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Cardiovascular I > Hemostasis and coagulation > Flashcards

Hemostasis and coagulation Flashcards

1
Q

What is hemostasis?

A

Prevention of blood loss

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2
Q

What are the general steps of hemostasis?

A

Vascular constriction
Formation of platelet/primary plug
Formation of blood clot/secondary plug
Clot retraction and dissolution
Growth of fibrous tissue into the blood clot

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3
Q

What causes vasoconstriction in response to trauma?

A

Local myogenic spasm/contraction
Release of vasoconstrictors from platelets

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4
Q

What are the histological features of platelets?

A

Very small
No nucleus

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5
Q

What stimulates platelet production?

A

Thrombopoietin

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6
Q

What inhibits platelet activation?

A

Prostacyclin produced by endothelial cells

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7
Q

What is a potent inducer of platelet activation?

A

TXA2/thromboxane

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8
Q

What are the steps of platelet plug formation?

A

Adhesion
Activation
Aggregation

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9
Q

What mediates platelet adhesion?

A

Platelet receptors/glycoproteins bind to vWF on endothelial cells

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10
Q

What molecules released or produced from activated platelets help with platelet aggregation?

A

ADP
Serotonin
Thrombaxin

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11
Q

How does aspirin work?

A

It inhibits clycooxygenase and decreases the release of thrombaxin

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12
Q

What platelet receptors bind to vWF?

A

Gp 1b/1a

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13
Q

What platelet receptors bind to fibrinogen?

A

Gp IIb/IIa

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14
Q

What forms bridges between platelets?

A

Fibrinogen

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15
Q

What normally occurs to activate procoagulants?

A

Injury to endothelial cells
Failure of endothelial cells to produce anticoagulant factors
Activation of platelets

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16
Q

When does a clot start developing after trauma?

A

Within 15 to 20 seconds

17
Q

What does a clot begin to retract?

A

After 20 to 60 minutes

18
Q

What clotting factors require vitamin K?

A

Factor II, VII, IX, X

19
Q

What anticoagulants require vitamin K?

A

Protein C
Protein S

20
Q

What activates protein C?

A

Thrombomodulin

21
Q

How does Warfarin work?

A

Inhibits VKOR from reactivating vit K

22
Q

What activates the intrinsic pathway of coagulation?

A

When blood comes into contact with a negatively charged surface

23
Q

What activates the extrinsic pathway of coagulation?

A

When blood comes into contact with material from damaged cells
Tissue factor activation

24
Q

What is the function of thrombin?

A

Catalyzes the proteolysis of fibrinogen to fibrin
Activates factor XIII
Catalyzes the formation of new thrombin
Catalyzes the formation of Va and VIIIa

25
Q

What is the function of factor XIII?

A

Mediates formation of stable fibrin

26
Q

What can be indicated by failure of clot retraction?

A

Low platelets

27
Q

What activates and accelerates contraction during clot retraction?

A

Thrombin
Calcium ions

28
Q

What molecules in platelets lead to strong contraction during clot retraction?

A

Thrombosthenin
Actin
Myosin

29
Q

What increases the levels of circulating t-PA?

A

Bradykinin
Catecholamines

30
Q

What are the paracrine factors?

A

Prostacyclin
NO

31
Q

What is the function of prostacyclin?

A

Vasodilation
Inhibits platelet activation

32
Q

What is the general time frame to change a clot into fibrous tissue?

A

1 to 2 weeks

33
Q

What is the cessation of bleeding dependent on when testing bleeding time?

A

Adequate number of platelets
Ability of platelets to adhere to vWF and fibrinogen
Ability of the platelets to aggregate

34
Q

What is pathway is assessed by PT?

A

Extrinsic pathway

35
Q

What factors are assessed by PT?

A

Factors VII, X, II, V, and fibrinogen

36
Q

What pathway is assessed by PTT?

A

Intrinsic pathway

37
Q

What factors are assessed by PTT?

A

Factors XII, XI, IX, VIII, X, V, II, and fibrinogen

Cardiovascular I (20 decks)

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