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112 Cards in this Set
- Front
- Back
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What is Hemostasis?
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Causes bleeding to stop.
The process of keeping blood within a damanged blood vessel. |
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What is the opposite of Hemostasis?
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Hemmorage.
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Define: Endothelial cells:
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The endothelium is the thin layer of cells that lines the interior surface of blood vessels,
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What happens to endothelial cells when endothelial injury occurs?
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Endothelial cells cease secretion of coagulation and aggregation inhibitors and secret von Willebrand factor adn tissue thromboplastin
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What does the von Willebrand factor and tissue thromboplastin do?
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Initates the maintance of hemostasis after injury.
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Define thromboplastin :
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Thromboplastin is a plasma protein aiding blood coagulation through conversion of prothrombin to thrombin
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Define: Coagulation:
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Coagulation is a complex process by which blood forms clots.
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Define thromboplastin :
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Thromboplastin is a plasma protein aiding blood coagulation through conversion of prothrombin to thrombin
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Define: Coagulation:
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Coagulation is a complex process by which blood forms clots.
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What are the 4 mechanisms that Hemostasis is maintained in the body?
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1. Vascular Spasm
2. Platelet plug formation 3. Blood Coagulation 4. Fibrinolysis |
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Define Vascular Spasm:
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Damaged blood vessels constrict.
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What does vasconstriction temporarily decrease?
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Decreases blood flow and pressure within the vessel.
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Define Platelet Plug Formation:
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Platelets adhere to damaged endothelium to form platelet plug and then degranulate.
This is known as Primary Hemostasis. |
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The second step, Platelet Plug Formation is rapidly followed from vascoconstriction.
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True. There is a rapid turn around from steps 1 and 2.
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When The platelets are activated at the collagen, what do they release?
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Cytokines.
(Around the area of injury). |
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What do platelet factors reinforce?
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Reinforce local vasoconstriction and activate more platelets which stick to one another.
This forms a lose platelet plug. |
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When platelets stick together, they stick to the...
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collagen.
They are then activated. |
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Define Blood coagulation:
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Clots form through the conversion of Fibrinogen to Fibrin, and its addition to the platelet plug.
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What is the Secondary Hemostasis?
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Fibrinogen to Fibrin + Platelet Plug
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What do platelet factors reinforce?
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Reinforce local vasoconstriction and activate more platelets which stick to one another.
This forms a lose platelet plug. |
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What is "the cascade" during Secondary Hemostasis:
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Cascade = series of enzymatic reactions that ends in the formation of a fibrin protein fiber mesh (stablizes the platelet plug).
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What is the step name in the Secondary Hemostasis process?
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Blood Coagulation Step.
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Define: Fibrinolysis:
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As damaged vessles repair itself, clot retracts, dissolved by the enzyme plasmin.
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The product of Coagulation is:
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A Fribrin Clot.
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What is the main enzyme of a fibrin clot?
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Plasmin.
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When Plasmin cuts Fibrin Mesh, the circulating fragments are cleared by:
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Other Proteases, kidney and liver.
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What are the three Interactive components of hemostasis?
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Platelets, Coagulation, Vascular.
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What is "the cascade" during Secondary Hemostasis:
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Cascade = series of enzymatic reactions that ends in the formation of a fibrin protein fiber mesh (stablizes the platelet plug).
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What is the end product of hemostasis?
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Thrombus.
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Define Thrombus:
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Clot.
Blood clot formed in situ within the vascular system of the body and impeding blood flow. |
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What is the step name in the Secondary Hemostasis process?
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Blood Coagulation Step.
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What is the vascular system?
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Vessles that carry blood.
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Define: Fibrinolysis:
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As damaged vessles repair itself, clot retracts, dissolved by the enzyme plasmin.
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The product of Coagulation is:
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A Fribrin Clot.
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What is the main enzyme of a fibrin clot?
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Plasmin.
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When Plasmin cuts Fibrin Mesh, the circulating fragments are cleared by:
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Other Proteases, kidney and liver.
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What are the three Interactive components of hemostasis?
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Platelets, Coagulation, Vascular.
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What is the end product of hemostasis?
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Thrombus.
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Define Thrombus:
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Clot.
Blood clot formed in situ within the vascular system of the body and impeding blood flow. |
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What is the vascular system?
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Vessles that carry blood.
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What is the most commonly used tube top color for coagulation?
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Blue Tops.
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What do blue tops have?
