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29 Cards in this Set
- Front
- Back
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Thrombopoietin
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increased size, number, ploidy of megakaryocytes
secreted at constant rate by liver level in blood determined by binding to platelets and megakaryocyte more platelets - lower level injection has no clinical effect |
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GP Ib
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receptor on platelet that binds vWF
vWF binds collagen - allows platelet adhesion |
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GP IIb/IIIa
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when platelet is activated it binds fibrinogen
GP IIb/IIIa from another platelet binds the same fibrinogen -> platelet aggregation |
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platelet activation
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Thrombin, collagen key players
also serotonin, PAF, ADP, TXa2, vasopressin |
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bleeding time
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not a good predictor
cut skin - measure how long till blood clot |
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von willebrand factor (vWF)
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primary function - hemostasis - binds GP Ib.
Carries factor VIII - protects |
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if vWF is low, what else should be low
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Factor VIII
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Ristocetin Cofactor Activity
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measures amount of vWF
Ristocetin binds vWF. add activated platelets and measure aggregation |
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Bernard Soulier Syndrome
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GP Ib deficiency
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Glanzmann's thrombasthenia
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GP IIb/IIIa deficiency
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von willebrand disease
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most common coagulation problem
quantitative or qualitative problem with vWF see low factor VIII increased bleeding from brusing, nosebleeds, bleeding gums, heavy menstrual problem increased bleed time decreased Ristocetin activity |
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inherent inhibitors of coagulation
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Antithrombin III
Protein C/Protein S t-PA PGI2 and NO plasmin |
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Vitamin K dependent proteins
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factor 2, 7, 9, 10, and protein C and S
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effect of thrombin (factor IIa)
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converted from prothrombin by Factor 10a and Factor 5a
thrombin converts: 11 -> 11a 8 -> 8a 5 -> 5a 13 -> 13a fibrinogen -> fibrin interacts with thrombomoulin to activate protein C in ANTI-coagulation + more! |
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factor XIII
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coverted to factor XIIIa by thrombin - important for covalent bonding of fibrin - clot stability
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Plasmin
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Degrades fibrinogen, fibrin, platelet GP, factors 5, 8, 11, 12, 13 and vWF
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D-dimer
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breakdown product of fibrinogen
increased serum D-dimers indicates clotting somewhere in the boddy |
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antithrombin III
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binds factor 2, 9, 10 prevents their use in coagulation cascade
heperin binds ATIII-factor II complex potentiating the effect |
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protein C and protein S
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inhibits factor 5
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thrombomodulin
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binds thrombin (factor IIa) - allowing activation of protein C in the ANTI-coagulation pathway
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heparin cofactor II
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only inhibits thrombin
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Plasminogen activator Inhibitor I
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inactivates u-PA or t-PA to prevent clot breakdown
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alpha2 antiplasmin
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binds plasmin and deactivates it - prevent clot breakdown
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prothrombin test
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measures extrinsic pathway
important to measure degree of anticoagulation with warfarin when compared to PTT can be used to determine factor VII deficiency not useful for measuring hemophilia as it does not use factor 8 or 9 |
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INR
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international normalized ratio to standardize the test across hospitals
normal is 2-3 prolonged by heparin, lepirudin, argatroban |
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activated partial thromboplastin time (aPTT)
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measures intrinsic pathway of cagulation
used to measure heparin effectiveness |
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thrombin time
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measure rate of fribrinogen to fibrin conversion
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mixing studies
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determines if there is a factor deficiency or an coagulation inhibitor
patient plasma mixed with normal control plasma, a deficiency should be corrected since the control plasma has all the factors whereas an inhibitor would not correct should always do a mixing study! |
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cofactors
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Va is for Xa
VIIIa is for IXa TF for VIIa Protein S for Protein C Thrombomodulin for thrombin |
