Term
| Coagulation Cascade draw it out |
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Definition
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Term
| First thing that happens upon vascular injury |
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Definition
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Term
| Second thing that happens upon vascular injury |
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Definition
| 1' hemostasis from platelets adhering to von Willebrand factor and aggregation |
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Term
| After primary hemostasis is what? |
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Definition
| secondary hemostasis, where a fibrin plug forms and there is local activation of the coagulation cascade |
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Term
| What is the role of the granule ADP, released from platelets? |
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Definition
| Local aggregation/recruitment of more platelets |
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Term
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Definition
| Fibrinolysis, to prevent extensive spreading of the clot |
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Term
| What is the role of thrombomodulin |
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Definition
| Activation of protein C to block the coagulation cascade |
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Term
| What laboratory assessments can be performed to determine the integrity of primary hemostatic process? |
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Definition
| Platelet count, PFA 100 (platelet function assay), or platelet aggregation tests |
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Term
| People who have issues with primary hemostasis will have what sort of presentation? |
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Definition
| "superficial bleeding" in gums and bruising which is worsened by NSAIDs |
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Term
| Secondary Hemostasis is a series of enzymatic conversions that ultimately forms what from what? |
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Definition
| Thrombin from soluble plasma fibrinogen to fibrin |
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Term
| The components of the developing Thrombin are assembled on a ________ surface and held together by ____ ions |
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Definition
| Phospholipid surface; held together by Ca ions |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| What factors are involved only in the Intrinsic pathway? |
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Definition
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Term
| What factor is involved only in the Extrinsic pathway? |
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Definition
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Term
| What factors are involved in the Common pathway? |
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Definition
| I (Fibrinogen), II (Prothrombin), 5, 10, 13 |
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Term
| What is the only factor in the extrinsic pathway? |
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Definition
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Term
| What are the two natural coagulants that help to control coagulation? |
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Definition
| Antithrombin and Protein C |
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Term
| What is the role of Antithrombin and how does it work? |
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Definition
| Inhibits activity of Thrombin and Factor IXa, Xa, XIa, XIIa by binding to heparin-like molecules on endothelial cells |
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Term
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Definition
| Increases action of Antithrombin |
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Term
| What is the role of Protein C and how is it activated? |
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Definition
| Protein C inactivates cofactors Va and VIIIa with help of Protein S; Activated by binding of Thrombin to Thrombomodulin |
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Term
| Activation of the clotting cascade also sets into motion what other cascade and what does it do? |
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Definition
| Fibrinolytic cascade to moderate the size of the clot |
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Term
| What molecule is primarily involved in the Fibrinolytic Cascade and what does it do? |
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Definition
| Plasmin, which breaks down fibrin and interferes with its polymerization |
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Term
| What is Plasmin generated from and what activates it? |
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Definition
| From Plasminogen, which is converted into Plasmin by t-PA (the most important plasminogen activator) |
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Term
| Plasmin (activated by t-PA), goes on to degrade what and release high levels of what? |
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Definition
| Fibrinogen and cross-linked fibrin; From the cross-linked fibrin break up comes a lot of D-Dimer release |
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Term
| What is an Elevated D-Dimer highly indicative of? |
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Definition
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Term
| What does Prothrombin time test? |
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Definition
| Extrinsic and Common pathways (VII, Factor I/Fibrinogen, II/Prothrombin, V, and X) |
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Term
| What is the International Normalized Ratio (INR)? |
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Definition
| Standardized way to report PT between all hospitals |
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Term
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Definition
| The integrity of the Intrinsic and Common pathways (I, II, V, VIII, IX, X, XI, and XII) |
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Term
| Which test is used to monitor anticoagulation therapy with warfarin? |
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Definition
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Term
| Which test is used to monitor anticoagulation therapy with heparin? |
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Definition
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Term
| What does a 1:1 mix test? |
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Definition
| Factor Deficiency vs Inhibitor of Factor (if the person if factor deficient, mixing with normal plasma will trigger a clot, if they have an inhibitor then there will be no clot formation) |
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Term
| Fibrinogen is decreased in what coagulopathies? |
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Definition
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Term
| What marker is really useful for diagnosing DIC? |
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Definition
