Hemostasis

Question 1

Three layers of a blood vessel:

Answer 1

Tunica intima
Tunica media
Tunica externa

Question 2

Tunica intima

• *Internal elastic lamina in arteries

Answer 2

• Endothelium
• Basal lamina
• Subendothelial layer

Question 3

• Circumferentially arranged smooth muscle cells
• *External elastic lamina in arteries

Answer 3

Tunica media

Question 4

• Collagenous tissue and elastic fibers

Answer 4

Tunica adventitia/externa

Question 5

The eicosanoid platelet inhibitor

Answer 5

ECs secrete prostacyclin

Question 6

A vascular “relaxing” factor

Answer 6

ECs secrete nitric oxide

Question 7

An anticoagulant that regulates thrombin generation

Answer 7

ECs secrete the glycosaminoglycan heparan sulfate

Question 8

A vascular “relaxing” factor

Answer 8

ECs secrete nitric oxide

Question 9

A regulator of the extrinsic pathway of coagulation

Answer 9

ECs secrete TFPI

Question 10

Anticoagulant Properties

• Antagonist of TXA2
• Promotes vasodilation

Answer 10

Prostacyclin (PGI2)

Question 11

Anticoagulant Properties

• Smooth muscle relaxation - vasodilation
• Inhibits platelet activation
• Promotes angiogenesis via VEGF, bFGF

Answer 11

Nitric oxide

Question 12

Anticoagulant Properties

• Limits activation of extrinsic coagulation pathway

Answer 12

Tissue factor pathway inhibitor (TFPI)

Question 13

Anticoagulant Properties

• Promotes activation of Protein C

Answer 13

Thrombomodulin

Question 14

Anticoagulant Properties

• Enhances antithrombin

Answer 14

• Heparan Sulfate

Question 15

Procoagulant Properties

Answer 15

• Vasoconstriction
• Collagen
• von Willebrand Factor
• P-selectin
• Tissue Factor

Question 16

Collagen
• Platelets:___,____ receptors

Answer 16

GPVI, a2p1

Question 17

von Willebrand Factor
- Secreted from_____

Answer 17

Weibel-Palade bodies

Question 18

• Adhesion molecule promoting platelet and WBC binding

Answer 18

P-selectin

Question 19

Promotes activation of the coagulation system

Answer 19

Tissue Factor

Question 20

Fibrinolytic Properties

activates plasminogen to plasmin

• Plasminogen Activator Inhibitor-1 (PAI-1)
• Thrombin Activatable Fibrinolysis Inhibitor (TAFI)

Answer 20

• Tissue Plasminogen Activator (tPA)

Question 21

• Initial response to a vascular
injury

Answer 21

Primary Hemostasis

Question 22

Promotes activation of the coagulation system

Answer 22

Tissue Factor

Question 23

PRIMARY HEMOSTASIS

Platelets adhere to damaged vessel wall via interactions with____ and _____

• Endothelium:_____
• Platelets:

Answer 23

VWF and collagen

VWF

GPIb/IX/V

Question 24

Gp 1b/ix/v deficiency

Answer 24

Bernard soulier syndrome

Question 25

Gp iib/iiia deficiency

Answer 25

Glansmann thrombastenia

Question 26

PRIMARY HEMOSTASIS Platelets are activated - Shape change: from small, round discs to flat plates with spiky protrusions Release of secretory granules (2)

Answer 26

ADP - Adenosine Diphosphate TXA2 - Thromboxane A2

Question 27

PRIMARY HEMOSTASIS Platelet aggregation by _______ and ______

Answer 27

Fibrinogen and GP Ib/Illa

Question 28

PRIMARY HEMOSTASIS End product:

Answer 28

platelet plug formation

Question 29

Coagulation System Pathways (3)

Answer 29

Intrinsic Extrinsic Common

Question 30

• Do not play a significant role in physiologic coagulation • Deficiencies are reflected in prolonging the aPTT • Has a role in coagulation and inflammation

Answer 30

Contact Factors - Special Pathway

Question 31

Endpoint of SECONDARY HEMOSTASIS

Answer 31

Stable fibrin clot

Question 32

Intrinsic Tenase Complex

Answer 32

IXa VIIIa

Question 33

Extrinsic Tenase Complex

Answer 33

TF VIIa Calcium

Question 34

• Generates a burst of thrombin at the site of injury

Answer 34

Prothrombinase Complex

Question 35

Prothrombinase Complex

Answer 35

Xa Va Calcium