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Flashcards in Hemostasis Deck (70)
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1
Q

Factor 1 aka ?

A

Fibrinogen

2
Q

Factor II aka ?

A

prothrombin

3
Q

Factor III aka ?

A

Tissue Factor

4
Q

Factor V aka?

A

Proaccelerin, labile factor

5
Q

Factor VII aka ?

A

Proconvertin

6
Q

Factor VIII aka ?

A

Anti-hemophilic factor

7
Q

Factor IX aka ?

A

christmas factor

8
Q

Factor X aka?

A

Stuart prower factor

9
Q

Factor XI aka?

A

Plasma thromboplastin antecedent

10
Q

Factor XII aka?

A

Hageman factor

11
Q

Factor XIII

A

Fibrin stabilizing factor

12
Q

Serine proteases (list)

A

factor XII, prekallikrein, factor XI, factor IX, factor X, Factor VII, Factor II
(2, 7, 9, 10, 11, 12, PK)

13
Q

Vit K dependent proteases

A

Factor II, VII, IX, X, protein C, “Protein S”

2, 7, 9, 10, C, S

14
Q

Extrinsic tenase made of

A

TF + VIIa

15
Q

Intrinsic tenase made of

A

IXa + VIIIa

16
Q

Prothrombinase complex

A

Xa + Va

17
Q

Contact factors include:

A

HMWK, PK, FXII

18
Q

Describe intrinsic coagulation pathway up to Xa

A

XII, PK, HWMK –> XIIa –> XIa –> IXa (+VIII) –> Xa

12, 11, 9, 8, 10, 5, 2

19
Q

Describe the common coagulation pathway

A

Xa (+Va) –> IIa/thrombin –>Fibrin and XIIIa

20
Q

Describe extrinsic coagulation pathway

A

TF + VIIa –> Xa (+Va) –> THrombin –> Fibrin and XIIIa

21
Q

Enzyme complex include _____ + ______ + Ca + Phospholipid surface

A

protease, cofactor

22
Q

Vit K causes a post translational modification to _____?

A

gamma carboxy glutamic acid residue

23
Q

Warfarin acts by

A

blocking vit K reductase enzyme (depletes vit K)

24
Q

vWF two main function is:

A
  1. platelet adhesion (vWF to subendothelium)

2. Carrier for factor VIII (t1/2 2-12 hr)

25
Q

5 main coagulation roles of thrombin

A
  1. activate platelets
  2. Cleaves fibrinogen
  3. Activates V and VIII (amplification)
  4. XIIIa - stablize fibrin
  5. XIa (intrinsic pathway amp)
26
Q

Thrombin roles for fibrinolysis

A
  1. Activates protein C

2. Activates TAFI

27
Q

Antithrombin III can inhibit _____ and ______

A

Xa and Thrombin

28
Q

Unfractionated heparin (cofactor for ________) increase efficiency binding to ___________ and _________

A

Antithrombin

Xa and Thrombin

29
Q

LMWH (co factor for ______) increase efficiency binding to _______?

A

only Xa

30
Q

Fondaparinux is =?

A

a pentasaccharide (for heparin) - only helps bind with Xa

31
Q

C1 (esterase) inhibitor regulates ______ and ______

A
  1. Classic complement pathway (immunology)

2. (Vascular) Contact factor (XIa, XIIa, Kallikrein)

32
Q

Protein C effect is to _______; protein C is classified as _____

A

Decrease (Va and VIIIa) thrombin - anticoagulant

33
Q

Protein C zymogen is activated by _____

A

thrombin

34
Q

Protein C binds to ________ (cofactor)

A

Thrombomodulin

35
Q

______ inhibits protein C binding to thrombomodulin

A

proinflammatory agents

36
Q

Factor V leiden definition?

A

Glu–> Arg mutation - resistant to protein C “APC Resistant”

37
Q

Factor V leiden effect?

A

Venous thromboembolism

38
Q

Warfarin can initially cause _______________? Why?

A

Transient Hypercoagulable state
Protein C is vit K dependent/short half life
Protein C deficient = cannot lower thrombin –> more clot

39
Q

Protein C Deficiency would lead to?

A

thrombosis

40
Q

TFPI = aka?

A

Tissue Factor Pathway Inhibitor (TFPI)

41
Q

TFPI mechanism:

A

inhibits extrinisic coagulation pathway

Binds Xa –> binds TF-VIIa => Quad complex (TF/TFPI/Xa/VIIa)

42
Q

TFPI function/results:

A

prevents atherosclerosis

43
Q

Plasminogen –> _______

A

plasmin

44
Q

Plasmin is a ________ ___________, that breaks down _____, ______, _____

A

serine protease
Fibrin
Fibrinogen
ECM proteins

45
Q

tPA = aka?

A

tissue plasminogen activator

46
Q

tPA can activate _____ in the prescence of ______

A

plasminogen, fibrin

47
Q

tPA is cleaved by ____

A

Plasmin

48
Q

uPA = aka?

A

urokinase plasminogen activator

49
Q

uPA is synthesized by ?

A

kidney + endothelial cells (and tumor cells)

50
Q

uPA was released as:

A

prourokinase/scu-PA

51
Q

uPA works by binding to ____, cleaved by ____ which then can cleave ____

A

fibrin clot, plasmin, plasmin

52
Q

Deficiency in uPA or tPA

A

Thrombosis

53
Q

TAFI activated by?

A

THrombin-thrombomodulin complex –> exopeptidase

54
Q

TAFI = Aka?

A

thrombin activatable fibrinolysis inhibitor

55
Q

TAFI acts on?

A

C terminal of proteins (Fibrin) = less plasminogen binding site on fibrin

56
Q

TAFI regualtes ?

A

down regulate: PLasmin and clot lysis

57
Q

PAI-1 = aka?

A

plasminogen activator inhibitor 1

58
Q

PAI-1 is stored mostly in

A

alpha granules in platelets

59
Q

PAI-1 inhibits ____ and ____

A

tPA and uPA

60
Q

PAI1: Deficiency or excess effect

A
Excessive bleeding
Thrombotic events (excess)
61
Q

a2 - antiplasmin

A

Binds plasmin 1:1 and inactivates

F13 - links a2-antiplasmin to fibrin

62
Q

a2-antiplasmin deficiency

A

bleeding disorder

63
Q

Endothelial cells express what anticoagulant?

A
  1. heparan sulfate & Dermatan sulfate
  2. Thrombomodulin
  3. TFPI
64
Q

Endothelial cells express what fibrinolytic factors

A

tPA

uPA

65
Q

Endothelial cells express what anti-plt factors

A
  1. PGI2 & NO

2. AMP/Adenosin (from ADP) enzymes

66
Q

Primary hemostasis concerns with

A

platelet activation, aggregation, adhesion

67
Q

Secondary hemostasis concerns with

A

fibrin clot

68
Q

protein S is _____ dependent

A

vit K

69
Q

Protein S distribution

A

60% boudn to C4bBP (regulate complement - inactive), 40% free

70
Q

Protein S is a cofactor to _____?

A

Protein C/APC