo-coagulation or hyper coagulation:

Platelet deficiency

A

Hypo

43
Q

Hypo-coagulation or hyper coagulation:

Deficiency in FIX

A

Hypo

44
Q

What is diffuse intramuscular coagulation (DIC)

A

Bleeding and clotting at the same time

45
Q

Clotting factor deficiencies:

A
  1. Hemophilia A and B (FVII and FXI)
  2. von Willibrand’s Disease
  3. Advanced liver disease
  4. Vitamin K deficiency
46
Q

Drug induced hypo coagulation:

A
  1. Aspirin and anti-platelet drugs
  2. Warfarin
  3. Heparin
47
Q

Effects of surgery on coagulation:

A
  1. Surgery has hypercoagulation effect (platelets, clotting factors)
  2. Dilation thrombocytopenia, loss of clotting factors

Physiology (2 decks)

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