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Med 2: Cardio > Hematostasis > Flashcards

Hematostasis Flashcards

(44 cards)

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1
Q

What are the 6 steps of hemostasis?

A
  • vascular constriction
  • formation of platelet plug (primary hemostatic plug)
  • formation of a blood clot as a result of blood coagulation (secondary hemostatic plug)
  • clot retraction
  • fibrinolysis
  • growth of fibrous tissue into the blood clot
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2
Q

What are the two causes of vasoconstriction? Which vessels do each act on?

A
  • local myogenic spasm: circular smooth muscle

- local factors from traumatized tissues and blood platelets: smaller vessels

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3
Q

The first reaction contraction of circular smooth muscles is called? What is this type of contraction reducing?

A
  • Myogenic contraction

- reduce the flow of blood from a ruptured vessel

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4
Q

What are the by product vasoconstrictors from the platelet plug formation?

A

Thromboxane A 2 (TXA 2) and serotonin (5-HT)

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5
Q

What are some facts about platelets?

A
  • no nuclei
  • can’t reproduce
  • contractile protiens are: actin, myosin, thrombosthenin
  • ER and Golgi: make enzymes and store calcium
  • factor XIII
  • cell membrane have glycoprotein coat
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6
Q

What are 5 types of platelet disorders?

A
  • thrombocytosis
  • thrombocytopenia
  • platelet function defects
  • inherited
  • acquired
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7
Q

What are 3 examples of inherited platelet disorders?

A
  • von willebrand disease
  • bernard-soulier syndrome
  • glanzmann thrombasthenia
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8
Q

What are examples of aquired platelet disorders?

A
  • certain drugs like nsaids, PCN, ASA, or heparin
  • idiopathic thrombocytopenic purpura
  • chronic myeloproliferative disorders
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9
Q

Platelet plug formatiom includes what 3 A’s?

A

Adhesion, activation, aggregation

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10
Q

Where is the von willebrand factor found? What is it? What does it do?

A
  • megakaryocytes and in alpha granules
  • its a glycoprotien made by endothelial cells
  • it binds to the platelet receptor glycoprotein (Gp Ib)
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11
Q

What triggers a conformational change in the platelet receptors?

A

Adhesion

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12
Q

What 3 things promote platelet aggregation?

A

-ADP, serotonin, TXA2

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13
Q

What inhibits clotting by decreasing the release of TXA2? Its an inhibitor of what?

A
  • aspirin

- aspirin is an inhibitor of cyclooxygenase

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14
Q

What forms bridges between platelets? What step of the primary hemostatic plug does this happen?

A
  • Fibrinogen

- aggregation

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15
Q

What is a clot?

A

Semisolid mass composed of platelets and fibrin

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16
Q

When a vessel is ruptured, what is activated? What does it override when its activated?

A
  • Procoagulants

- overrides anticoagulants

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17
Q

When does a clot start to develop? Within how many minutes does the opening of the vessel get filled with a clot? When does the clot retract?

A
  • 15-20 seconds clot develops
  • 3-6 minutes
  • 20min to 1hr
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18
Q

What factor require the liver to be functioning? What vitamin is required as well?

Study These Flashcards
A
  • Factor II and IIa, VII and VIIa, IX and IXa, and X and Xa

- vitamin k

19
Q

What are the names for factor I, Ia, II, IIa?

Study These Flashcards
A
  • I: fibrinogen
  • Ia: fibrin
  • II: prothrombin
  • IIa: thrombin
20
Q

Warfarin is an anticoagulant drug. What is its antidote, or reverses its function?

21
Q

What is central to the coagulationc cascade?

22
Q

What is required for clot retraction?

23
Q

What two things increase the levels of circulating t-PA?

Study These Flashcards
A

Catecholamines and bradykinin

24
Q

What are two paracrine factors of anti-clotting mechanisms? What do they do?

Study These Flashcards
A
  • prostacyclin (PGI-2): vasodilation and inhibits platelet activation
  • nitric oxide: through cGMP inhibits platelet adhesion and aggregation
25
What pathway does PT measure? Which does PTT measure? What are their functions?
- PT: extrinsic, assess anticoagulant effect of warfarin | - PTT: intrinsic, ability to convert fibrinogen to fibrin clot
26
What type of vitamin is vitamin k? What symptoms would you see if absorption of this is defected?
- Fat soluble | - steatorrhea, greasy stools, bloating, gas
27
What do platelets release when there is a wound? What action does it cause?
- TXA2 and serotonin | - increase platelet aggregation and vasoconstriction
28
What is the lifespan of platelets? When they die, how are they removed from the body?
- 8-12 days | - by macrophages in the spleen
29
What are released from endothelial cells that stimulate muscle contraction?
Endothelins-1 (ET-1)
30
What are platelets?
Fragments of megakaryocytes
31
What are the two types of platelet granules? What are in each?
- alpha granules: procoagulant factor 5, fibrinogen, von willebrand factor, PF4, growth factors (tissue growth factor, PDGF) - dense granules: ADP, serotonin, calcium
32
What granule and aspect of this granule plays a role in the recruitment and activation of platelets?
- Dense granules | - ADP
33
What glycoprotien receptor binds to collagen?
Glycoprotein Ia/Ib
34
Which glycoprotein receptor binds to von willebrand factor? What disease is linked tothe lack of this receptor?
- glycoprotien Ib/IX | - Glanzman’s thromboasthenia
35
Which glycoprotien receptor binds to fibrinogen? If there is a lack of this receptor, what disease can occur?
- glycoprotien receptor IIb/IIIa | - Bernand-Soulier syndrome pseudo-vWD
36
What do endothelial cells release to INHIBIT platelet aggregation and relax smooth muscle? What is the process that it does this?
- Prostacyclin - prostacyclin activates platelet adenylate cyclase, increases cAMP, decrease intracellular Ca, and inhibits platelet activation
37
What is a potent inducer of platelet aggregation and vasoconstriction? Where are they released from?
- TXA2 | - platelets
38
Injury of the endothelial exposes collagen. That exposure of collagen causes what and why?
- Adhesion of platelets to the endothelium | - glycoprotien receptor Ia/IIa seeks the exposed collagen to link to
39
What happens in the activation step of platelet plug creation?
- adhesion causes an intracellular signalling cascade leading to exocytosis of platelets to go to the injured site - activates both the alpha and dense granules
40
If a patient is bleeding with low platelet count, what step of coagulation will not work?
Second step: primary hemostatic plug
41
Whats the difference between a clot and thrombus?
- clot: semisolid mass composed of platelets and fibrin | - thrombus: blood clot in a vessel that has ability to move
42
Between procoagulants and anticoagulants, which dominates?
Anticoagulant
43
What factors are released in the intrinsic pathway? Extrinsic? What factor do both pathways meet at?
- intrinsic: factors 12, 11, 9, 8 - extrinisic: factor 7 and tissue factor - factor 10
44
What type of cells clear the activated clotting factors once its no longer needed?
Kupffer cells of the liver

Med 2: Cardio (11 decks)

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