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Term
| What are some causes of Prolonged PT? |
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Definition
| Liver disease, Vit K deficiency, Warfarin therapy, Factor VII deficiency (all of which result in a normal APTT) |
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Term
| What are some causes of Prolonged APTT? |
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Definition
| Factor XII, XI, IX, VIII deficiency or Heparin therapy, Lupus, von Willebrand disease (PT normal for all) |
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Term
| What are some causes of Prolonged PT and APTT? |
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Definition
| Severe liver disease, Factor II, V, and X deficiency, DIC, and Severe Vit K deficiency |
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Term
| What causes Bleeding Disorders? |
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Definition
| Coagulation factor and Fibrinolytic pathway deficiencies or Platelet disorders |
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Term
| Thrombotic disorders due to liver synthesis issues (excessive alcohol) results in a deficiency of what factors? |
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Definition
| All but Factor VIII (made in endothelium too) |
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Term
| What are the Vitamin K dependent Factors? |
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Definition
| Factors II, VII, IX, X, Protein C, Protein S |
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Term
| What are the causes of Vit. K deficiency? |
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Definition
| Liver disease, Poor nutrition, *Long Term Antibiotic Use |
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Term
| What is Disseminated Intravascular Coagulation (DIC)? |
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Definition
| Activation of formation of thrombi throughout microcirculation with simultaneous activation of fibrinolysis which consumes platelets and coagulation factors |
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Term
| What two situations can trigger DIC? |
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Definition
| Release of Thromboplastic substances into circlation, or, Widespread injury to endothelial cells |
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Term
| Most causes of DIC are due to what? |
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Definition
| Acute Promyelocytic Leukemia (APL) |
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Term
| What are the Laboratory findings of DIC in PT/aPTT, Fibrinogen, D-Dimer, Platelet count, Schistocyte presence |
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Definition
| Prolonged PT and aPTT, Decreased Fibrinogen, Increased D-Dimer, Decreased Platelets, Presence of Schistocytes in peripheral smear |
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Term
| What is Thrombocytopenia defined as and what is a common cause? |
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Definition
| Decreased platelet count; often seen in epistaxis (nose bleeds) or decreased production/decreased survival of platelets |
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Term
| Bleeding time, PT, and aPTT in Thrombocytopenia |
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Definition
| Prolonged bleeding time if <75k platelets, normal PT and aPTT |
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Term
| What is the cause of Immune/Idiopathic Thrombocytopenic Purpura (ITP)? |
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Definition
| Autoantibodies against platelets to decrease their count |
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Term
| What will be the result of coagulation tests with Idiopathic Thrombocytopenic Purpura? |
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Definition
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Term
| What is the cause of Thrombotic Thrombocytopenic Purpura (TTP)? |
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Definition
| Deficiency of vWF cleaving |
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Term
| What is the Pentad of symptoms seen in Thrombotic Thrombocytopenic Purpura (TTP)? |
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Definition
| Hemolytic anemia, Thrombocytopenia, Fever, Renal dysfunction, Mental status changes |
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Term
| What will Thrombotic Thrombocytopenic Purpura show on blood smear and coagulation tests? |
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Definition
| Schistocytes, low platelets, Normal Coagulation tests |
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Term
| Hemolytic-Uremia Syndrome is very similar to TTP and is associated with what pathogen? |
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Definition
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Term
| What is the main symptom of Hemolytic-Uremia syndrome? |
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Definition
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Term
| What are three acquired coagulation disorders? |
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Definition
| Vit. K deficiency, Liver disease, and Autoantibody formation |
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Term
| What is the most common severe hereditary bleeding disorder and what inheritance does it have? |
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Definition
| Factor VIII deficiency (Hemophilia A, X-linked recessive) |
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Term
| What kind of bleeding is seen in Factor VIII deficiency (Hemophila A) and what PT and APTT time is seen? |
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Definition
| Deep joint bleeding; Normal PT but prolonged APTT |
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Term
| What is the second most common severe hereditary bleeding disorder and what inheritance does it have? |
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Definition
| Factor IX deficiency (X-linked recessive as well) |
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Term
| What is the PT and APTT time for Factor IX (Hemophilia B)? |
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Definition
| Normal PT, prolonged APTT |
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Term
| What kind of inheritance does von WIllebrand Disease have? |
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Definition
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Term
| What are the symptoms of von Willebrand Disease? |
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Definition
| Spontaneous bleeding from mucous membranes, excessive bleeding from wounds |
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|
Term
| What does Factor VIII have to do with von Willebrand Disease? |
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Definition
| Von Willebrand Factor carries Factor VIII |
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Term
| PT, PTT, Ristocetin cofactor, and Thrombocyte levels of Von WIllebrand Disease |
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Definition
| Normal PT, Prolonged PTT, decreased Ristocetin cofactor, and Decreased VIII |
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