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18 Cards in this Set

  • Front
  • Back
Antithrombogenic substances
Prostacyclin (PGI2), nitric oxide, tissue plasminogen activator, thrombomodulin
Steps in hemostasis
1. Endothelial injury relases tissue factor (activates factor VII, extrinsic pathway); exposure of thrombogenic subendothelial collagen activates factor XII (intrinsic pathway), release of vWF; decreased synthesis of antithrombogenic substances; 2. Platelet adhesion to vWF through glycoprotein Ib; 3. Platelet activation with degranulation and synhesis of TXA2 and ADP (aggregators); 4. Aggregation mediated by TXA2 and ADP and fibrinogen/Gp IIb-IIIa
Bernard Soulier syndrome
Autosomal recessive. Deficiency of platelet GPIb. Defective platelet adhesion
Glanzman thrombastenia
Deficiency of Gp IIB-IIIa; defective platelet aggregation
Immune thrombocytopenic pupura
Antiplatelet antibodies and destruction in spleen by macrophages (bing IgG coated platelets via Fc receptor). Thrombocytopenia, prolonged bleeding time, normal PT and PTT. Petechiae, ecchymoses, menorrhagia, nosebleeds
Thrombotic thrombocytopenic purpura
Platelet thrombi with scant fibrin with no activation of coagulation system. Fever, thrombocytopenia, hemolytic anemia, neurologic symptoms, renal failure. Increased bleeding time, normal PT/PTT, schistocytes
Hemolytic uremic syndrome
Gastroenteritis with bloody diarrhea, fever, thrombocytopenia, renal failure, hemolytic anemia. Produced by verotixin-producing E. coli 0157
Activation of coagulation system
Intrinsic pathway (Factor XII): exposure to subendothelial collagen; Extrinsic pathway (factor VII): tissue thromboplastin by endothelium
Kinin cascade
Hageman factor converts prekallikrein into kallikrein. HMWK is converted to bradykinin by kallikrein
Fibrinolytic system cascade
Kallikrein activates plasminogen into plasmin which inhibits fibrin from coagulation cascade
Vitamin K-dependant factors
Factors II, VII, IX, X. Both intrinsic and extrinsic paths need vitamin k-dependant gamma carboxylation
Prothrombin time (PT)
Tests extrinsic and common paths. Factors V, VII, X, prothrombin and fbrinogen. Used to monitor warfarin therapy
MOA of warfarin
Blocks epoxide reductase (activates vitamin K). Takes 3-4 days for effect due to long half life of previously carboxylated factors which are still circulating
Partial thromboplastin time (PTT)
Tests intrinsic and common paths. Factors XII, XI, IX, VIII, X, V, prothrombin, fibrinogen. Used to monitor heparin
DIC
Thrombocytopenia, prolonged PT/PTT, decreased fibrinogen, elevated D-dimers
Hemophilia
Deficiency of factor VIII or IX. X-linked recessive (affects males). Bleeding at circumcision, hemarthrosis, easy bruising and hematomas. No petechiae or ecchymoses. Normal platelets and bleeding time, normal PT, prolonged PTT (intrinsic path coagulopathy)
Increased PT and PTT
Vitamin K deficiency, liver disease
Von Willenbrand disease
bleeding from mucuous membranes, prolonged bleeding time, normal PT/PTT, abnormal response to ristocetin