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[OS 201] 4th Exam > Trans - Hemostasis > Flashcards

Trans - Hemostasis Flashcards

1
Q

hemostasis - define

A

process which spontaneously arrests flow of blood from vessels carrying blood under pressure - control unwanted blood flow

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2
Q

3 components of hemostasis

A
  1. vasoconstriction
  2. adhesion and aggregation of formed elements
  3. blood coagulation
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3
Q

blood coagulation - define

A

process resulting in formation of insoluble fibrin clot from fibrinogen in plasma

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4
Q

blood coagulation is determined by:

A

procoagulant and anticoagulant factors

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5
Q

problem of blood coagulation

A

may lead to obstruction of normal blood flow

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6
Q

fibrinolysis - define

A

degradation of fibrin clot

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7
Q

final common pathway

A
  1. factor Xa converts prothrombin to thrombin
  2. thrombin converts fibrinogen to fibrin and factor XIII to factor XIIIa
  3. factor XIIIa stabilizes fibrin
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8
Q

how does factor XIIIa stabilize fibrin?

A

by catalyzing formation of covalent cross links

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9
Q

intrinsic pathway - how is it activated

A

when collagen comes into contact with plasminogen following endothelial damage

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10
Q

intrinsic pathway

A
  1. damaged surface stimulates kininogen and kallikrein
  2. kininogen and kallikrein converts XII to XIIa
  3. XIIa converts XI to XIa
  4. XIa converts IX to IXa
  5. IXa and VIIIa converts X to Xa
  6. Xa leads to final common pathway
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11
Q

extrinsic pathway - how is it activated

A

activated by a tissue factor released by damaged tissues in response to trauma

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12
Q

what tissue factor activates the extrinsic factor

A

tissue thromboplastin

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13
Q

extrinsic pathway

A
  1. trauma induces a change from VII to VIIa
  2. VIIa contributes to release of tissue thromboplastin from blood vessels
  3. tissue thromboplastin converts X to Xa
  4. Xa leads to final common pathway
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14
Q

TPA - function

A

tissue plasminogen factor, converts plasminogen to plasmin

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15
Q

[T/F] TPA acts on all plasminogen

A

F, it only acts on plaminogen physically associated with fibirin

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16
Q

thrombus - define

A

blood clot formed within intravascular space during life

17
Q

thrombus - may lead to:

A
  1. ischemia

2. infarction

18
Q

ischemia - define

A

hypoperfusion of tissues

19
Q

infarction - define

A

necrosis of tissue due to prolonged ischemia

20
Q

a thrombus may fragment to yield:

A

thromboembolus

21
Q

embolus - define

A

portion of material distinct from blood and carried by bloodstream from one site of the body to another

22
Q

virchow’s triad

A

predisoposing factors to coagulation

  1. stasis - sluggish blood flow
  2. altered endothelial surface due to damage or injury
  3. hypercoagulability of blood
23
Q

virchow’s triad - stasis may be caused by:

A

hyperviscosity, as in polycythemia

24
Q

polycythemia - define

A

presence of high amount of RBCs in blood, may cause hyperviscosity

25
Q

virchow’s triad - hypercoagulability may be caused by:

A

imbalance of coagulant and anticoagulant factors

26
Q

administration of TPA is most useful when:

A

when it is given before fibrin cross links are formed

27
Q

heparin - mechanism of action

A
  1. binds plasma protein antithrombin, inducing conformational change that enhances inhibitory effect against thrombin and Xa
  2. also binds thrombin, bringing it into close proximity with antithrombin
28
Q

heparin interferes with what pathway?

A

final common pathway

29
Q

heparin - how to administer

A

intravenously for rapid anticoagulatin

30
Q

[T/F] heparin is for long-term anticoagulation

A

F

31
Q

[T/F] warfarin is for long-term anticoagulation

A

T

32
Q

warfarin - how to administer

A

orally for long-term anticoagulation

33
Q

4 vitamin K dependent anticoagulant factors

A

9, 10, 7, 2

34
Q

warfarin - mechanism of action

A
  1. vitamin K antagonist - blocks synthesis of vitamin-K dependent factors
  2. inhibits posttranslational conversion of glutamate to gamma-carboxyglutamate (for calcium-mediated binding to membrane surfaces)
35
Q

treatment of warfarin toxicity

A
  1. fresh frozen plasma - replenishment of clotting factors (short term)
  2. vitamin k - restores capacity for synthesis of clotting factors (long term)
36
Q

gamma-carboxyglutamate - significance

A
  1. uncommon modification of amino acids found in some functional clotting factors (e.g. vitamin-K dependent factors)
  2. induces affinity for calcium ions

[OS 201] 4th Exam (5 decks)

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