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Blood Coagulation Disorders

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Questions and Answers

What is the primary deficiency in Hemophilia B?

Factor IX deficiency

Which of the following is NOT a mechanical method for thrombosis prevention?

Anticoagulant medications

What is the primary function of the common pathway in the coagulation cascade?

To form a blood clot

What is the primary regulator of hemostatic balance?

<p>All of the above</p> Signup and view all the answers

Which of the following is an acquired deficiency of a clotting factor?

<p>Vitamin K deficiency</p> Signup and view all the answers

What is the initiating event in the extrinsic pathway of the coagulation cascade?

<p>Endothelial injury</p> Signup and view all the answers

What is the primary purpose of F13 in the coagulation cascade?

<p>To stabilize the fibrin clot by cross-linking fibrin threads</p> Signup and view all the answers

Which pathway is responsible for activating the intrinsic pathway under most physiologic conditions?

<p>Extrinsic pathway</p> Signup and view all the answers

What is the end product of hemostasis?

<p>Fibrin clot</p> Signup and view all the answers

What is the triggering event for the extrinsic pathway of the coagulation cascade?

<p>Damage to the vascular wall or tissues</p> Signup and view all the answers

At which point do the intrinsic and extrinsic pathways merge?

<p>Factor X</p> Signup and view all the answers

What is the primary role of thrombin in the coagulation cascade?

<p>To catalyze the conversion of fibrinogen into fibrin monomers</p> Signup and view all the answers

What is the primary function of the intrinsic and extrinsic pathways in the coagulation cascade?

<p>To form a prothrombin activator, which converts prothrombin into thrombin</p> Signup and view all the answers

What is the role of Vitamin K in the coagulation cascade?

<p>To facilitate the production of prothrombin in the liver</p> Signup and view all the answers

What is the ultimate outcome of the coagulation cascade?

<p>The formation of fibrin threads, which make up the clot</p> Signup and view all the answers

What is the precursor protein that is converted into thrombin in the coagulation cascade?

<p>Prothrombin</p> Signup and view all the answers

What is the primary mechanism by which viral infections initiate the clotting cascade?

<p>Production of circulating antigen-antibody complexes that activate F12</p> Signup and view all the answers

Which of the following conditions is most likely to lead to the release of tissue thromboplastin into circulation, thereby initiating the clotting cascade?

<p>Tissue destruction</p> Signup and view all the answers

What is the primary mechanism by which endotoxin initiates the clotting cascade?

<p>Stimulation of endothelium to release tissue thromboplastin</p> Signup and view all the answers

Which of the following is a risk factor for developing DIC in the post-operative period?

<p>Tissue manipulation during abdominal surgery</p> Signup and view all the answers

What is the primary source of tissue thromboplastin in placental disorders, such as placenta abruption?

<p>Placenta</p> Signup and view all the answers

What is the primary consequence of interrupted blood vessel integrity?

<p>Immediate vasoconstriction</p> Signup and view all the answers

What prevents platelet activation and platelets from sticking to the blood vessel wall in normal circumstances?

<p>Prostacyclin PGI2</p> Signup and view all the answers

What is the primary function of the vascular phase in hemostasis?

<p>Preventing excessive bleeding through vasoconstriction</p> Signup and view all the answers

What triggers the release of chemical messengers in hemostasis?

<p>Damaged vascular endothelium</p> Signup and view all the answers

What is the outcome of the simultaneous and interrelated biochemical reactions in hemostasis?

<p>Prevention of excessive hemorrhage</p> Signup and view all the answers

What is the primary purpose of fibrinolysis in the coagulation cascade?

<p>To prevent excessive clotting and maintain vascular patency</p> Signup and view all the answers

Which of the following proteins is NOT involved in the fibrinolytic system?

<p>Clotting factor XII (Hageman factor)</p> Signup and view all the answers

What is the primary mechanism by which endothelium maintains a balance between hemostasis and thrombosis?

<p>Release of anticoagulant substances that inhibit platelet aggregation</p> Signup and view all the answers

Which of the following is a characteristic of the extrinsic pathway of coagulation?

<p>Production of a clot within 15-20 seconds</p> Signup and view all the answers

What is the purpose of thrombomodulin in the coagulation cascade?

<p>To bind to thrombin and render it inactive</p> Signup and view all the answers

What is the outcome of widespread small thrombi in the microcirculation?

<p>Tissue damage, necrosis, and shock</p> Signup and view all the answers

What is the result of fibrinolysis in the context of DIC?

<p>Breakdown of clots with anticoagulant effect</p> Signup and view all the answers

What is the most important issue in the treatment of DIC?

<p>Stopping the triggering event</p> Signup and view all the answers

What is the primary consequence of microvascular thrombi in DIC?

<p>Irreversible tissue damage</p> Signup and view all the answers

What is the time frame for the liver to restore coagulation factors after removal of the triggering event?

