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CMBM exam 5 > Clotting system > Flashcards

Clotting system Flashcards

1
Q

How are platelets activated?

A

Vascular injury contact and attach to one another to make a plug

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2
Q

What attaches to platelets go catalyze a serious of reactions in thrombin generation?

A

Coagulation factors

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3
Q

What does thrombin catalyze the deposition of?

A

Fibirin

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4
Q

Describe platelets.

A

Enucleated cells of the blood and are vital to clot initiation
Smooth and discoid when inactive w/ canalicular system
Pseudopodia extended when active

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5
Q

What is expressed when vascular injury occurs?

A

Extracellular collagen and von Willebrand factor (vWF)

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6
Q

What is a receptor protein in platelets and can attach to collagen?

A

GPIa

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7
Q

What happens when GPIb is exposed?

A

Becomes able to bind to vWF which causes a confrontational shift

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8
Q

What occurs when GPIIb or GPIIIa is exposed?

A

More binding of collagen and vWF

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9
Q

Fibringen is called what in active form?

A

Fibrin

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10
Q

Factor II (prothrombin) has what function?

A

Serine protease

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11
Q

What is tissue factor function?

A

Receptor and cofactor

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12
Q

What is the function for Ca2+?

A

Cofactor

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13
Q

What is the function for factor V?

A

Cofactor

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14
Q

What is the function for factor VII?

A

Serine protease

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15
Q

What is the function for factor VIII?

A

Cofactor

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16
Q

What is the function for factor IX (christmas factor)?

A

Serine protease

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17
Q

What is the function of factor X (Stuart-Prower factor)?

A

Serine protease

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18
Q

What is the function of factor XI?

A

Serine protease

19
Q

What is the function factor XII?

A

Ca2+ dependent transglutaminase

20
Q

What does regulatory protein thrombomodulin do?

A

Endothelial cell receptor, binds tropin

21
Q

What does regulatory protein C do?

A

Activated by thrombomodulin-bound thrombin; serine protease

22
Q

What does regulatory protein S do?

A

Cofactor

Binds activated protein C

23
Q

What is the structure of a clotting protease?

A 
Catalystic head - protease domain (serine)
2 EDF-like domains (not a growth factor) - stem for head, binding sites for regulators/cofactors 
Gla domain (membrane surface) chilates Ca2+
24
Q

What is necessary for the gamma-carboxyglutamate modification?

A

Vitamin K (modifies Gla)

25
Q

What does warfarin do?

A

Potent anticoagulant which functions by mimicking the structure of vit K

26
Q

What do factors V and VIII have in common?

A

Must be activated by proteolutic cleavage
Sit on anionic phospholipids surface
Associate with both an active serine protease and substrate

27
Q

What is factor V a cofactor for?

A

fXa

28
Q

What is factor VIII a cofactor for?

A

fIXa

29
Q

What are the tree parts to the coagulation cascade?

A

Extrinsic, Intrinsic, Common

30
Q

What is the clinical readout for how fast the extrinsic pathway forms a clot?

A

Prothrombin time (PT)

31
Q

What is the clinical readout of how fast the intrinsic pathway forms a clot?

A

Activated partial thromboplastin time (aPTT)

32
Q

What leads to hemophilias A and B?

A

VIII and IX

33
Q

What lead to major bleeding disorder?

A

VII

34
Q

What are the three phases coagulation?

A

Initiation
Priming (amplification)
Propagation

35
Q

What is the coagulation cascade initiated by?

A

Tissue factor (TF)

36
Q

What does TF bind to and what occurs?

A

fVIII which autocatalyzes to form active TF/fVIIa complex

37
Q

How does amplification occur?

A

Small levels of thrombin generated and are used to activate cofactors

38
Q

What does thrombin do?

A

Activates fV to fVa
Activates fXI to fXIa
Triggers release to fVIIIa from vWF

39
Q

What increases the half-life of fVIII?

A

vWF

40
Q

What occurs in the propagation phase?

A

The activated intrinsic factors and cofactors that have been generated are active
IIa generates a thrombin burst which catalyzes the deposition on insoluble fibrin at wound site

41
Q

What is formed when fibrinogen is cleaved by thrombin?

A

Insoluble fibrin

42
Q

What enzyme causes cross-linking of fibrin in a soft clot?

A

fXIIIa

43
Q

What will cleave fibrin to break down clots?

A

Plasminogen activated to plasmin

CMBM exam 5 (19 decks)

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