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55 Cards in this Set
- Front
- Back
All of the following statements are true of the lipid bilayer EXCEPT: a. It has cholesterol as one of its components b. It contains only saturated fatty acids c. It is comprised mostly of phospholipids d. It provides an environment in which proteins can function.
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B: It contains only saturated fatty acids
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Competitive antagonists attach to receptors a. Irreversibly alter them b. Mimic agonists c. Uncouple receptors from G proteins d. Prevent attachment of agonist
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D: Prevent attachment of agonist
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Which substance on the list below LEAST penetrates the lipid bilayer? a. Sodium ions b. Sodium pentothal c. Carbon dioxide d. Halothane
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A: Sodium ions
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Neurotransmitter is released from the nerve terminal by a process known as a. Exocytosis b. Endocytosis c. Pinocytosis d. Phagocytosis
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A: Exocytosis
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An increase in myocardial contractility caused by dobutamine involves which signal transduction system? a. Gi Guanylate cyclase cGMP b. Gi Adenylate cyclase cAMP c. Gs Guanylate cyclase cGMP d. Gs Adenylate cyclase cAMP
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D: Gs Adenylate cyclase cAMP
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The sodium-potassium pump is stimulated by a. Insulin b. Epinephrine c. Both d. Neither
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C: Both
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What ions move in what direction during depolarization and repolarization of the nerve? a. Sodium out Potassium in b. Sodium in Potassium out c. Potassium in Sodium out d. Potassium out, Sodium in
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B: Sodium in Potassium out
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Which electrolyte disturbance causes the resting cell to hypopolarize or depolarize? a. Hyponatremia b. Hypernatremia c. Hypokalemia d. Hyperkalemia
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D: Hyperkalemia
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When the sodium channel is in the inactivated state, the neuron is a. Hyperpolarized b. Repolarized c. Absolute refractory d. Relatively refractory
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C: Absolute Refractory
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The Na/K ATPase pump transports sodium and potassium ions against concentration gradients at what ratio? a. 3 Sodium in, 2 Potassium out b. 2 Sodium out 3 Potassium in c. 3 Sodium out 2 Potassium in d. 2 Sodium in 3 Potassium out
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C: 3 Sodium out 2 Potassium in
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When the endothelial lining of the blood vessel is damaged, platelets adhere to the subendothelial collagen. What substance anchors platelets to subendothelial collagen?
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Von Willebrand's factor (VIII:vWF or VIII:R)
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What clotting factor activates the platelet at the site of vascular injury?
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Thrombin (Factor IIa)
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What two substances, released from the activated platelet, stimulate platelet aggregation?
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Thomboxane A2 and ADP
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What substance links platelets together (aggregates them)?
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Fibrinogen (Factor I)
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What agents inhibit platelet aggregation by impairing cyclo-oxygenase?
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Aspirin (ASA) and Non-steroidal anti-inflammatory drugs (NSAIDS)
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What clotting factors are found in the extrinsic pathway?
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Factor III (Tissue factor or Thromboplastin) and Factor VII (Proconvertin)
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What clotting factors are found in the intrinsic pathway?
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Factor XII (Hageman), Factor XI, Factor IX (Christmas), Factor VIII
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What clotting factors are found in the final common pathway?
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Factor V (Proaccelerin), Factor X (Stuart Prower), Factor I (Prothrombin), Factor II (Fibrinogen), Factor XIII
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What clotting factor is considered the physiologic initiator of the coagulation cascade?
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Factor III (Thromboplastin or Tissue Factor)
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What clotting factor promotes fibrin cross-linking?
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Factor XIII
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Antithrombin III inhibits what five clotting factors? Which of these 5 belong to the intrinsic pathway? What two of these five clotting factors are most profoundly inhibited?
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Antithrombin III inhibits Factor II, IX, X, XI, XII Factors XII, XI, IX belong to the intrinsic pathway Factor II and X are most profoundly inhibited
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What four clotting factors are Vitamin K dependent? Which factors belong to the extrinsic pathway?
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Factor II, VII, IX, X. Factor VII belongs to the extrinsic pathway
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How does heparin work?
