Hemostasis

Question 1

Cofactors are enzymes except..

Answer 1

V & VIII

Question 2

Vitamin K derivates

Answer 2

II, VII, IX & X

Question 3

I

Answer 3

1 Fibrinogen
source - liver
clot formation

Question 4

II

Answer 4

2 prothrombin
liver/platelets
Vit K derivative
active forme activates I, V, VII, XIII

Question 5

III

Answer 5

3 Tissue Factor
Vascular wall
cofactor with VII
*activates clotting cascade, procoagulant

Question 6

IV

Answer 6

4 Calcium
diet
promotes clotting

Question 7

V

Answer 7

5 Proaccelerin
liver
X cofactor

Question 8

VI

Answer 8

6 - no assignment

Question 9

VII

Answer 9

7 - Proconvertin
liver
vit K derivative
activates IX and X

Question 10

VIII

Answer 10

8 - Antihemophiliac
liver
activates X

Question 11

IX

Answer 11

9 - Christmas
liver
vit K derivative

Question 12

X

Answer 12

10 - Struart Power
liver
vit k derivative
activates II

Question 13

XI

Answer 13

11 Plasma Thromboplastin
liver
activates IX

Question 14

XII

Answer 14

12 Hageman
liver
activates XI

Question 15

XIII

Answer 15

13 Fibrin stablizing
liver
links fibrin

Question 16

vWF

Answer 16

Von Willibrand Factor
endothelial layer
adhesion, procoagulant

Question 17

Endothelial Vasocontrictors

Answer 17

ADP
Thromboxane A2
Serotonin

Question 18

Endothelial Vasodilators

Answer 18

NO

Prostacyclin

Question 19

Endothelial Coagulation Inhibitor

Answer 19

Tissue Factor Pathway Inhibitor

Question 20

Subendothelial - Tunica Media

Answer 20

thrombogenic

collagen and fibronectin

Question 21

II cont…

Answer 21

Pothrombin –> Thrombin is vital to both pathways

thrombin activates V, VII and IX, “the anticoag”

Question 22

CBT Initiation

Answer 22

TF and VIII complex activate common and intrinsic pathways

Question 23

CBT Amplification

Answer 23

platelets activated

Question 24

CBT Propogation

Answer 24

bursts of thrombin

Question 25

Fibrinolytic System

Answer 25

no more plugging needed | protein C & S inhibit III, V and VIII

Question 26

Platelet

Answer 26

formed at marrow, no nucleus produces thrombin alpha and dense granules

Question 27

Alpha granules

Answer 27

vWF fibrinogen, fibronectin platelet factor 4 platelet growth factor

Question 28

Dense Granules

Answer 28

``` serotonin ADP ATP histamine epinephrine ```

Question 29

Intrinsic Clotting Pathway

Answer 29

vessel damage initiated by prekalikrein and HMWK XII, XI, IX and VIII

Question 30

Extrinsic Clotting Pathway

Answer 30

outside injury FIII tissue factor activates factor VII

Question 31

Common Pathway

Answer 31

formation of prothrombinase complex stable clot X, V, II, XIII

Question 32

bleeding time

Answer 32

3-7 mins

Question 33

platelet count

Answer 33

150,000-350,000 <100,000 = thrombocytopenic <50,000 = surgical risk <20,000 = bleeding risk dose 1 pack/kg

Question 34

PT

Answer 34

``` prothrombin time 12-14 sec III, VII & X, V, II, I *prolonged with extrinsic or common pathway disorder altered by coumadin derivates ```

Question 35

aPTT

Answer 35

``` 25-32 sec XII, XI, IX, VIII X, V, II, I, XIII *prolonged with intrinsic or common pathway disorder -heparin and lovenox ```

Question 36

cryoprecipitate

Answer 36

fibrinogen < 80-100 mg/dl with bleeding

Question 37

Sickle Cell Trait

Answer 37

heterozygous, 10%

Question 38

Sickle Cell Disease

Answer 38

homozygous

Question 39

HIT Type 1

Answer 39

not immune mediated onset 1-4 days mild thrombocytopenia, resolves usually high dose heparin

Question 40

HIT Type 2

Answer 40

``` immune mediated onset 5-14 days severe thrombocytopenia usually low dose heparin associated with poor outcomes ```

Question 41

Hemophilia A

Answer 41

FVIII deficiency

Question 42

Hemophilia B

Answer 42

FIX deficiency