Normal Hemostasis - Coag Cascade

Question 1

Factor 1/ FI
also a?

increased with?

high levels associated with?

dysfucntional w?

Answer 1

AFR
increased w inflammation/pregnancy/smokers

high fibrinogen assoc w bleeding

dysfuctional w thrombosis

Question 2

FII

Answer 2

prothrombin
Vit K dependent
one of magic 4

Question 3

FIII - TFIII
cofactor or activation of?

Answer 3

released from injured cells
cofactor for activation of FVII

no known deficiency

Question 4

FIV

mediates?
low #

in coag screen?

Answer 4

calcium

mediates plt adhesion

low number not a problem in vivo

in coag screen must add calcium to overcome anticoag

Question 5

FV

can attach?
inactivated by?

Answer 5

LABILE
can attach to receptors
inactivated by protein C

Question 6

FVI

Answer 6

doesnt exist

Question 7

FVII
what kind?

activated by?

Answer 7

Stable factor

Vit K dependent
magic 4

activated by FFIII/ Calcium

Question 8

FVIII

what complex?
deficiency?
unstable when?

what portion?

Answer 8

von willebrand complex

deficiency = hemophilia A

unstable when not bound to VWF

coagulant/clotable portion

Question 9

FIX
deficiency?

Answer 9

christmas factor

Vit K dependent
magic 4

deficiency Hemophilia B

Question 10

F X
what complex

Answer 10

magic 4
prothrombin complex
stuart factor

Question 11

F XI

what kind?

deficiency?

complexes with?

Answer 11

contact factor activated by glass

Def causes hemophilia C

complex with HMWK

Question 12

F XII
another name?
what kind?

only factor?

Answer 12

hageman

contact factor activated w glass

activates XI w HMWK/PK and kalikrein

ONLY FACTOR DEF THAT DOESNT CAUSE BLEEDING

Question 13

F XIII
also called

acts by

bonds where?

not? MUST

Answer 13

fibrin stabilizing factor

act by thrombin/calcium

covalent bonds between D domains in fibrin

Not tested for in coag screen, MUST detect a def w UREA CLOT LYSIS

Question 14

PK

Answer 14

contact factor

does not cause bleeding w defciencies

Question 15

HMWK

Answer 15

contact factor

doesnt cause bleeding

Question 16

Bradykinins
increase
contract

dilate

induce

Answer 16

increase vasc perm

contract smooth muscle
dialate BV

induce inflammation

Question 17

Healthy clot

Answer 17

fibrinogen, XIII, VWF

Question 18

NOT EDTA

Answer 18

degrades factor V

Question 19

NOT heparin
inhibits?

Answer 19

inhibits coag factors

Question 20

No hemolyzed blood

what happens in rbcs?

Answer 20

erythrocetin in rbcs has thromoplastic effect

Question 21

Handling

Answer 21

glass can activate coag cascade, use PLASTIC

Question 22

Sample storage
fridge for?

what rt?

freeze at? and then

Answer 22

Fridge for 4hr

PT room temp

freeze at -20c or colder rapidly and thaw rapidly

Question 23

What can IIa convert?

Answer 23

can convert I - Ia

thrombin

Question 24

Factor X activation

Answer 24

requires activation of complex

tenase complex

intrinsic and extrinsic

Question 25

Factor II (prothrombin) activation

Answer 25

requires prothrominase complex

Question 26

The Magic Four all located in all dependent on all depleated by

Answer 26

II, VII, IX, X all in liver all Vit K dependent - adds second carboxyl group to complete factor All depleated by warfarin therapy (keeps vit K in storage form)

Question 27

Thrombin is the only factor to

Answer 27

convert fibrinogen I to fibrin Ia enhances V, VIII

Question 28

Factor V/VIII short not? able to ? targets? activated by?

Answer 28

Labile factors short lived not enzymes - cofactors able to particpate in coag inactive form targets protein C activated by IIa

Question 29

Thrombin IIa

Answer 29

acts on fibrinogen I , splits fibrinopeptides A and B form visible solid clot w calcium activates XIII

Question 30

Plasminogen to plasmin

Answer 30

important for fibrinolysis when Xa is activated - pk converts to kalikrein to plasminogen to plasma Kalikren converts HMWK to bradykinins