What does it do? |
Sodium Citrate. (3.2 - 3.8%)
Functions as an anti-coagulant by chealting calcium. |
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What does the citrate prevent?
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Prevents the rapid deterioration of liable coagulation factors.
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What is the proportion of blood to the sodium citrate anti-coagulation volume?
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9:1 Ratio
Blood : Sodium Citrate anticoagulant. |
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The 4 Screening coagulation tests performed with Blue Tops:
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1. Bleeding Time
2. Prothrombin Time (PT) 3. Partial Thromboplastin Time (PTT/ aPTT) 4. Thrombin Time (DIC) |
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What pathway is the PTT / aPTT?
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Intrinsic Pathway.
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What Pathway is the Prothrombin Time (PT) a part of?
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Extrinsic Pathway.
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What pathway is Thrombin Time a part of (DIC)
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Common Pathway.
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4 Specific Tests in Coagulation tests:
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1. Factor assays - hemophilia
2. Tests of thrombosis - TT/ FDP 3. Platelet function studies: adhesion, aggregation, release tests 4.Bone Marrow Study |
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What do blue tops have?
What does it do? |
Sodium Citrate. (3.2 - 3.8%)
Functions as an anti-coagulant by chealting calcium. |
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What does the citrate prevent?
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Prevents the rapid deterioration of liable coagulation factors.
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What is the proportion of blood to the sodium citrate anti-coagulation volume?
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9:1 Ratio
Blood : Sodium Citrate anticoagulant. |
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The 4 Screening coagulation tests performed with Blue Tops:
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1. Bleeding Time
2. Prothrombin Time (PT) 3. Partial Thromboplastin Time (PTT/ aPTT) 4. Thrombin Time (DIC) |
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Screening Test: Bleeding Time
Why is the Bleeding Time test done? |
Done to assess platelet function.
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Screening Test: Bleeding Time
Describe the Bleeding Time test (basic) |
Cut underside of forearm (no hair, no veins).
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Screening Test: Bleeding Time
Describe the Duke Method: |
Patient pricked with needle/ lancet (earlope, fingertip)
3-4mm deep Wipes blood ever 30 seconds on filter paper Test ends when bleeding ends. |
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What is the usual bleeding time?
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1-3 minutes.
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Screening Test: Prothrombin Time
What does the PT (Prothrombin Time) measure? |
PT measures how long it takes blood to clot.
Checks for bleeding problems Check to see if medication to prevent clots is working. |
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Screening Test: Prothrombin Time
What is another name for the Prothrombin Time (PT) test? |
PT is also known as INR Test.
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INR means:
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International Normalized Ratio.
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Screening Test: Bleeding Time
Why is the Bleeding Time test done? |
Done to assess platelet function.
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Screening Test: Partial Prothrombin Time test is also known as:
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PTT is also known as an aPTT
activated partial thromboplastin time |
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Screening Test: Bleeding Time
Why is the Bleeding Time test done? |
Done to assess platelet function.
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Screening Test: Bleeding Time
Describe the Bleeding Time test (basic) |
Cut underside of forearm (no hair, no veins).
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What is the purpose of a PTT / aPTT?
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Performance indicator that measures the efficacy of both the intrinsic and common coagulation pathways.
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Screening Test: Bleeding Time
Describe the Duke Method: |
Patient pricked with needle/ lancet (earlope, fingertip)
3-4mm deep Wipes blood ever 30 seconds on filter paper Test ends when bleeding ends. |
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Screening Test: Bleeding Time
Describe the Bleeding Time test (basic) |
Cut underside of forearm (no hair, no veins).
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Intrinsic Pathway is also known as the __ ___ pathway.
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as the CONTACT ACTIVATION Pathway.
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Screening Test: Bleeding Time
Describe the Duke Method: |
Patient pricked with needle/ lancet (earlope, fingertip)
3-4mm deep Wipes blood ever 30 seconds on filter paper Test ends when bleeding ends. |
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What is the usual bleeding time?
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1-3 minutes.
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What is the usual bleeding time?
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1-3 minutes.
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Screening Test: Prothrombin Time
What does the PT (Prothrombin Time) measure? |
PT measures how long it takes blood to clot.
Checks for bleeding problems Check to see if medication to prevent clots is working. |
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Screening Test: Prothrombin Time
What is another name for the Prothrombin Time (PT) test? |
PT is also known as INR Test.
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INR means:
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International Normalized Ratio.
