Haemostasis 2 week 26
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Questions and Answers

The coagulation cascade is traditionally divided into 4 interacting pathways – intrinsic, extrinsic, common, and unique pathways.

False

The intrinsic pathway involves reactions with a specific group of clotting factors that are only present in the blood stream.

True

The extrinsic pathway requires a factor that is normally present in the blood.

False

Both the intrinsic and extrinsic systems eventually converge on and activate the intrinsic pathway.

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

The Extrinsic Pathway begins when damage occurs to the surrounding tissues.

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

The principal initiator of coagulation in vivo is tissue factor (TF).

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

TF-FVIIa complex activates Factor VIII of the Intrinsic Pathway.

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

The Extrinsic Pathway involves interaction between tissue factor (as cofactor), FVII and Ca++.

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

The Intrinsic Pathway begins when blood comes into contact with collagen in damaged blood vessel wall.

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

Both intrinsic & extrinsic pathways activate the common pathway, resulting in production of fibrin to seal off the breach in blood vessel wall.

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

Traditional Coagulation Cascade Model fully explains how blood clots in vivo.

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

Factor VIII or IX deficiency leads to a serious bleeding tendency, although the extrinsic pathway is intact.

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

Secondary haemostasis occurs in distinct, but non-overlapping, steps: Initiation, Amplification, and Propagation.

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

Fibrinolysis is the process that dissolves & removes the fibrin clot following secondary haemostasis.

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

The size of both the primary & secondary hemostatic plugs must be restricted to keep blood vessel patent.

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

Endothelium is a physiological regulator of global hemostasis by acting as a physical barrier.

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

Surface heparin-like glycosaminoglycans (GAGs) enhance ATIII & TFPI activity in primary hemostasis.

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

Plasminogen activator inhibitor-1 is produced in the liver.

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

Antithrombin III inhibits only factor VIIa.

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

Protein C is activated by heparin.

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

Protein S is produced in endothelial cells.

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

Thrombin-activatable Carboxypeptidase B binds to lysine residues in fibrin, promoting plasminogen binding and activation.

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

Plasminogen activator binds and inactivates tissue plasminogen activator.

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

Alpha2-Antiplasmin is produced in the liver.

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

Polyphosphates form a loose fibrin network that is easily degraded by plasmin.

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

Extracellular nuclear material promotes fibrin degradation.

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

Plasminogen activator inhibitor-1 complex is not inhibited by thrombin-thrombomodulin.

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

Which pathway requires a factor that is not normally present in the blood?

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

Which pathway involves interactions between tissue factor, Factor VII, and Ca++?

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

Which factor deficiency leads to a serious bleeding tendency, although the extrinsic pathway is intact?

<p>Factor VIII deficiency</p> Signup and view all the answers

What are the components involved in the Common pathway?

<p>Factor X, Factor V, Factor II (Prothrombin)</p> Signup and view all the answers

What is true about the Intrinsic pathway?

<p>All components occur in the bloodstream</p> Signup and view all the answers

What promotes plasminogen binding and activation by binding to lysine residues in fibrin?

<p>Thrombin-activatable Carboxypeptidase B</p> Signup and view all the answers

Which physiological regulator inhibits the TF-FVIIa & TF-FVIIaFXa complexes?

<p>Antithrombin III</p> Signup and view all the answers

What is the mechanism of action of Thrombin-activatable Carboxypeptidase B (TAFI)?

<p>Binds to lysine fibrinolytic inhibitor residues in fibrin</p> Signup and view all the answers

What is the role of Plasminogen activator inhibitor-1 (PAI-1) in fibrinolysis?

<p>Binds and inactivates tissue plasminogen activator</p> Signup and view all the answers

What is the function of Extracellular nuclear material in the context of haemostasis?

<p>Promotes PAI-1 inhibition of tPA</p> Signup and view all the answers

What is the role of Alpha2-Antiplasmin in haemostasis?

<p>Binds and inactivates plasmin</p> Signup and view all the answers

Which physiological regulator is a cofactor for both Thrombin-activatable Carboxypeptidase B (TAFI) & activated protein C?

<p>Protein S</p> Signup and view all the answers

Which physiological regulator is enhanced by heparin (exogenous) & heparin-like glycosaminoglycans (GAGs) on endothelial cells?