<p>24-48 hours</p> Signup and view all the answers

What is the primary function of fibrin degradation products in the coagulation cascade?

<p>To act as anticoagulants</p> Signup and view all the answers

What is the role of thrombin in the coagulation cascade?

<p>To break down fibrinogen into fibrin threads</p> Signup and view all the answers

How do protein C and S prevent clot formation?

<p>By inactivating factor 5 and 8</p> Signup and view all the answers

What is the role of heparin in the coagulation cascade?

<p>To prevent further expansion of the clot</p> Signup and view all the answers

What is the primary function of antithrombin III in the coagulation cascade?

<p>To inactivate thrombin</p> Signup and view all the answers

What is the role of t-PA in the coagulation cascade?

<p>To dissolve the clot after healing</p> Signup and view all the answers

What is the consequence of deficiencies in protein C and S?

<p>Predispose to thrombosis</p> Signup and view all the answers

What is the site of synthesis of antithrombin III?

<p>Liver and endothelial cells</p> Signup and view all the answers

What is the role of the liver in the coagulation cascade?

<p>To remove fibrin degradation products from the circulation</p> Signup and view all the answers

What is the consequence of inactivating thrombin in the coagulation cascade?

<p>Clot formation is inhibited</p> Signup and view all the answers

Study Notes

Blood Coagulation

Blood Clotting Disorders

  • Bleeding Disorders:
    • Hemophilia A (Factor VIII deficiency)
    • Hemophilia B (Factor IX deficiency)
    • Von Willebrand disease (VWF deficiency)
  • Thrombotic Disorders:
    • Thrombophilia (increased risk of thrombosis)
    • Antiphospholipid syndrome (APS)

Factor Deficiencies

  • Inherited Deficiencies:
    • Factor VIII deficiency (Hemophilia A)
    • Factor IX deficiency (Hemophilia B)
    • Factor XI deficiency (Hemophilia C)
    • Factor XII deficiency (rare)
  • Acquired Deficiencies:
    • Vitamin K deficiency (impairs clotting factor synthesis)
    • Liver disease (impairs clotting factor synthesis)

Hemostatic Balance

  • Balance between:
    • Blood clotting (thrombosis) and
    • Blood clot dissolution (fibrinolysis)
  • Regulation by:
    • Coagulation factors (e.g., thrombin)
    • Anticoagulant factors (e.g., protein C, antithrombin)
    • Fibrinolytic factors (e.g., plasmin)

Thrombosis Prevention

  • Mechanical Methods:
    • Compression stockings
    • Intermittent pneumatic compression (IPC)
    • Venous filters
  • Pharmacological Methods:
    • Anticoagulant medications (e.g., warfarin, heparin)
    • Antiplatelet medications (e.g., aspirin, clopidogrel)

Coagulation Cascade

  • Intrinsic Pathway:
    • Initiated by contact activation (e.g., injury)
    • Involves factors VIII, IX, X, and XI
  • Extrinsic Pathway:
    • Initiated by tissue factor (e.g., endothelial injury)
    • Involves factors VII, X, and thrombin
  • Common Pathway:
    • Involves factors X, thrombin, and fibrin
    • Results in clot formation

Blood Coagulation Disorders

  • Bleeding disorders: Hemophilia A (Factor VIII deficiency), Hemophilia B (Factor IX deficiency), and Von Willebrand disease (VWF deficiency)
  • Thrombotic disorders: Thrombophilia (increased risk of thrombosis) and Antiphospholipid syndrome (APS)

Factor Deficiencies

  • Inherited deficiencies: Factor VIII deficiency (Hemophilia A), Factor IX deficiency (Hemophilia B), Factor XI deficiency (Hemophilia C), and Factor XII deficiency (rare)
  • Acquired deficiencies: Vitamin K deficiency (impairs clotting factor synthesis) and Liver disease (impairs clotting factor synthesis)

Hemostatic Balance

  • Balance between blood clotting (thrombosis) and blood clot dissolution (fibrinolysis)
  • Regulated by coagulation factors (e.g., thrombin), anticoagulant factors (e.g., protein C, antithrombin), and fibrinolytic factors (e.g., plasmin)

Thrombosis Prevention

  • Mechanical methods: Compression stockings, Intermittent pneumatic compression (IPC), and Venous filters
  • Pharmacological methods: Anticoagulant medications (e.g., warfarin, heparin) and Antiplatelet medications (e.g., aspirin, clopidogrel)

Coagulation Cascade

  • Intrinsic pathway: Initiated by contact activation (e.g., injury), involves factors VIII, IX, X, and XI
  • Extrinsic pathway: Initiated by tissue factor (e.g., endothelial injury), involves factors VII, X, and thrombin
  • Common pathway: Involves factors X, thrombin, and fibrin, results in clot formation

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