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104 Cards in this Set
- Front
- Back
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What is homeostasis? |
Process of holding body in a steady state |
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What is hemostasis? |
Balance between clotting and bleeding |
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What is coagulation? |
Process of stopping blood flow from a wound |
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What are the four processes of coagulation? |
Vascular response Platelet plug formation Fibrin formation Fibrinolysis |
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What is petechiae? |
Pinpoint hemorrhaging from arterioles or venules |
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What is ecchymosis? |
Large, irregular hemorrhagic areas of the skin |
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What is purpura? |
Hemorrhage into skin, mucous membranes, internal organs and other tissues |
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What is platelet adhesion? |
Platelet sticking to the surface |
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What is platelet aggregation? |
Clumping of platelets to form a plug |
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What are the major hemostatic systems? |
Vascular system Platelets Coagulation system Fibrinolytic system |
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What are the minor hemostatic systems? |
Kinin system Serine protease inhibitors Complement system |
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What are the components of primary hemostasis? |
Vascular system Platelets |
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What are the layers of a blood vessel? |
Tunica adventita Tunica media Tunica intima |
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What are the components of the tunica adventitia? |
Connective tissue |
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What are the components of the tunica media? |
Elastic tissue and smooth muscle |
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What are the components of the tunica intima? |
Flat endothelial cells that line the vessel walls |
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What actions are used to prevent bleeding? |
Vasoconstriction Diversion of blood flow Contact activation of platelets Contact activation of coagulation |
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What are platelets? |
Cytoplasmic fragments of megakaryoctes |
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What substance stimulates platelet production? |
Thrombopoietin |
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What is the lifespan of platelets? |
8-10 days |
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What are the components of the platelet structure? |
Peripheral zone Sol-gel zone Organelle zone |
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What are the parts of the peripheral zone of platelets? |
Glycocalyx Platelet membrane Submembranous region |
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What are the parts of the sol-gel zone of platelets? |
Cytoskeleton Microtubules Microfilaments |
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What are the parts of the organelle zone of platelets? |
Granules Mitochondria Dense tubular system |
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What are the alpha granules? |
Potassium Fibrinogen Factor V PF4 vWF |
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What are the dense granules? |
Non-metabolic ADP Serotonin Calcium |
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What are the functions of platelets? |
Maintain blood vessel integrity Platelet plug formation Stabilize platelet plug with fibrin |
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Where are the majority of the coagulation factors produced? |
Liver |
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Which coag factor is not produced in the liver? |
vWF |
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Where is vWF produced? |
Endothelial cells Megakaryocytes |
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What is factor I? |
Fibrinogen |
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What is factor II? |
Prothrombin |
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What is factor III? |
Tissue factor Tissue thromboplastin |
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What is factor IV? |
Ionized calcium |
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What is factor V? |
Labile factor Proaccelerin |
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What is factor VII? |
Stable factor Proconvertin |
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What is factor VIII? |
Antihemophilic factor |
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What is factor IX? |
Christmas factor |
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What is factor X? |
Stuart-Prower factor |
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What is factor XI? |
Plasma thromboplastin antecedent |
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What is factor XII? |
Hageman factor Contact factor |
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What is factor XIII? |
Fibrin-stabilizing factor |
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What is the Fitzgerald factor? |
HMWK |
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What is the Fletcher factor? |
Prekallikrein |
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What are the categories of coag factors? |
Substrate Cofactors Enzymes |
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What are the substrate coag factors? |
Fibrinogen |
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What are the cofactor coag factors? |
Factor III Factor V Factor VIII Fitzgerald factor |
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What are the enzyme coag factors? |
Serine proteases Transaminases |
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What are the contact proteins group? |
Factor XII Factor XI HMWK PK |
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The contact proteins are involved in which coagulation pathway? |
Intrinsic |
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What proteins are not consumed in the clot formation? |
VII IX X XI XII PK HMWK |
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What proteins are consumed in clot formation? |
I II V VIII XIII |
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What are the prothrombin proteins group? |
II VII IX X |
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What are the vitamin K dependent coag factors? |
II VII IX X |
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What are the fibrinogen group proteins? |
I V VIII XIII |
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How is the extrinsic pathway activated? |
