Biochem Final Hemostasis Ws

Front 1

what vitamin plays a role in clotting

Back 1

K

*helps make clotting factors

Front 2

what does a bleed test for?

Back 2

platelet fx
vWF disease

**cut is so superficial coagulation isnt needed for clot

Front 3

what does PT test for?

Back 3

ID inherited problems with:

VII (extrinsic)
I 2 5 10 (common)

**add TF and Ca/PL

**also used to measure warfarin
*FAST! 10 sec

Front 4

what does aPTT test for?

Back 4

tests functionality of:

Intrinsic: 8 9 11 12
Common: 10 5 2

monitro heparin theripy

*add (-) surface, PL/Ca

Front 5

what are 2 contrasting roles of thrombin?

Back 5

1. activate fibrin, 13, 5, 8, 11
2. anticoagulant, bind APC and inactivate 5 8

Front 6

what is included in the common path
intrinsic
extrinsic

Back 6

common: prothrombinase, thrombin
intrinsic: 11, tenase
Extrinsic: initiation complex

Front 7

where is it located?
Initiation
Tenase
Prothrombinase
Thrombin

Back 7

Initiation: PM subendi
Tenase: PM of platelet
Prothrombinase: PM of platelet (some on endo)
Thrombin: free in plasma

Front 8

what proteolytic coagulation factor is most seneitive to vit K deficiency

Back 8

7a, it has the shortest half life

Front 9

in hemophelia A what factor is comprimised, what pathway is this involved in?

Back 9

8

**intrinsic

Front 10

waht inhibits intitation complex

Back 10

tissue factor pathway inhibitor

Front 11

what inhibits the tenase complex

Back 11

AT3: 9 10 2
APC: 5 8

Front 12

what inhibits prothrombinase

Back 12

AT3: cleave 9, 10, 2
APC: cleave 5,8

Front 13

what inhibits thrombin (2)

Back 13

AT3: 2 9 10

Front 14

waht is coagulation
2
4

Back 14

2 thrombin
4 calcium

Front 15

waht is citrate?
how does it work, what is added, what is it used for

Back 15

anticoagulatn added to blood tubes. its added to blood, it has 3 carboxyl groups that when added to the blood will bind to calcium to prevent coagulation

**the uncoagulated blood can be used for PT and aPTT tests

**Calcium is added to allow coagulation when needed

Front 16

what is EDTA
how does it work, what is addes, what is it used for

Back 16

its an anticoagulatnt added to blood tubes
it has 4 carboxyl groups which bind to Ca and dfont allow coagulation cascade to occus. its used for CBC

**in orger to allow the blood to coagulate you just add calcium

Front 17

what does heparin do when its in blood tubes

Back 17

works as anticoagulant for plasma analysis.
heparin has sulfated glycosaminoglycans which bind to and activate AT3 so that 2, 9, 10 are cleaved and inactivated. this prevents coagulation

**cant be used in coagulation cascade anymore, must use citrate or EDTA for that

Front 18

what hemostasis tests use plasma, what uses whole blood

Back 18

whole blood: bleeding
plasma: TP, aPTT

Front 19

what reagents are added to the hemostasis tests
bleed
TP
aTPP

Back 19

bleed: none
TP: TF, PL, Ca (TF & PL called 'thromboplastin"
aTPP: (-) surface, PL, Ca

Front 20

what system is tested (platelet, intrinsic, extrinsic) for
bleed
TP
aTPP

Back 20

bleed: platelet
TP: extrinsic (VII) & common
aTPP: intrinsic (9) & common

Front 21

what is the uqique factor tested by each of the hemostsis tests
bleed
TP
aTPP

Back 21

bleed: no clotting factors, tests platelet fx
TP: VII (warfarin)
aTPP: 9 (hemo B, heparin)

Front 22

what hemostasis tests monitors warfarin, heparin

Back 22

warfarin: TP
heparin: aTPP

Front 23

why does TP test happen faster than aTPP

Back 23

TP tests fewer factors

TP: 7 (10 5 2 1) (extrinsic, initiation complex only)
aTPP: 12 11 9 8 (10 5 2 1) (intrinsic path requires many more factors to become activated

Front 24

what is deficient
Hemophelia A
Hemophelia B

Back 24

A: 8
B: 9

"ate, be mine"

Front 25

what will the tests look like for hemo a

Back 25

problem with 8 (intrinsic path, aPTT is messed up)

Bleed: normal
TP: normal
aTPP: long

Front 26

will TP detect issues with factor 8 or 9

Back 26

nope

TP does extrinsic path, 8 9 are required in tenase complex- intrinsic path

Front 27

if you put a clot in 5 M urea and the clot stays hard what does that mean. what is the clot dissolves

Back 27

hard: 13 is good!
dissolves: 13 is deficient

Front 28

how do you test factor 13

Back 28

put a clot in 5 M urea, if it stays hard your good. if it dissolves you have 13 issues

Front 29

waht does asprin do to clotting?

Back 29

prevents plateleg aggregation
**anticoagulant

**asprin inhibits COX 1/2, No TXA2 is made, TXA2 activates platelets, no TXA2 no activation no coagulation

Front 30

does asprin affect platelets or coagulation factors

Back 30

platelets

**asprin inhibits COX 1/2 so that no TXA2 is made and platelets arent activates

Front 31

what hemostasis test will monitor asprin therapy

Back 31

bleed time

**asprin messes with platelet activation/aggregation

Front 32

how does heparin affect coagulation? what hemostasis components are affects, how would you measure it

Back 32

Activates AT3 which inactivates 9 10 2

** factor 9 is intrinsic so use aPTT to test

Front 33

how does warfarin affect coagulation, what hemostasis components are affected, what test do you monitor with

Back 33

warfarin inhibits vit K recycle, this affects 7 9 10 2 but 7 has the shortest half life so it is affected first. Extrinsic path, use PT.

**vit K adds GLA to make the factor (-) and allow it to interact with the PM nad Ca

Front 34

what might the issue be...
Platelet low
Bleed time long
aPTT normal
PT normal

Back 34

decreased platelet synthesis

Thrombocytopenia

Front 35

what might the problem be
platet count: normal
bleed time: LONG
aPTT: normal
PT: normal

Back 35

platelet dysfinction
aspin ingestion (antiinflammatory drugs)

Front 36

what might the problem be
platete count: normal
bleed time: long
aPTT: normal to long
PT: normal

Back 36

vWF disease
factor 8

Front 37

what might the problem be
platet count: normal
bleed time: normal
aPTT: long
PT: normal

Back 37

intrinsic path: (tenase 9 8 or 11)

**maybe hemophelia

Front 38

what might the problem be
platetcount: normal
bleed time: normal
aPTT: normal
PT: LONG

Back 38

problem with 7

Front 39

what might the problem be
platet count: normal
bleed time: normal
aPTT: LONG
PT: LONG

Back 39

10 5 1 2 problems
liver disease/obstructed biliary system
vit k deficit
heparin or warfarin

Front 40

why would a pt with hemo A not be advised to take asprin. they bleed from joints

Back 40

hemo A is a problem with 8

**if you have excess bleeding you dont want to take an anticoagulant, esp if you bleed form joints where there is little TF for coagulation. you REALLY need platelet plug (asprin destroys platelet plug)