Pathology Exam 2

Front 1

The ability to maintain blood in a fluid state and prevent loss from sites of vascular damage

Back 1

Hemostasis

Front 2

3 components of the hemostatic system

Back 2

1) the vascular wall
2) platelets
3) coagulation proteins

Front 3

Primary hemostatic plug

Back 3

The excitation of platelets due to the sub endothelial collagen exposure after injury

Front 4

Platelet response to vascular injury is ___hemostasis

Back 4

Primary

Front 5

Platelet adhesion involves activation of its membrane receptor ___, the adhesion protein _____, and the appropriate surface of ____

Back 5

Glycoprotein Ib/IX, von Willebrand factor, subendothelial collagen

Front 6

Mediates the adhesion of platelets to collagen

Back 6

von Willebrand factor

Front 7

Which membrane receptor becomes activated during the recruitment of other platelets?

Back 7

Glycoprotein IIb/IIIa

Front 8

What happens during the activation phase of the primary hemostatic response?

Back 8

1) Release of 2nd messengers
2) Secretion of ADP
3) Activation of IIb/IIIa receptor

Front 9

What causes platelets to adhere to one another?

Back 9

Cytoplamic ADP

Front 10

Fibrin clot formation is ___hemostasis

Back 10

Secondary

Front 11

What does thrombin do?

Back 11

Converts fibrinogen to fibrin, which adds stability to the blood clot

Front 12

How are fibrin monomers linked?

Back 12

Covalently by Factor XIII

Front 13

The activation of factor XII by kallikrein, followed by activation of Factor XI by XIIa; factor XIa activates factor IX. This is which pathway?

Back 13

The intrinsic pathway

Front 14

The activation of factor VII by tissue factor is by which pathway?

Back 14

The extrinsic pathway

Front 15

This pathway involves the activation of factor X to Xa, followed by conversion of pro thrombin to thrombin and fibrinogen to fibrin.

Back 15

The common pathway

Front 16

Primary regulatory hemostasis regulates what?

Back 16

Platelets

Front 17

What inactivates Factor X?

Back 17

Antithrombin

Front 18

Antithrombin pairs with ___to inactivate thrombin

Back 18

Heparin

Front 19

A major effector enzyme that regulates the cofactors Va and VIIIa

Back 19

Protein C

Front 20

A major cofactor that helps in secondary hemostasis

Back 20

Protein S

Front 21

This binds to plasminogen and turns it into plasmin

Back 21

Tissue plasminogen activator (TPA)
- can be used in patients who have had MI

Front 22

What does plasmin do?

Back 22

Breaks up fibrin clots

Front 23

Shifts that favor the regulation steps lead to _____

Back 23

Bleeding disorders

Front 24

Shifts that favor pro coagulation result in ____

Back 24

Thrombosis

Front 25

A measurement of the time needed for plasma to form a clot in the presence of added tissue thromboplastin and Ca2+ ions

Back 25

Prothrombin time (PT)

Front 26

Routinely used to measure degree of anticoagulation in patients receiving oral anticoagulants

Back 26

PT

Front 27

Prolonged PT can result from what?

Back 27

- Decreased/abnormalities in Factor II, V, VII, X and/or fibrinogen

Front 28

A measurement of the time needed for plasma to form a clot in the presence of added kaolin (to activate contact-dependent factor XII), cephalin (phospholipid), and Ca2+ ions

Back 28

Partial thromboplastin time (PTT)

Front 29

PT initiates this coagulation pathway

Back 29

Extrinsic

Front 30

PTT activates this pathway

Back 30

Intrinsic

Front 31

Prolonged PTT can result from what?

Back 31

Decreased or abnormalities in factors II, V, VIII, IX, X, XI, XII and fibrinogen

Front 32

Routinely used to measure degree of anticoagulation in patients receiving heparin therapy

Back 32

PTT

Front 33

Normal range of platelets

Back 33

150,000-400,000/ uL

Front 34

Thrombocytosis and thrombocythemia denote what?

Back 34

Increase in platelet number

Front 35

A decrease in platelet number

Back 35

Thrombocytopenia

Front 36

This procedure, which replaces bleeding time, performs like in vitro bleeding time

Back 36

PFA-100

Front 37

If a mixing study corrects clotting time, what was deficient?

