coagulation

Question 1

unwanted clot that adheres to blood vessel wall

Answer 1

thrombus

Question 2

unwanted clot that floats in the blood stream

Answer 2

embous

Question 3

what occurs whe4n platelets cover exposed subendothelium

Answer 3

platelet adherence

Question 4

what is the term for recruitment of other platelets after release of thromboxane, ADP and 5-Ht

Answer 4

platelet activation

Question 5

what is the term for cross linking of platelets by fibrinogen via the GP IIb/IIIa receptor

Answer 5

platelet aggregation

Question 6

what is the reactive subendothelial matrix protein exposed in a tissue injury

Answer 6

collagen and von willebrand factor

Question 7

what does von willebrand factor do?

Answer 7

promote platelet adherence and activation

Question 8

what does ADP do

Answer 8

stimulate platelet aggregation

Question 9

what thrombi are platelet rich

Answer 9

white thrombi

Question 10

what thrombi are fibrin rich

Answer 10

red thrombi

Question 11

where are red thrombi commonly found

Answer 11

veins

Question 12

where ware white thrombi commonly found

Answer 12

arteries

Question 13

what commonly causes white thrombi

Answer 13

atherosclerosis

Question 14

what commonly causes red thrombi

Answer 14

blood stasis or inappropriate activation of coagulation cascade

Question 15

what forms fibrin

Answer 15

factor IIa acting on fibrinogen

Question 16

what are the 3 causes of thrombosis according to virchows triad

Answer 16

1. endothelial injury
2. abnormal blood flow
3. hypercoagubility

Question 17

endothelial injury can be caused by what

Answer 17

hypertension and high cholesterol

Question 18

what is the body’s response to vascular injury

Answer 18

1. repairs injury without thrombosis or ischemia

2. proportionate and reversible

Question 19

list the steps of coagulation cascade in order after an injury to endothelial cell

Answer 19

1. glycoprotein 1b signals release of vWF
2. glycoprotein 1a releases collagen
3. ADP, 5-HT and TXA2 recruit more platelets
4. platelets are held together by fibrinogen
5. degranulation recruits more platelets
6. facot X is activated to Xa, forming prothrombin (II) to thrombin (IIa)
7. thrombin turns fibrinogen to fibrin

Question 20

what is the process of fibrinolysis?

Answer 20

1. plasminogen, inactive plasmin circulates in blood
2. endothelial cells synthesize and release tissue plasminogen activator at injury
3. t-PA binds fibrin and converts plasminogen to plasma
4. Plasmin remodels the clot and limits its growth by digesting fibrin

Question 21

list 3 activators of fibrinolysis

Answer 21

1. t-PA
2. urokinase
3. streptokinase

Question 22

list an inhibitor of fibrinolysis

Answer 22

aminocaproic acid

Question 23

what must be present for fibrinolysis to take place

Answer 23

t-PA

Question 24

what does t-PA do

Answer 24

converts plasminogen, a single chain peptide to plasmin, a 20chain peptide

Question 25

what does plasmin do

Answer 25

digests fibrin in clots

Question 26

List 3 types of indirect thrombin inhibitors and there molecular weights

Answer 26

1. unfractionated heparin - MW = 15,000 daltons 2. low molecular weight heparin - MW=5000 3. synthetic pentasaccharide - MW=1500

Question 27

List 3 low molecular weight heparin drugs

Answer 27

enoxaparin dalteparin tinzaparin

Question 28

what are 2 adverse effects from long term dosing of unfractionated heparin

Answer 28

alopecia | osteoporosis

Question 29

list a synthetic pentasaccharide drug

Answer 29

fondaparinux

Question 30

what do synthetic pentasaccharides do?

Answer 30

bind to Xa only

Question 31

what must be monitored with UFH?

Answer 31

H/H S/S of bleeding platelets aPTT/PTT

Question 32

what can reverse UFH

Answer 32

protamine sulfate

Question 33

what must be monitored for synthetic pentasaccharides

Answer 33

1. H/H 2. S/S 3. SrCr

Question 34

what all must bind together to activate X to Xa

Answer 34

VIIa, IIa, Ca, and tissue factor

Question 35

thrombin does what

Answer 35

converts soluble fibrinogen to fibrin (insoluble)

Question 36

what does factor XIIIa do in the extrinsic pathway of coag. cascade

Answer 36

converts fibrin to a cross linked (2 chain) fibrin polymer

Question 37

what activates factor XIIIa

Answer 37

thrombin and calcium

Question 38

what are the adverse effects of LMWHs

Answer 38

bleeding and HIT (less than UFH)

Question 39

heparins are contraindicated in purpura. what is that

Answer 39

bleeding under skin

Question 40

the heparins do not have what ability on there own

Answer 40

anticoagulant ability, work with antithrombin

Question 41

what is AT

Answer 41

serine protease inhibitor that keeps IIa, IXa, Xa XIa and XIIa from being activated