Hemodynamic Disorders III

Question 1

Where do intrisnic and extreinisic pathways merge

Answer 1

factor X

Question 2

many of the factors need to be bound to what for max activity

Answer 2

phospholipid surface

Question 3

what is necessary for coagulation

Answer 3

calcium

Question 4

what is the end result of the coagulation cascade

Answer 4

cross-linked fibrin

Question 5

Prothrombin time (PT)

Answer 5

extrinsic

Question 6

what pathways is prolonged by warfarin

Answer 6

extrinsic

Question 7

Partical thromboplastin time (PTT)

Answer 7

intrinsic

Question 8

what pathway is prolonged by heparin

Answer 8

intrinsic

Question 9

what pathway is slower

Answer 9

intrinsic

Question 10

antithrombin III

Answer 10

directly inactivated serine proteases

increased by heparin

Question 11

protein C

Answer 11

inhibits cofactors Va and VIIIa
decreases rate of clot formation
requires activation

Question 12

plasmin

Answer 12

breaks down fibrin

Question 13

protein S

Answer 13

enhances activity of protein C

Question 14

thrombomodulin

Answer 14

activated by thrombin
binds to thrombin
activates protein C

Question 15

tissue pathway factor inhibitor

Answer 15

inhibits VIIa-tissue factor complex

Question 16

how is free plasmin inactivated

Answer 16

circulating alpha2 antiplasmin

Question 17

urokinase

Answer 17

present in plasma

activates plasminogen

Question 18

tPA

Answer 18

actives highest degree of activation when attached to fibrin

activates plasminogen

Question 19

streptokinase

Answer 19

bacterial product

activates plasminogen

Question 20

anticoagulants

Answer 20

prevent clot formation and extension

Question 21

antiplatelet drugs

Answer 21

interfere with platelet activity

Question 22

thromboytic agents

Answer 22

dissolve existing thrombi

Question 23

what factors does heparin inhbit

Answer 23

thrombin
factor IXa
factor X

Question 24

what is heparin produced by

Answer 24

basophils and mast cells

Question 25

how does heparin affect already fromed clots

Answer 25

does not disintegrate them

Question 26

how is heparin given

Answer 26

IV or subcutaneous injection

Question 27

how is warfarin given

Answer 27

orally

Question 28

how does warfarin work

Answer 28

interferes with vit K metabolism

Question 29

what are the vitamin K dependent clotting factors

Answer 29

VII XI X II

Question 30

dabigatran

Answer 30

direct thrombin inhibitor

Question 31

rivaroxaban and apixaban

Answer 31

direct factor Xa inhibitors

Question 32

besides the K dependent clotting factos, what does warfarin affect

Answer 32

protein C and S

Question 33

PT and PTT for low dose heparin

Answer 33

PT - normal | PTT- prolonged

Question 34

PT and PTT for high does heparin

Answer 34

PT - prolonged | PTT - prolonged

Question 35

PT and PTT for low dose warfarin

Answer 35

PT - prolonged | PTT - normal

Question 36

PT and PTT for high does warfarin

Answer 36

PT- prolonged | PTT - prolonged

Question 37

contraindication to warfarin

Answer 37

pregnancy | elderly

Question 38

warfarin necrosis most liley to happen where

Answer 38

thighs, breasts ,buttocks

Question 39

patients with warfarin necrosis have low levels of what

Answer 39

protein C

Question 40

herparin-induced thrombocytopenia

Answer 40

antibodies to herparin bind to heparin/platelet factor 4 complex results in endothelial injury and platelet activation which induces a prothrombotic state

Question 41

heparin - induced thrombocytopenia occurs more commonly in what

Answer 41

unfractionated heparin than low molecular weigh heparin

Question 42

bernad soulier disease

Answer 42

defect of platelet adhesion | problem with glycoprotein IB

Question 43

glanzmann's thrombasthenia

Answer 43

defect of platelet aggregation | problem with glycoproetin IIB/IIIa

Question 44

thrombotic thrombocytopenic purpura

Answer 44

antibodies directed against von willebrand factor cleaving protease

Question 45

von willebrand's disease

Answer 45

defiency of von willebrand's antigen | most common bleeding disorder

Question 46

Hemophilia A

Answer 46

factor VIII deficiency | X-linked recessive

Question 47

Hemophilia B

Answer 47

factor IX deficiency | X-linked recessive

Question 48

Hemophilia C

Answer 48

more mild factor XI deficiency autosomal recessive

Question 49

DIC

Answer 49

results from release of any substance into bloodstream that results in widespread activation of thrombin

Question 50

what are biochemical markers of DIC

Answer 50

plasmin and thrombin activity

Question 51

what can you use to diagnose DIC

Answer 51

D-DIMER