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Hemostasis Flashcards

(63 cards)

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1
Q

MODERN CONCEPT OF BLOOD COAGULATION

A

Cascade or “Waterfall” Hypothesis

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2
Q

MODERN CONCEPT OF BLOOD COAGULATION STAGES

A

STAGE 1 : Generation of thromboplastin activity (“intrinsic” and “extrinsic”)
STAGE 2 : Conversion of prothrombin to thrombin by “thromboplastin” in the presence of calcium

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3
Q

CONTACT GROUP

Includes:

A

Prekallikrein
Kallikrein
Factor XII
Factor XI

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4
Q

PROTHROMBIN (VITAMIN K DEPENDENT) GROUP

Includes:

A

Factor II, VII, IX, and X

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5
Q

Synthesized in the liver with Vitamin K as Co-Factor

A

PROTHROMBIN

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6
Q

is needed to carboxylate glutamate of the vitamin K dependent factors

A

Vitamin K

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7
Q

FIBRINOGEN GROUP

Includes :

A

Factor I, V, VIII, and XIII

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8
Q

Highest molecular weights of all factors
Most labile
Consumed in coagulation

A

FIBRINOGEN GROUP

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9
Q

Act as substrates for plasmin

A

FIBRINOGEN GROUP

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10
Q

FIBRINOGEN GROUP

All are found in the alpha granules of platelets EXCEPT __ and ___

A 
Factor XIII (platelet cytoplasm)
Factor VIII:C
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11
Q

A globulin (MW 341,000)

A

FACTOR I - Fibrinogen

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12
Q

FACTOR I - Fibrinogen NV

A

NV: 200-500mg/dL

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13
Q

FACTOR I - Fibrinogen Strengthened by Factor

A

Strengthened by Factor XIII

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14
Q

Stable protein of alpha globulin type (MW 63,000)

A

FACTOR II - Prothrombin

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15
Q

Related to Factor VII

A

FACTOR II - Prothrombin

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16
Q

A powerful proteolytic enzyme
Potent platelet aggregating substance
MW = 40,000

A

THROMBIN

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17
Q

The _ is the amount that will coagulate 1mL of standard fibrinogen solution in 15 seconds at 28C

A

THROMBIN UNIT

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18
Q

Protein intermediate between beta and gamma globulin

A

FACTOR V - Proaccelerin

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19
Q

Labile, deteriorating rapidly in oxalated plasma and even in frozen (-20C) specimens

A

FACTOR V - Proaccelerin

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20
Q

Not destroyed or consumed in the clotting process

Appears to be a beta globulin

A

FACTOR VII - Proconvertin

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21
Q

In-vivo survival after transfusion = 50% is lost within 8-12H More stable in FFP stored in -30 to -70C

A

FACTOR VIII – Antihemophilic Factor

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22
Q

The entire molecule as it circulates in the plasma

Composed of VIII:C and VIII:vWF portions which is not covalently bound

A

VIII/vWF

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23
Q

Portion capable of binding to endothelium and supporting normal platelet adhesion and function. Tested by the bleeding time