Back 37

A factor(s)

Front 38

If mixing study doesn't correct clotting times, what does this signify?

Back 38

An inhibitor is present, either factor-specific or lupus anticoagulant

Front 39

Acquired bleeding disorders are often caused by what?

Back 39

Medication or a pathological process

Front 40

Clinical manifestations include mucocutaneous bleeding and/or bleeding associated with trauma. Laboratory manifestations include a prolonged bleeding time and thrombocytopenia.

Back 40

Disorder of primary hemostasis

Front 41

Clinical manifestations include soft tissue bleeding and/or bleeding associated with trauma. Laboratory manifestations include a prolonged PT and/or PTT and/or thrombin time.

Back 41

Disorders of secondary hemostasis

Front 42

Clinical manifestations include soft tissue bleeding and/or bleeding associated with trauma. Laboratory manifestations are often normal in screening tests.

Back 42

Disorders of the regulatory system

Front 43

von Willebrand factor is a carrier molecule for what factor?

Back 43

Factor VIII

Front 44

Different epitopes on vWF are responsible for what?

Back 44

Its adhesion to endothelium and platelets and it association to factor VIII

Front 45

This factor participates in the generation of Factor X

Back 45

Factor VIII

Front 46

T/F, Factor VIII is released from vWF when a clot is formed?

Back 46

True

Front 47

Where is Factor VIII synthesized?

Back 47

The liver

Front 48

This is most often an autosomal dominant disorder associated with production of decreased amounts of a normal protein (quantitative abnormality) or production of a protein with abnormal function (qualitative abnormality), or both. The dominant clinical manifestation is mucocutaneous bleeding

Back 48

vWF Syndrome

Front 49

Clinical manifestations of vWF are?

Back 49

Laboratory manifestations include prolonged bleeding time, prolonged PTT (due to decreased Factor VIII), and decreased vWF and decreased Factor VIII

Front 50

Therapeutic options for vWF syndrome are

Back 50

desmopressin (releases vWF from endothelial cells) and antifibrinolytic agents in mild cases, factor VIII concentrates containing vWF and cryoprecipitate in more severe cases

Front 51

This is a sex-linked recessive disorder that is due to decreased production of Factor VIII. The clinical hallmark is recurrent soft tissue bleeding, and symptoms usually start early in life. Clinical manifestations include hemarthrosis, soft tissue bleeding, bleeding with trauma, intramuscular hematomas, intracranial hemorrhage, and generally excessive bleeding

Back 51

Hemophilia A

Front 52

Laboratory features of hemophilia a include what?

Back 52

Laboratory features include normal bleeding time, prolonged PTT, decreased VIII, normal vWF, and normal IX. Severe hemophilia A is characterized by a Factor VIII level of <1%, moderate forms have 1-5% VIII, and mild forms have >5% VIII

Front 53

Decreased factor IX will lead to this disorder

Back 53

Hemophilia B

Front 54

Deficiencies in these will give markedly prolonged PTT's, but these patient's aren't at increased risk for bleeding

Back 54

Factor XII and contact factors

Front 55

Patients w/ deficiencies in this will have inc. risk for bleeding and have normal PT and PTT levels

Back 55

Factor XIII

Front 56

Bleeding due to thrombocytopenia presents as what?

Back 56

Petechial hemorrhages in skin and mucous membranes

Front 57

Spontaneous bleeding due to thrombocytopenia is seen when cells are below what number?

Back 57

20,000

Front 58

This disorder is often an immune mediated destruction of platelets. Platelets coated with antibody directed against platelet-specific antigens are sequestered in the spleen and reticuloendothelial system

Back 58

Idiopathic Thrombocytopenia Purpura (ITP)

Front 59

This is an acute disorder of unknown cause that is characterized by intravascular platelet activation with formation of platelet-rich microthrombi throughout the circulation. Left untreated, it is associated with high mortality

Back 59

Thrombotic Thrombocytopenia Purpura (TTP)

Front 60

This disorder results from uncontrolled activation of the hemostatic system. There is both systemic thrombin formation and systemic plasmin formation

Back 60

DIC