Module 3: Mechanisms of Normal Hemostasis (from review sheet)

Question 1

Hemostasis

Answer 1

prevention and arrest of bleeding by rapid repair of nay ruptures in blood vessels

Question 2

5 components of hemostasis

Answer 2

vascular
platelet
coagulation system
fibrinolytic system
natural anticoagulants and inhibitors

Question 3

3 things secreted by endothelial cells that make them thromboresistant

Answer 3

heparin sulfate
Prostacyclin
nitrous oxide

Question 4

2 types of vasoconstriction after injury

Answer 4

muscular
humoral (delayed due to release of endothelin)

Question 5

endothelin

Answer 5

secreted by endothelial cells

induces smooth muscle contraction for vasoconstriction

Question 6

2 things released by injured tissue

Answer 6

Tissue thromboplastin (III)
Tissue Plasminogen Activator (TPA)

Question 7

Tests for vascular response (3)

Answer 7

bleeding time
closure test
capillary fragility test

Question 8

why is Thrombopoiesis different from other cells (2)

Answer 8

megakaryocytic get bigger as they mature

no cellular division

Question 9

platelet lifespan in blood

Answer 9

8-10 days

Question 10

3 zones of platelet

Answer 10

peripheral
sol gel
organelle

Question 11

peripheral zone

Answer 11

plasma membrane
outer coating
glycocalyx
Important for adhesion and aggregation

Question 12

Sol gel zone

Answer 12

cytoskeleton with contractile proteins thrombosthenin and actomyosin
importnat in plt retraction, shape changes, viscous metamophosis in secondary aggregation

Question 13

Organelle zone

Answer 13

canicular system, dense bodies, alpha granules (PF3, fibrinogen, thrombospondin, PF4), dense tubular system (stores Ca2+)
Important in plt retraction and prostaglandin synthesis

Question 14

% of platelets in circulation

Answer 14

70%

Question 15

% of platelets in spleen

Answer 15

17%

Question 16

% of platelets in liver, lungs, bone marrow

Answer 16

13%

Question 17

Platelet factor

Answer 17

substance absorbed onto the plt membrane or carried in the plt granules that are released during the release reaction and that influence homeostasis

Question 18

PF1

Answer 18

absorbed coagulation factor V

Question 19

PF2

Answer 19

fibrinogen activating factor

Question 20

PF3

Answer 20

platelet phospholipid

acts as organization surface to bring required factors into close proximity and facilitate reaction

Question 21

PF4

Answer 21

anti-heparin factor

glycoprotein that inhibits the reaction of heparin

Question 22

Platelet functions (2)

Answer 22

hemostatic functions (plug, adhesion, aggregation and retraction)
Thromboplastic (actual clot, plt releases chemicals that reinforce vasoconstriction, aggregation and coagulation reactions that promote growth and healing)

Question 23

platelet adhesion requires (2)

Answer 23

GPIb

vwF

Question 24

Primary aggregation requires (4) - reversible

Answer 24

ADP
GIIb/IIIa
Ca2+
Fibrinogen

Question 25

secondary aggregation requires (2) - irreversible

Answer 25

ADP and thrombin

Question 26

Result of secondary aggregation (3)

Answer 26

induce prosaglandin synthesis activate enzymes that hydrolyse plt membrane phospholipids Arachidonic acid used by cyclooxyrgenase to produce PGH2 and then the enzyme TxA2 syntheses changes PGH2 into TxA2

Question 27

Thromboxane A2 functions (3)

Answer 27

release calcium lowers camp levels vasoconstrictor

Question 28

Contractile protein involved in plt retraction

Answer 28

Thrombosthenin

Question 29

Inhibitors of plt aggregation will increase CAMP levels by

Answer 29

activating adenylcyclase or inhibiting phosphodiesterase

Question 30

Aggregation agents will decrease CAMP levels by

Answer 30

inhibiting adenycyclase or activating phosphodiesterase

Question 31

Chelating agents inhibit plt aggregation by

Answer 31

removing Ca2+

Question 32

Heparin inhibits

Answer 32

thrombin

Question 33

Aspirin inhibits plt aggregation by

Answer 33

inhibiting TxA2 synthesis in plts

Question 34

Screening test for plts (4)