A

VIII:vWF

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24
Q

Portion acting in intrinsic system as cofactor to factor Ixa.
Tested by PTT

A

VIII:C

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25
Antigenic property of procoagulant portion as measured by monoclonal immunologiocal techniques
VIIIC:Ag
26
Factor VIII related antigen Large vWF portion and measured by immunologic techniques of Laurell rocket or immunoradiometric assay using heterologous antibodies
VIIIR:Ag
27
Ristocetin (antibiotic) cofactor activity | Required for platelet aggregation studies
VIIIR:RCo
28
Stable protein factor Not consumed during clotting Not destroyed by ageing No significant loss in blood and plasma stored at 4C X 2W Adsorbed by aluminum hydroxide and barium sulfate
FACTOR IX – Plasma Thromboplastin Component
29
Stable a-globulin protein factor | Activity related to Factor VII
FACTOR X – Stuart-Prower Factor
30
B-globulin protein factor | Activity related to Factor VII
FACTOR XI – Plasma Thromboplastin Antecedent
31
Stable globulin Adsorbed into powdered glass, Celite, or bentonite (negatively charged) Activity is accelerated by Fletcher (Prekallikrein) and Fitzgerald factor (HMWK)
FACTOR XII – Hageman Factor
32
Thrombin splits 4 arginyl-glycine bonds of fibrinogen to produce two peptides A, two peptides B and a fibrin monomer
FACTOR XIII – Fibrinase
33
Fine clot is produced from further polymerization | Fine clot is soluble in 5M urea and 1% monochloroacetic acid
FACTOR XIII – Fibrinase
34
FACTOR XIIa Initiates the Initiates Initiates
intrinsic coagulation system fibrinolysis kinin and complement systems
35
``` KALLIKREIN Perpetuates _ activation and its own production Initiates the _ Initiates _&_ Directly activates __ ```
Factor XII kinin system fibrinolytic and complement systems Factor IX
36
Most important Found in plasma and serum Acts on thrombin to form metathrombin
ANTITHROMBIN III
37
ANTITHROMBIN III Made up of:
Alpha 2 globulin Alpha 2 macroglobulin (Heparin cofactor) Alpha 2 antitrypsin
38
ATIII-deficiency
Thromboembolism and liver disease
39
``` ALPHA2 MACROGLOBULIN Inhibits _ but not completely Protect its bound enzymes against other circulating antithrombins Inhibits _ by inhibiting plasmin Inhibits _ ```
thrombin fibrinolysis kallikrein
40
ALPHA1 ANTITRYPSIN Potent inhibitor of _ Inactivates_ and _
Factor Xia | plasmin and thrombin
41
C’1 ESTERASE INHIBITOR Inhibitor of _ and _ Inhibits _ _ and _
fibrinolysis and coagulation | Factor XIIa, XIIf and XIa
42
Vitamin K dependent Potent inhibitors of coagulation Destroys Factors Va and VIIIa
PROTEIN C and S
43
_ is the cofactor of Protein C
Protein S
44
C:S complex enhances fibrinolysis by activating __ __
plasminogen activators
45
an enzyme that cleaves fibrinogen, fibrin, and other coagulation factors (ie. _ and _ )
PLASMIN VIII and V
46
Present in the blood are large amounts of alpha globulins with antiplasmin activity
INHIBITORS OF PLASMINOLYSIS
47
INHIBITORS OF PLASMINOLYSIS | Two types:
Immediate acting | Slow acting
48
Inhibitors of Plaminogen activators : _ and _
EACA and Tranexamic acid
49
Fine chromatin | Abundant cytoplasm
MEGAKARYOBLAST
50
(+) globules Many polyribosomes DMS first appears
PROMEGAKARYOCYTE
51
Marginated chromatin | Multinucleation
MEGAKARYOCYTE
52
Coagulation factors, permeability factors, PDGF (smooth muscle cell proliferation), fibrinogen, B-thromboglobulin and PF4 (heparin inhibition), and Factor Va
ALPHA GRANULES
53
Adenosine and guanosine di- and triphosphates, calcium, magnesium, serotonin
DENSE BODIES
54
``` Platelet Factors: PF-1 : Absorbed to __ PF-2 : A _ _ PF-3 : Involved in intrinsic cascade acting as prothrombin activator by catalyzing the reactions between Factors _ _ and _ PF-4: Inhibitor of _ and _ like activity ```
``` factor 5 - thrombin accelerator - Xa, V, and calcium - heparin and Factor XIII ```
55
PLATELET SYSTEM | Subdivided into 4 major zones under the electron microscope:
PERIPHERAL ZONE SUBMEMBRANE AREA SOL-GEL ZONE ORGANELLE ZONE
56
PERIPHERAL ZONE
– Glycocalyx and Plasma Membrane
57
SUBMEMBRANE AREA
– Filaments
58
SOL-GEL ZONE
– Microtubular
59
Blood vessels and tissues injured; bleeding begins through _ and _ __ of the injured vessels The torn endothelium__ and curls up _ _ are released from damaged tissues
transected and injured vessels Nervous vasoconstriction retracts Thromboplastic substances
60
Plasma flows over the damaged tissues – __is activated and triggers the activation of the intrinsic system; __ activates tissue thromboplastic substances and activates the extrinsic system
Factor XII Factor VII
61
The activated _ thromboplastin(s) in the presence of calcium then interacts with _ and _ , forming definitive thromboplastin which converts prothrombin to thrombin
extrinsic | Factor V and X
62
In the meantime, _ adhere to damaged endothelium; _ from extrinsic pathway and _ adhere with the platelets adhering to __, causing aggregation to a plug
platelets thrombin ADP subendothelial collagen
63
In the meantime, the intrinsic mechanism is activated  _ _ Fibrinogen  Fibrin Fibrin absorbs excess thrombin and the remainder is neutralized by _ The _ so produced between and on the framework of the platelet plug polymerizes and contracts, thus effectively anchoring the platelet plug and sealing the defect of the vessel _ grows over the plug and clot within the lumen is dissolved for _
increased thrombin antithrombins fibrin latticework Endothelium recanalization

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