Thrombosis I Flashcards Preview

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Flashcards in Thrombosis I Deck (56):
1

primary hemostasis

platelet plug formation

2

secondary hemostasis

coagulation cascade

3

hemostasis sequence

endo injury/dysfunction - vasoconstriction

primary hemostasis

secondary hemostasis

antithrombotic activity

fibrinolysis

4

virchows triad

1 endo injury
2 prothrombotic state
3 abnormal flow

contribute to thrombosis
-endo most important - can cause other 2

5

economy class syndrome

stasis

6

hypercoagulability

antithrombin, protein C, protein S deficiency

protein C resistance - factor V leiden

7

Gp1b

platelets bind to vWF on endo via this receptor

8

GpIIbIIIa

platelets aggregate to one another by this receptor to fibrinogen

9

favor platelet aggregation

ADP and TxA2

10

factor XIII

important for cross linking of fibrin
-makes final clot strong

11

PGI2

inhibit platelet aggregation

12

protein C pathway

inhibit coagulation

13

heparin and antithrombin III

inhibit coagulation

14

tPA

finbrinolysis

15

plasmin

fibrinolysis

16

plasminogen activator inhibitor

inhibit fibrinolysis

17

alpha-2 antiplasmin

inhibit fibrinolysis

18

alpha-2 macroglobulin

inhibit fibrinolysis

19

vWF

binds GpIb

but also can bind GpIIbIIIa (bridge platelets)

20

intrinsic clotting pathway

XII > XIIa
XIIa: PK to K and XI > XIa
XIa: IX > IXa

IXa and VIIIa with Ca and phospholipid**
-results in X >Xa (to common pathway)

21

kallikrein

feedback to more XII > XIIa

22

extrinsic clotting pathway

Tissue factor + VII > VIIa
VIIa with calcium: X >Xa (to common pathway)

23

common clotting pathway

Xa, Va, calcium, and phospholipid
-results in II > IIa (prothrombin > thrombin)

IIa:many effects of thrombin
-XI >XIa (intrinsic)
-VIII > VIIIa (intrinsic)
-V > Va (common)
-XIII > XIIIa - with calcium
-fibrinogen > fibrin - with calcium

24

XIIIa

cross-linking of fibrin

25

TFPI

inhibit TF:VIIa complex from:
-IX > IXa (extrinsic)
-X > Xa (Ca dependent)

26

thrombin activity through PAR

PAR = protease activated receptor
-induces TxA2 - platelet aggregation
-activated endo cells
-activates leukocytes

27

aPTT

measure of intrinsic pathway
-citrated plasma, Ca, phospholipid, activating surface (glass bead or kaolin)

28

PT

measure of extrinsic pathway
-citrated plasma, Ca, phospholipid, tissue factor

29

intrinsic tenase complex

on phospholipid surface
-VIIIa and IXa
-convert X > Xa

30

extrinsic tenase complex

on phospholipid surface
-VIIa, TF, and Ca
-convert X > Xa

31

prothrombinase complex

on phospholipid surface
-Va and Xa
-convert prothrombin > thrombin (II > IIa)

32

VIII

complexe with vWF in circulation

33

hageman factor

XII

34

christmas factor

IX

35

stuart-prower factor

X

36

labile factor

V

37

fibrinogen

I

38

fibrin

Ia

39

TT

thrombin time
-measure of citrated plasma and thrombin
-if think pt has fibrinogen problem

40

tissue factor

III

41

calcium

IV

42

factor VI

activated factor V

43

Vit K dependent factors

II, VII, IX, X
-no activated carboxylase groups

44

warfarin

affects Vit K dependent factors
2, 7, 9, 10

45

unfractionated heparin

affects 12, 11, 9, 7, 10, 2

46

low MW heparin

fractionate
-affects only Xa

47

antithrombin

works on activated factors
IIa, Xa, VIIa, IXa, XIa, XIIa

48

Vit K

works on factor synthesis
2, 7, 9, 10

49

factor VII deficiency

pro-thrombotic state
-problem with thrombosis

50

protein C and S

block amplification

51

clotting cascade in vivo

TF, Ca, VIIa - convert IX > IXa
IXa and VIIIa: X > Xa
Xa and Va: prothrombin > thrombin
thrombin: fibrinogen > fibrin

52

thrombin effects

VIII > VIIIa
XI > XIa
V > Va
fibrinogen > fibrin
XIII > XIIIa

53

thrombomodulin

binds thrombin
-which goes and activates protein C
-active protein C and protein S result in proteolysis of factors Va and VIIIa

54

proteolysis of factors Va and VIIIa

end result of thrombomodulin

55

heparin like molecules

with antithrombin III _ inactivate thrombin and Xa and IXa

56

thrombin receptor

on endo cells
-binds thrombin

-causes endo release of PGI2, NO, adenosine diphosphatase - inhibitors of platelet aggregation
-also cause release of tPA - initiate fibrinolysis