Coagulation 3 Flashcards by Hannah Garrison

What is the FIRST coagulation factor activated in the extrinsic pathway?
a. fibrinogen
b. Stuart-Prower factor
c. Tissue factor
d. labile factor

c. tissue factor

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The extrinsic pathway is activated by

vascular injury or when the vessel wall comes into contact with blood

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The extrinsic pathway includes factors

3 & 7

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The extrinsic pathway is _______________- than the intrinsic pathway

faster

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The extrinsic pathway is measured by the

PT & INR

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The extrinsic pathway is inhibited by

warfarin

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_____________ activates the extrinsic pathway

Tissue factor

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Tissue factor activates factor

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Factor 7 activates _ in the presence of _

10; 4 (Ca+)

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What is the mnemonic for the extrinsic pathway?

For 37 cents, you can purchase the extrinsic pathway

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What factor will be the first factor to become deficient in patients with liver failure, vitamin K deficiency, and those on warfarin?

factor 7 (has the shortest half-life)

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How fast can a clot form via the extrinsic pathway of the coagulation cascade?

~15 seconds

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What factors are specific to the classical intrinsic pathway? (select 3)
a. 4
b. 6
c. 7
d. 8
e. 9
f. 11

8, 9 & 11

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The intrinsic pathway is activated by

blood trauma

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The intrinsic pathway includes factors

12, 11, 9 & 8

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The intrinsic pathway is _______ than the extrinsic pathway

slower

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The intrinsic pathway is measured by

PTT & ACT

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The intrinsic pathway is inhibited by

heparin

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The classical intrinsic pathway is also called the

contact activation pathway

What is the mnemonic for the intrinsic pathway?

If you can’t buy the intrinsic pathway for $12, you can buy it for $11.98

What factor is missing with hemophilia A?

factor 8

______ are missing with thrombocytopenia

Platelets

What are the five steps of the intrinsic pathway?

blood trauma exposure to collagen–> activates factor 12
factor 11 activation
factor 9 activation
factor 10 activation (via factor 9a & 8)
Prothrombin activator activates thrombin (factor 2a)

How long does it take to form a clot via the intrinsic pathway of the coagulation cascade?

~6 minutes

What factors make up the intrinsic pathway?

12, 11, 9, & 8

Place the events of the final common pathway in the correct sequence: thrombin activates fibrin monomer prothrombin activator activates thrombin activated fibrin stabilizing factor crosslinks fibrin

1st. Prothrombin activator activates thrombin 2nd. Activated fibrin stabilizing factor crosslinks fibrin 3rd. Thrombin activates fibrin monomer

The primary goal of both the intrinsic and extrinsic pathways are to

produce prothrombin activator

The final common pathway begins where

prothrombin activator changes prothrombin (2) to thrombin (2a)

Thrombin (2a) is a proteolytic enzyme that changes

fibrinogen to fibrinogen monomer

After the platelets aggregate, _______ is incorporated into the platelet plug

fibrin

The clot will stay in place until the

underlying vascular tissue has repaired itself

Prothrombinase is a complex of

complex of 10a + 5a + 4

What is the mnemonic for the final common pathway?

The final common pathway can be purchased at the five and dime for 1 or 2 dollars on the 13th of the month.

What is the role of thrombin?

it converts fibrinogen to fibrinogen monomer

What must be present to convert fibrinogen monomer to fibrin fibers?

Calcium (factor 4)

Identify the true statements regarding fibrinolysis. (select 2) a. D-dimer measures fibrin split products b. plasminogen is synthesized in the endothelium c. tPA inhibitor inhibits the conversion of fibrinogen to fibrin d. alpha-2 antiplasmin inhibits the action of plasmin on fibrin

a. D-dimer measures fibrin split products d. alpha-2 antiplasmin inhibits the action of plasmin on fibrin

Since the clot is only a temporary fix while the vessel repairs itself, the body needs a way to breakdown the clot after it is no longer needed. This process is called

fibrinolysis

________ is a proteolytic enzyme that degrades fibrin into fibrin degradation products

Plasmin

Plasminogen is incorporated into the clot as it's being formed, but it lays dormant until a

plasmin activator activates it (e.g. tPA, urokinase)

The body has a mechanism to stop the clot from increasing indefinitely. These processes include:

vasodilation & washout of ADP & TxA2 tissue factor pathway inhibitor neutralizes tissue factor protein C & S, inhibiting factors 5a & 8a antithrombin inactivates thrombin (2a) as well as factors 9a, 10a, 11a, and 12a

Fibrin degradation products are measured by

D-dimer

Plasmin activation is the result of:

injured tissue releasing tissue plasminogen activator (tPA) (major) urokinase produced by the kidneys and released into the circulation (minor)

Plasmin activators are used therapeutically to

dissolve thrombi and restore blood flow

Once the clot is degraded, the body needs a way to turn off the fibrinolytic process:

tPA inhibitor (TPAI) inhibits the conversion of plasminogen to plasmin Alpha-2 antiplasmin inhibits the action of plasmin on fibrin

What 2 enzyme inhibitors turn-off the fibrinolytic process?

tPA inhibitor (TPAI) alpha-2 antiplasmin