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Fundamentals 2 > Hemostasis and Thrombosis > Flashcards

Hemostasis and Thrombosis Flashcards

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1
Q

ecchymoses

A

larger bruises that color change as hemoglobin is broken down

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2
Q

petechiae

A

tiny hemorrhages

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3
Q

purpura

A

medium hemorrhages

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4
Q

hematoma

A

accumulation of blood in a tissue

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5
Q

hemarthrosis

A

hemorrhage into a joint

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6
Q

hemostasis by definition

A

stopping the flow of blood

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7
Q

3 stages of hemostasis

A

1) reflex vasoconstriction
2) primary hemostasis
3) secondary hemostasis

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8
Q

reflex vasoconstriction

A

baroreceptors detect low BP and vessels automatically constrict to roughly stop bleeding / increase BP

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9
Q

7 steps of primary hemostasis in general

A

1) endothelial injury
2) exposure of subendothelial vWF + collagen
3) platelet adhesion to vWF
4) change in platelet shape + receptor affinity change
5) secretion of granule contents
6) platelet recruitment and aggregation
7) platelet plug

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10
Q

what is primary hemostasis?

A

platelet plug

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11
Q

How do platelets adhere to vWF?

A

through Gp1B receptors

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12
Q

What does a change in platelet shape change affinity for?

A

GpIIb / II a affinity

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13
Q

What are platelets derived from?

A

megakaryocytes

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14
Q

what 3 receptors do platelets express? What are they for?

A

1) fibrinogen - GpIIb/a
2) vWF - Gp1B
3) collagen - a2B1

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15
Q

What do activated platelets express at their surface?

A

phosphatidylserine

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16
Q

how can you assess platelet function?

A

measure closure time

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17
Q

closure time

A

time it takes for blood to plug a small hole

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18
Q

what type of granules do platelets contain?

A

alpha and dense-core granules

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19
Q

What molecules is an activator of platelets?

A

ADP

*induces conformation change

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20
Q

Thromboxane A2

A

potent vasoconstrictor that promotes platelet aggregation and activation

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21
Q

How does aspirin work

A

inhibits COX

by inhibiting COX, you have less thromboxane A2 and less platelet activation

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22
Q

COX

A

normally catalyzes production of thromboxane A2

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23
Q

Plasminogen activator inhibitor (PAI)

A

secreted by endothelial cells

limits fibrinolysis and favors thrombosis

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24
Q

vWF

A

large protein in subendothelial tissue that allows platelets to bind

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25
What links primary and secondary hemostasis?
vWF allows platelets to bind vWF also stabilizes Factor VIII
26
What is the end product of secondary hemostasis?
fibrin clot
27
What is the first step of secondary hemostasis?
vascular injury expresses Tissue Factor which binds to and activates factor VII
28
tissue factor
activates factor VII membrane protein that is synthesized by “activated” endothelial cells, fibroblasts, and smooth muscle cells
29
What are the coagulation factors?
a series of serine proteinases
30
What does thrombin do?
converts fibrinogen to fibrin triggers positive feedback
31
What blood test measures the extrinsic pathway and common pathway?
PT
32
What blood test measures the intrinsic pathway and common pathway?
PTT
33
What does a long PT or PTT indicate?
clotting problem takes too long to clot
34
INR
compares PT to standard
35
High INR indicates ...
high likelihood of bleeding
36
What is hemophilia associated with?
absence of factor VII
37
After tissue factor activates, factor VII what happens?
factor IX is activated
38
What factors does thrombin activate as part of positive feedback loop
factor 13, 11, 8 and 5
39
Factor XIII
stabilizes fibrin clot by cross-linking fibrin important for clot stabilization
40
What can elevated D-Dimer indicate?
you had or have a clot somewhere that is currently being degraded
41
Problems with D-dimer
use when suspicion is low/moderate as a screening test not the best test
42
How does D-dimer arise physiologically?
plasmin degrades the fibrin clot into D-dimers
43
t-PA
converts plasimonogen to plasmin *plasmin breaks down fibrin
44
alpha2-antiplasmin
prevents plasmin by sequestering it allows the clot to remain for longer
45
what occurs at the same time as activation of the coagulation cascade?
fibrinolytic cascade is also set in motion
46
urokinase
also converts plasminogen to plasmin, like tPA
47
what regulates plasmin activity?
alpha2-antiplasmin
48
heparin-like molecule
activates antithrombin which inhibits thrombin
49
difference in fibrinolysis and anti-thrombosis
fibrinolysis = breakdown of fibrin clot anti-thrombosis = clot never forms to begin with
50
What is another term for thrombin?
factor II
51
What else does heparin inhibit, in addition to thrombin?
factor X
52
protein C/S network
inactivates Va and VIIIa and thereby quells the common/intrinsic pathways for coagulation
53
heparin
anticoagulant combines with antithrombin to inhibit the activity of thrombin and Xa
54
What type of drug is aspirin?
NSAID
55
clopidogrel
antiplatelet blocks ADP receptors which inhibits platelet activation
56
xarelto / rivaroxaban
anticoagulant directly inhibits factor Xa, thus inhibiting coagulation
57
warfarin / coumadin
anticoagulant inhibits vitamin K-dependent clotting factor synthesis cannot produce clotting factors in the liver
58
VKORC1
enzyme that activates vitamin K stores in the liver needed to synthesize clotting factors
59
Virchow triad
endothelial injury abnormal blood flow hypercoagulability *risk factors for thrombosis
60
lines of zhan
only thrombi show lines of Zahn blood clots lack lines of Zahn layers of fibrin admixed with layers of aggregated platelets and blood cells
61
Factor V leiden
in-born hypercoagulable state factor V is resistant to inactivation by protein C+S therefore, factor V stays on for longer and there is more clotting
62
definition of embolus
any bolus that moves ex: thrombosis = clot embolus

Fundamentals 2 (30 decks)

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