Answer 34

plt count bleeding time closure time capillary fragility

Question 35

Function tests for plt adhesion, aggregation, retraction (5)

Answer 35

``` plt adhesion tests plt aggregation tests prothrombin consumption time PF3 availability clot retraction ```

Question 36

Tests for cause of low plt (3)

Answer 36

bone marrow examination tests for anti-plt antibody Plt survival studies

Question 37

All activated enzymes are _____ except XIIIa

Answer 37

serine proteases

Question 38

XIIIa

Answer 38

transamidase

Question 39

Factor that is never "activated"

Answer 39

I

Question 40

Factor VIII made up of 2 components

Answer 40

antihemophilic | VWF

Question 41

Contact group key words

Answer 41

His private parts hurt HMWK, PTA, PK, Hageman

Question 42

Prothrombin group key words

Answer 42

Presents save christmas Santa Prothrombin, stuart-prower, christmas, stable

Question 43

Fibrinogen group key words

Answer 43

Fancy ladies acquire funds Fibrinogen, Labile, antihemophilic, fibrinase

Question 44

Intrinsic group key words (APTT)

Answer 44

Horny prostitutes have coitus and spread legs for precious pennies HMWK, Prothrombin, hageman, christmas, antihemophilic, stuart power, labile, fibrinogen, pta, pk

Question 45

extrinsic group key words (PT)

Answer 45

Silly sluts love pillow fights Stuart prower, stable, labile, prothrombin, fibrinogen

Question 46

Factors key words

Answer 46

``` French I Fibrinogen prostitutes II Prothrombin tell III Tissue factor clients IV Ca2+ loves V Labile stupid VII Stable anyways VIII Antihemophilic children IX Christmas spend X Stuart-prower pennies XI PTA hella XII Hageman fast XIII Fibrinase ```

Question 47

Thrombin major functions (4)

Answer 47

converts fibrinogen to fibrin activates factor XIII enhances factor V and VIII induces plt aggregation

Question 48

How does factor XIII stabilize fibrin clot

Answer 48

catalyzing formation of strong covalent bonds between amino acids of fibrin monomers in different polymers

Question 49

Localization and control of hemostasis (5)

Answer 49

inhibition of hemostasis by products of coagulation concentration of coagulation factors by their adoption onto plt surface Natural antithrombins in plasma (pinocytosis) Tissue damage starts fibrinolytic system Thrombomodulin binds to thrombin and activates protein C (destroys V and VIII)

Question 50

most significan antithrombin

Answer 50

antithrombin III activated by heparin Inhibits: II, VII, IX, X, XI, XII

Question 51

2 ways plasminogen activated plasmin

Answer 51

tpa secreted by injury weakly activated by thrombin accelerated by XII, HMWK, PK

Question 52

5 actions of plasmin

Answer 52

``` digest/destroy structure of fibrinogen/fibrin produces FDP destroys V, VIII, IX, XI activates complement enhances XII and PK ```

Question 53

FDP roles (3)

Answer 53

inhibit thrombin inhibit fibrin polymerization increase vascular permeability

Question 54

tests for fibrinolysis (2)

Answer 54

``` D Dimer (increased; secondary fibrinolysis) Fibrinogen assay (decreased) ```

Question 55

Groups consumed during coagulation

Answer 55

fibrinogen group XI from contact group II from prothrombin group

Question 56

Groups present in serum (after clotting)

Answer 56

contact and prothrombin (except factor II)

Question 57

groups Present in plasma

Answer 57

contact, prothrombin and fibrinogen (except I, XIII)

Question 58

Groups absorbed by BaSO4

Answer 58

prothrombin group

Question 59

Groups Present in absorbed plasma

Answer 59

contact and fibrinogen

Question 60

Groups dependent on Vit K

Answer 60

Prothrombin

Question 61

Groups synthesized in liver

Answer 61

Prothrombin and fibrinogen (except VIII)