Hemostasis

Question 1

Whats primary and secondary hemostasis

Answer 1

Primary

• Vasoconstriction
• Platelet Plug formation - activation, adhesion, aggregation

Secondary
- Fibrin Clot formation - Coagulation Cascade

Question 2

Gimme platelet’s GP interactions during adhesion and aggregation

Answer 2

Adhesion

• vMF - 1b-9-5
• Collagen - 1a 2a

Aggregation
- platelet - 2b, 3a; Fibrinogen

Question 3

Gimme the fat cascades

Answer 3

Intrinsic Pathway/ Contact activation (on collagen, others)

• Factor 12, 11, 9 + 8
• Factor 10

Extrinsic Pathway - PT time

• Tissue Factor + Factor 7
• Factor 10

Factor 10-5
- Prothrombin - Thrombin

Thombin - Fibrinogen to Fibrin + Factor 13 to cross link

Question 4

Gimme fat natural anti-coagulants + fibrinolytics

Answer 4

Natural AC:

• Protein C Protein S
• • Block 5 + 8
• Antithrombin III
• • Block 10, Thrombin (2) also 9 11 12 7

Tissue Factor Pathway Inhibitor
– Block 10, TF-7 complex

tissue Plasminogen Activator
- Plasminogen to Plasmin

Question 5

Platelet disorders vs Coagulation disorders

Answer 5

Petechiae, Skin, Mucous membrane
VS
Deeper - joints, muscles, deep ecchymoses;

Question 6

Tests

Answer 6

1st Line: PT, aPTT/PTT

• Partial thromboplastin time / activated partial thromboplastin time (aPTT)
• Prothrombin time

INR: PTtest/PTnormal power to an index

2nd Line: mixing test for aPTT - if corrected means deficiency if not corrected is inhibit

Question 7

Whats Hemophilia A and Hemophilia B and hereditary pattern

Answer 7

F8
F9

both XLR

Question 8

vWF Disease

Answer 8

vWF - AD

Function

• stabilize Factor 8 - hence aPTT prolonged
• Platelet adhesion - 1b 9 5

Question 9

Factor V Leiden

Answer 9

Resistant to APC - AD

Hypercoagulability