MTAP W4 (Hematology: Checkpoint notes: Hemostasis) Flashcards by JHOANNA LYNN LUMBOY

Q

process of forming barrier to blood loss and maintain blood in fluid state

when out of balance:
1. hemorrhage
2. thrombosis

A

hemostasis

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Q

formation of primary hemostatic plug or platelet plug

A

primary hemostasis

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Q

components:
1. vascular system
2. platelets

A

primary hemostasis

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Q

events include: vasoconstriction, platelet adhesion, platelet aggregation=initial plug

A

primary hemostasis

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Q

formation of stable fibrin clot

A

secondary hemostasis

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Q

components: coagulation factors

A

secondary hemostasis

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Q

events include: fibrin stabilization by factor XIII, coag factors interact on platelet surface to produce FIBRIN

A

secondary hemostasis

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Q

secondary hemostasis
fibrin stabilization by factor -

A

factor XIII/13

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Q

physiologic process that removes insoluble fibrin deposits by enzymatic digestion of stabilized fibrin polymers

A

fibrinolysis

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Q

gradual digestion and removal of fibrin clot as healing occurs

A

fibrinolysis

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Q

release of tissue plasminogen activator, conversion of plasminogen to plasmin, conversion of fibrin to fibrin degradation products

A

fibrinolysis

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Q

Primary hemostasis: Component

consist of ENDOTHELIAL CELLS, basement membrane and subendothelial connective tissue

A

tunica intima

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Q

Primary hemostasis: Component

thicker in arteries than in veins, contains smooth muscle cells which contract and expand

A

tunica media

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Q

Primary hemostasis: Component

thicker in veins than in arteries

A

tunica adventitia/externa

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Q

Primary hemostasis: Component

lines the blood vessels

A

endothelium

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Q

Primary hemostasis: Anticoagulant Properties

eicosonaid platelet inhibitor and vasodilator

A

prostacyclin

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Q

Primary hemostasis: Anticoagulant Properties

vascular ‘relaxing’ factor

A

nitric oxide

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Q

Primary hemostasis: Anticoagulant Properties

glycosaminoglycan that enhances antithrombin activity

A

heparan sulfate

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Q

Primary hemostasis: Anticoagulant Properties

extrinsic pathway regulator

A

tissue factor pathway inhibitor

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Q

Primary hemostasis: Anticoagulant Properties

endothelial surface receptor for thrombin

A

thrombomodulin

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Q

Primary hemostasis: Anticoagulant Properties

activating fibrinolysis

A

tissue plasminogen activator

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Q

protein C pathway is catalyzed by

A

thrombomodulin

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Q

downregulates coagulation by digesting activated factors V and VIII, thereby inhibiting thrombin formation

A

protein C pathway

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Q

Primary hemostasis: Procoagulant Properties

smooth muscle cells in arterioles and arteries induce -

A

vasoconstriction

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Primary hemostasis: Procoagulant Properties exposed subendothelial - bind VWF and platelets

collagen

Primary hemostasis: Procoagulant Properties damaged/activated ECs secrete - and adhesion molecules

vWF

Primary hemostasis: Fibrinolytic Properties activates fibrinolysis

tissue plasminogen activator

production is influenced by THROMBOPOIETIN prdocued in the liver or kidney secretes coagulation factors stored in their granules

platelets

first response to injured vessel

vasoconstriction

vasoconstriction is initiated by - and - derived from platelets and endothelial cells

Serotonin Thromboxane A

attachment of platelets to collagen and other components

adhesion

adhesion: collagen

in vivo

adhesion: glass

in vitro

Primary hemostasis at HIGH SHEAR rates, platelet adhesion requires presence of both - and receptor -

vWF and GPIB/IX/V

Primary hemostasis at LOW SHEAR rates - receptors mediate direct collagen binding

GPIaIIa and GPVI

Primary hemostasis occurs within 1-2mins after a break PASSIVE< non-energy-requiring process and potentially reversinle

vasoconstriction

multimeric protein that contains binding sites for both GP1b and IX

vWF

synthesized by ENDOTHELIAL CELLS and MEGAKARYOCYTES

vWF

vWF; stored in intracellular granules and secreted into the plasma - in endothelial cells

weibel palade bodies

vWF; stored in intracellular granules and secreted into the plasma - in platelets

alpha granules

stimulate platelets and activate them

platelet agonists

- agonists 1.ADP 2.PAF/platelet-activating factor 3.serotonin 4. thromboxane A 'STAP'

platelet-derived agonist

- agonists 1.collagen 2. thrombin 3. epinephrine 'CET'

non-platelet-derived agonist

strong agonist does not require - activity

cyclooxygenase

the most potent activator of platelets in vivo

thrombin

during platelet activation, PHOPHOLIPASE A2 converts phospholipid to -

arachidonic acid

ARACHIDONIC acid is converted to prostaglandin endoperoxidase by -

cyclooxygenase

causes release of ca which promotes platelet aggregation and vasoconstriction

TXA2

potent agonist and can stimulate platelet activation and secretion

TXA2

permanently blocks the action of cyclooxygenase-1 and TXA2 synthesis, impairing plt function

aspirin/acetylsalisylic acid

Platelet DENSE BODIES-small molecules component: - agonist for platelets

ADP

Platelet DENSE BODIES-small molecules component: - agonist for cells other than platelets; activates ca influx channel in outer membrane

ATP

Platelet DENSE BODIES-small molecules component: - platelet activation

calcium

Platelet DENSE BODIES-small molecules component: - vasoconstriction, platelet antagonist

serotonin

strong agonist does not require - activity

cyclooxygenase

- stimulation results in increased cytoplasmic calcium, more plt release and the appearance of active fibrinogen receptors

ADP

PLATELET ALPHA GRANULES- LARGE GRANULES GROUP 1-HEMOSTATIC PROTEINS platelet aggregation; conversion to fibrin

fibrinogen

PLATELET ALPHA GRANULES- LARGE GRANULES GROUP 1-HEMOSTATIC PROTEINS fibrin formation

Factor V, XI

PLATELET ALPHA GRANULES- LARGE GRANULES GROUP 1-HEMOSTATIC PROTEINS plt adhesion; carries FVIII in plasma

VWF

PLATELET ALPHA GRANULES- LARGE GRANULES GROUP 1-HEMOSTATIC PROTEINS fibrinolysis

plasminogen

PLATELET ALPHA GRANULES- LARGE GRANULES GROUP 1-HEMOSTATIC PROTEINS when released from activated plt, protect newly formed clots from lysis

PAI-a, a2-antiplasmin

PLATELET ALPHA GRANULES- LARGE GRANULES GROUP 2-NONHEMOSTATIC PROTEINS PLATELET SPECIFIC chemoattractant for neutrophils, fibroblast neutralizes heparin

b-thromboglobulin

PLATELET ALPHA GRANULES- LARGE GRANULES GROUP 2-NONHEMOSTATIC PROTEINS PLATELET SPECIFIC weak chemoattractant for neutrophils, fibroblasts neutralizes heparin

platelet factor 4