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What is the purpose of a PTT / aPTT?
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Performance indicator that measures the efficacy of both the intrinsic and common coagulation pathways.
Checks for abnormalities. |
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Screening Test: Partial Prothrombin Time test is also known as:
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PTT is also known as an aPTT
activated partial thromboplastin time |
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What is the purpose of a PTT / aPTT?
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Performance indicator that measures the efficacy of both the intrinsic and common coagulation pathways.
Checks for abnormalities in blood clotthing. |
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Intrinsic Pathway is also known as the __ ___ pathway.
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as the CONTACT ACTIVATION Pathway.
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Partial Thromboplastin Time (PTT)/ Activated Thromboplastin Time (aPTT) is used to monitor drugs like:
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cumadin and heparin (majour anti-coagulants)
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PTT is used in conjunction with the PT which measures the...
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... extrinsic pathway.
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Screening Test: Thrombin Time
Thrombin Time measures |
the time it takes for a clot to form in the plasma.
(..from a blood sample in anti-coagulant which had an added excess of thrombin). |
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What is another name for the Thrombin Time (TT) test?
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TT is also known as the Thrombin Clotting Time (TCT).
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Pathways:
The Intrinsic (aPTT) and Extinsic (PT) Pathway combine in the |
Common Pathway.
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Screening Test: Thrombin Time
Thrombin Time measures |
the time it takes for a clot to form in the plasma.
(..from a blood sample in anti-coagulant which had an added excess of thrombin). |
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The Common Path (Thrombin) leads to:
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Clotting
(Fibrinogen to Fibrin) |
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Screening Test: Thrombin Time
Process for the test? |
Repeated with pooled plasma from normal patients.
difference is the abnormailty in the convesion of fibrinogen to fibrin. |
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Coagulation Factors: Define what it means:
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factors in the blood whose actions are essential for blood coagulation.
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What is another name for the Thrombin Time (TT) test?
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TT is also known as the Thrombin Clotting Time (TCT).
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Fibrogen (used or not used?)
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not used
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Prothrobin (Stable or not stable?)
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Stable
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Partial Thromboplastin Time (PTT)/ Activated Thromboplastin Time (aPTT) is used to monitor drugs like:
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cumadin and heparin (majour anti-coagulants)
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The Common Path (Thrombin) leads to:
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Clotting
(Fibrinogen to Fibrin) |
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Coagulation Factors: Define what it means:
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factors in the blood whose actions are essential for blood coagulation.
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Screening Test: Thrombin Time
Thrombin Time measures |
the time it takes for a clot to form in the plasma.
(..from a blood sample in anti-coagulant which had an added excess of thrombin). |
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Screening Test: Thrombin Time
Process for the test? |
Repeated with pooled plasma from normal patients.
difference is the abnormailty in the convesion of fibrinogen to fibrin. |
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What is another name for the Thrombin Time (TT) test?
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TT is also known as the Thrombin Clotting Time (TCT).
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The Common Path (Thrombin) leads to:
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Clotting
(Fibrinogen to Fibrin) |
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Coagulation Factors: Define what it means:
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factors in the blood whose actions are essential for blood coagulation.
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Name the first 3 factors:
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1. Fibrinogen
2. Prothombin 3. Tissue Thomboplastin |
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Name Factors 4,5,6,7:
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4. Calcium
5. Labile Factor 6. Not Used 7. Stable Factor |
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Name the 8th Factor:
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8. Antihemopheliac Factor A
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What does "point of care testing" / "POCT" mean?
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Diagnostic testing performed at or near site where clinical care is delivered.
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Why is Point of Care Testing (POCT) benneficial?
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Provides quicker results (Faster TAT: Turn around time)
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What are 3 limitations of P.O.C.T?
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1. Variability is high
2. Standardization is low 3. Validity is low |
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Where can POCT be used in the operating room?
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- cardiac surgery
- interventional cardio / radiology - critical care |
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Where can POCT be used in Satellite sites?
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- dialysis
- emergency room - anticoagulation clinic |
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Will POC results match the lab?
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Not necessarily, but they will correlate.
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An INR within 0.4 of lab chances are
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80%
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An INR within 0.7% of lab are:
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90%
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An INR within 1.0 of lab are:
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95%
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Why is Point of Care important?
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Faster Turn Around Time (TAT) - point of clinician (not the lab).
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When is TAT important?
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- ER
- ICU/ CCU - OR - STAT Testig |