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Heparin binds to antithrombin III to enhance its anticoagulant effect 1000X on Factors II, X, XII, IX, and XI
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How does coumadin work?
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Coumadin competitively inhibits the vitamin K dependent clotting factors
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What anticoagulant affects the extrinsic and final common pathways?
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Coumadin
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What anticoagulant affects the intrinsic and final common pathways?
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Heparin
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What two coagulation test assess the extrinsic pathway?
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PT/INR
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What two coagulation tests assess the intrinsic pathway?
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PTT/ACT
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What enzyme is responsible for breaking down fibrin?
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Plasmin
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What two pharmacological agents inhibit plasmin?
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Epsilon-aminocaproic acid (Amicar) and aprotinin (Trasylol)
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Name 3 substances that convert plasminogen to plasmin?
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1. Tpa Tissue plasminogen activator 2. Streptokinase
3. Urokinase plasminogen activator |
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When is aprotinin generally used in anesthesia? How does it work?
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It is used for repeat sternotomies and works by inhibiting plasmin
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What is the normal activated coagulation time?
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80-150s
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What is the best test of primary hemostasis, or platelet function?
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Standardized skin bleeding time
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What is the most common reason for coagulopathy after a massive blood transfusion?
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Lack of functioning platelets
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What clotting factors are found in fresh frozen plasma?
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Everything except platelets
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Cryoprecipitate contains what clotting factors?
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Factor VIII:C, Factor VIII:vWF, Factor XIII and Factor I (fibrinogen)
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What are the typical manifestations of disseminated intravascular coagulation?
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Bleeding with oozing from tubes, wounds, and vascular access sites
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Transfused blood is deficient in what two coagulation factors?
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Factor V and VIII
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What is the most common inherited coagulation defect?
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Von Willebrand's disease
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The patient with von Willebrand's disease has not responded to desmopressin (DDAVP). What will you try next?
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Fresh frozen plasma
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What antiplatelet agent prevents ADP-induced platelet aggregation?
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Ticlopidine
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Each of the following clotting factors is made in the liver except? a. VIII:C b. IV c. X d. XII
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B: IV
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The clotting factor that is responsible for cross-linking fibrin is a. I b. II c. VII d. XIII
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D: XIII
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What anticoagulant works on the extrinsic pathway, and what test assesses the effectiveness of this anticoagulant?
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Coumadin and PT
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Cryoprecipitate contains coagulation factors a. I, VIII, XIII b. II, VII, X c. I, VII, X d. II, X, XI
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A: I, VIII, XIII
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When antithrombin III is activated by heparin, antithrombin III a. releases factors I, III, VII, and XIII b. binds factors I, III, VII, and XIII c. releases factors II, IX, X, XI, and XII d. binds factors II, IX X, XI, and XII
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D: binds factors II, IX, X, XI, and XII
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A patient who is scheduled for CABG is heparinized, and the ACT is less than 300s. The result is the same after a second dose of heparin. Why is the patient unresponsive to heparin, and what is your next action?
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The patient has a deficiency of antithrombin III and you should give FFP
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Prothrombin time is normally a 3-5s b. 12-14s c. 25-35s d. 80-150s
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B: 12-14s
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The reaction of protamine with heparin is a ____________ reaction.
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Neutralization reaction
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What substance converts fibrin to fibrin split products?
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Plasmin
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Each of the following statements about aprotinin is true except: a. aprotinin may cause an allergic reaction when administered to a patient for the first time b. Aprotinin may cause an anaphylactic reaction if administered to a patient for the second time c. Aprotinin is indicated for patients who are undergoing sternotomy for the second time d. Aprotinin accelerates the breakdown of fibrin
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D: Aprotinin accelerates the breakdown of fibrin
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Postoperative bleeding with continued oozing from wounds and catheter sites suggests what disorder?
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Disseminated intravascular coagulopathy
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Each of the following is decreased in the patient with DIC EXCEPT: a. fibrin split products b. fibrinogen c. prothrombin d factor VIII
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A: Fibrin split products
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What is the major cause of diffuse bleeding after a massive blood transfusion? a. ATIII deficiency b. thrombocytopenia c. factors V and VIII d. vitamin K deficiency
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B: Thrombocytopenia
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