Following vascular endothelial cell injury |
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How is the intrinsic pathway activated? |
Contact of coag proteins with subendothelial connective tissue |
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What is the purpose of the fibrinolytic system? |
Dissolution of fibrin clot |
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What is the purpose of the fibrinolytic system? |
Dissolution of fibrin clot |
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What are the activators of the fibrinolytic system? |
Streptokinase Urokinase Tissue plasminogen activator |
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What type of tube is used for coag testing? |
Sodium citrate |
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What is the blood to anticoagulant ratio for light blue tubes? |
9:1 |
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How does sodium citrate stop clotting? |
Binds free calcium |
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What are the common screening test for coagulation? |
Platelet count Bleeding time Prothrombin time Partial thromboplastin time Thrombin time |
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What is the purpose of the bleeding time test? |
Measures qualitative and quantitative platelet function |
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What is the principle of the prothrombin time? |
Thromboplastin and calcium are added to plasma and the length of time required to form a fibrin clot is measured |
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What does the prothrombin time measure? |
Extrinsic pathway Common pathway |
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What test is used to monitor oral anticoagulant therapy? |
Prothrombin time |
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What is the normal range for the PT? |
Approximately 11-13 seconds |
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What is the purpose of the INR? |
Adjust for thromboplastin sensitivity differences |
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What will cause a prolonged PT? |
I, II, V, VII, X factor deficiency Warfarin therapy Circulating anticoagulant Vitamin K deficiency Liver disease |
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What is the the principle of the APTT? |
Intrinsic and common plasma factore are measured by determining the clotting time of plasma after adding phospholipid, factor XII, and calcium |
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What test monitors heparin therapy? |
PTT |
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What is the normal range of the PTT? |
<35 seconds |
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What will cause a prolonged PTT? |
I, II, V, VII, IX, X, XII deficiency HMWK/PK deficiency Warfarin therapy Liver disease Circulating anticoagulant |
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What is primary hemostasis? |
Vascular response Platelet plug formation |
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What is secondary hemostasis? |
Fibrin formation Fibrinolysis |
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What is the purpose of mixing studies? |
Determines is hemostatic defect is caused by factor deficiency or circulating anticoagulant |
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What is the principle of the thrombin time? |
Thrombin hydrolyzes fibrinopeptide A/B from fibrinogen, the time required for thrombin to convert fibrinogen to fibrin is measured |
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What is the disadvantage of the thrombin time? |
Does not measure defects in extrinsic or intrinsic pathway |
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What is the normal range of the thrombin time? |
Approximately 15 seconds |
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What causes a prolonged thrombin time? |
Hypofibrinogenemia Circulating anticoagulant DIC |
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What is the principle of the fibrinogen assay? |
Concentration of fibrinogen is inversely proportional to the TT |
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How are fibrinogen assay results obtained? |
Calculated from calibration curve |
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What is the normal range of fibrinogen? |
200-400 mg/dL |
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What is the principle of the reptilase time? |
Reptilase hydrolyzes fibrinopeptide A from fibrinogen to form a clot |
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What is the normal value for the RT? |
18-22 seconds |
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What are the most common aggregating agents? |
ADP Collagen Epinephrine Ristocetin |
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What is the most common bleeding disorder? |
von Willebrand's disease |
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What problems arise from von Willebrand's disease? |
Adhesion defect of platelets Abnormal secondary hemostasis |
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What are the clinical manifestations of von Willebrand's disease? |
Bleeding gums GI bleed Bleeding mucous membranes |
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Normal plasma has what coag factors? |
All factors |
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Adsorbed plasma has what coag factors? |
V, VIII, XI, XII |
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Aged serum has what coag factors? |
VII, IX, X, XI, XII |
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What substance corrects PTT in mixing studies for hemophilia A? |
Adsorbed plasma |
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What substance corrects PTT in mixing studies for hemophilia B? |
Aged serum |
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What are the triggers for DIC? |
Tissue thromboplastin release Endothelial cell damage Direct activation of X and II |
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Tissue thromboplastin release activates what pathway during DIC? |
Extrinsic |
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Endothelial cell damage triggers what pathway during DIC? |
Intrinsic |
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What defect is present in Bernard Soulier? |
No receptor for vWF |
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What defect is present in Glanzmann's thromboasthenia? |
Defect with fibrinogen bridging |
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What are exogenous circulating anticoagulants? |
Heparin |
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What are endogenous circulating anticoagulants? |
Specific factor inhibitors Lupus like anticoagulants |
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What is the most commonly used oral anticoagulant? |
Warfarin |
