Flashcards in Thrombophilia Deck (22)
Discuss the mechanism by which coagulation is inhibited by tissue factor pathway inhibitor (TFPI)
Inhibits the TF pathway by inactivating Factor VIIa
Due to the action of TFPI: TF-VIIa is short lived and coagulation amplification occurs primarily through XI
The origin of Protein C (and Protein S)
synthesized in the liver
What are protein C, and S dependent upon?
What is the principle of Protein C & S by which coagulation is inhibited and affected factors?
It inactivates Va and VIIIa and may cause recurrent thromboses (blood clot)
State the condition that is responsible for the most commonly inherited cause of thrombophilia
Activated Protein C resistance (APCR)--Called Factor V Leiden mutation
The origin of antithrombin.
Is antithrombin dependent upon Vitamin K?
Principle of Antithrombin (AT) by which coagulation is inhibited, including affected factors.
Serine protease inhibitor (SERPIN)
Irreversibly binds & neutralizes the serine proteases in the intrinsic pathways: XIIa, XIa, IXa, Xa, Thrombin (IIa);
In the Antithrombin, When no heparin is present, AT's binding with the serine proteases is a __________ reaction
Slow progressive reactions
When either endothelial cell heparan or exogenously administered ____is present, _____ binding with the serine proteases is _____ and enhanced 1,000-fold!!
Heparin is present; AT's binding; Immediate
The effect of deficiency states of Antithrombin (AT) and protein C (protein S)
May cause recurrent thromboses
List eight factors that predispose a person to thrombosis.
Age, Hereditary, Immobilization/stasis, smoking, malignancy, injury to vessels (trauma, surgery), Elevated estrogens (Low Protein S, C, AT), Inflammation, Anti-phospholipid syndrome
State three types of thromboses.
Microcirculatory (TTP, HUS, DIC)
What is the process by which arterial thrombosis are formed?
Result of a disease process which causes major damage in a vessel wall: Myocardial infract and Arteriosclerosis
Major component of Arterial thrombosis.
Treatment for arterial thrombosis
anti-platelet drugs: Aspirin, Plavix
What is the process by which venous thrombosis are formed?
Result of a major stasis in blood flow: DVT, Pulmonary embolus
Major component of venous thrombosis.
Treatment for venous thrombosis.
Anti-fibrin drugs: Heparin, Coumadin
Defined as predisposition of thrombosis secondary to a congenital or acquired disorder
Defined as inappropriate formation of platelet or fibrin clots that obstruct vessels.