Lecture 8 - Coagulation (Classic)

Question 1

most coagulation factors are synthesized in the

Answer 1

liver

Question 2

factors circulate in __ form

Answer 2

inactive

Question 3

factor 4

Answer 3

calcium

Question 4

factor 2a

Answer 4

thrombin

Question 5

factor 1

Answer 5

fibrinogin

Question 6

the classic cascade model for coagulation includes

Answer 6

extrinsic, intrinsic and common pathways

Question 7

vitamin K dependent coagulation factors (essential!!!)

Answer 7

2 (thrombin), 7, 9, 10

Question 8

__ states can cause body to not process fat and end up with vitamin K deficiency = not able to clot well due to factors 2, 7, 9, 10 compromised

Answer 8

maldigestion dz (vitamin K is fat soluble)

Question 9

vitamin K dependent enzyme in the __ is essential for the sythesis of vitamin K-dependent factors

Answer 9

liver

Question 10

__ intoxication targets vitamin K dependent factors = can’t clot!

Answer 10

anticoagulatant rodenticides (factor 7)

Question 11

factor __ has the shortest half life

Answer 11

7

Question 12

what pathway occurs when negatively charged endothelium tissue is damaged

Answer 12

extrinsic/tissue factor pathway (factor 7/Ca/Tissue Factor)

Question 13

How is extrinsic pathway initiated

Answer 13

exposed subendothelial cells and tissue factor

factor 7 binds and is activated by Ca

Question 14

7a/Ca/Tissue factor activates

Answer 14

factor 10 (and factor 9)

Question 15

Factor 10a binds to

Answer 15

5a on the platelet, Ca++ brings negative charged complex to the negative surface bc it is +

Question 16

Factor 10a/5a/Platelet complex activates

Answer 16

small amounts of prothrombin (factor 2) to thrombin (2a)

Question 17

Thrombin (2a) converts __ and __

Answer 17

1. fibrinogen (factor 1) into fibrin monomers AND

2. factor 13 into 13a to cross link the fibrin monomers to form stable cross linked fibrin/secondary hemostatic plug

Question 18

What does factor 13a do?

Answer 18

cross link the fibrin monomers to form stable cross linked fibrin/secondary hemostatic plug

Question 19

what are 2 main feedback loops to amplify the extrinsic pathway

Answer 19

1. 10a activates 7 to 7a (starts whole cascade over)

2. 7a activates factor 9 to 9a which activates common pathway

Question 20

propagation is initiated by thrombin (factor 2) which activates everything and is called the __

Answer 20

thrombin burst = majority of fibrin forms from this!

Question 21

__ converts fibrin monomers into cross linked fibrin

Answer 21

thrombin (2a) (via 13a)

Question 22

__ initiates the thrombin burst

Answer 22

thrombin (2a)

Question 23

Factor 12 (hageman), HMWK, and prekallikrein are part of factors used __ (outside body) to activate coagulation system by physical contact. in the actual body they are not required to start the coagulation process. They have more involvement in __ pathways and __ and __ activation.

Answer 23

in vitro

inflammatory and complement, fibrolysis

Question 24

Factor 12, HMWK, prekallikrein are __ acivated by physical contact and __ are not important to hemostasis, but it’s function in hemostasis is useful in lab tests)

Answer 24

in vitro (outside body), in vivo (inside body)

Question 25

is the coagulation cascade the main function of factor 12 (hageman factor)

Answer 25

no, it is a minor function (it also involved in inflammation, complement and fibrolysis activation)

Question 26

hemostasis is the interaction of BV, platelets, and coagulation factors to stop hemorrhage without

Answer 26

obstructing blood flow (balance between fibrin clot formation and degradation)

Question 27

__ is initiated at the same time as coagulation

Answer 27

fibrinolysis (clot degradation)

Question 28

important fibrinolysis/coagulation inhibitor factors

Answer 28

1. plasmin 2. antithrombin 3 3. protein C with protein S 4. Tissue Factor Pathway Inhibitor (TFPI)

Question 29

Tissue factor activates tissue plasminogen activator which converts

Answer 29

plasminogen to plasmin (fibrionlysis)

Question 30

plasmin breaks down what 3 things

Answer 30

fibrinogen, fibrin monomers and cross linked fibrin