<p>Antithrombin III</p> Signup and view all the answers

What is the function of Polyphosphates released from dense granules in platelets during activation?

<p>Form a dense fibrin network</p> Signup and view all the answers

What is the role of Protein C in haemostasis?

<p>Inactivates Fva &amp; FVIIIa</p> Signup and view all the answers

What does the Thrombin-activatable Carboxypeptidase B (TAFI) bind to, promoting fibrinolysis?

<p>Lysine residues in fibrin</p> Signup and view all the answers

What is the principal initiator of coagulation in vivo?

<p>Tissue factor (Factor III)</p> Signup and view all the answers

Which of the following forms a primary complex with high-molecular-weight kininogen (HMWK) & prekallikrein on collagen in the Intrinsic Pathway?

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

Which of the following pathways is slower-responding and begins when blood comes into contact with collagen in damaged blood vessel wall?

<p>The Intrinsic Pathway</p> Signup and view all the answers

Which pathway involves interactions between tissue factor (as cofactor), Factor VII, and Ca++?

<p>The Extrinsic Pathway</p> Signup and view all the answers

Which factor deficiency leads to a serious bleeding tendency, although the intrinsic pathway is intact?

<p>Factor VII deficiency</p> Signup and view all the answers

What is the main process that dissolves & removes the fibrin clot following secondary hemostasis?

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

What process occurs in distinct, but overlapping, steps known as Initiation, Amplification, and Propagation?

<p>Secondary Hemostasis</p> Signup and view all the answers

What does the prothrombinase complex convert prothrombin (FII) to?

<p>Thrombin (FIIa)</p> Signup and view all the answers

Which of the following is involved in the primary complex formation with FVIIIa, Ca++, and phosphatidylserine in the Intrinsic Pathway?

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

Which of the following is released by endothelial cells to enhance antithrombin III (ATIII) & Tissue Factor Pathway Inhibitor (TFPI) activity in primary hemostasis?

<p>Nitric Oxide</p> Signup and view all the answers

What must be restricted to keep blood vessels patent during hemostasis?

<p>Primary &amp; secondary hemostatic plugs size</p> Signup and view all the answers

Which physiological regulator acts as a physical barrier in global hemostasis?

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

Which factor is involved in the Extrinsic pathway and requires a cofactor to be activated?

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

In which pathway does the principal initiator of coagulation in vivo act?

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

Which physiological regulator is a cofactor for both Thrombin-activatable Carboxypeptidase B (TAFI) and activated protein C?

<p>Protein C</p> Signup and view all the answers

Which factor deficiency leads to a serious bleeding tendency, although the extrinsic pathway is intact?

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

What does the prothrombinase complex convert prothrombin (FII) to?

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

What is the function of Polyphosphates released from dense granules in platelets during activation?

<p>Form a loose fibrin network</p> Signup and view all the answers

What is the main initiator of coagulation in vivo?

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

Which factor forms a primary complex with high-molecular-weight kininogen (HMWK) & prekallikrein on collagen in the Intrinsic Pathway?

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

Which of the following is true about the Common Pathway?

<p>Conversion of prothrombin (FII) to thrombin (FIIa)</p> Signup and view all the answers

Which pathway begins when blood comes into contact with collagen in damaged blood vessel wall?

<p>Intrinsic Pathway</p> Signup and view all the answers

What are the components involved in the Common Pathway?

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

Plasminogen activator inhibitor-1 is produced in the liver.

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

Alpha2-Antiplasmin is produced in the liver.

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

Both intrinsic & extrinsic pathways activate the common pathway, resulting in production of fibrin to seal off the breach in blood vessel wall.

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

What is the mechanism of action of Thrombin-activatable Carboxypeptidase B (TAFI)?

<p>Binds to lysine residues in fibrin, preventing plasminogen binding</p> Signup and view all the answers

What is the role of Alpha2-Antiplasmin in haemostasis?

<p>Binds and inactivates plasmin</p> Signup and view all the answers

What promotes plasminogen binding and activation by binding to lysine residues in fibrin?

<p>Thrombin-activatable Carboxypeptidase B (TAFI)</p> Signup and view all the answers

Which physiological regulator is enhanced by heparin (exogenous) & heparin-like glycosaminoglycans (GAGs) on endothelial cells?

<p>Antithrombin III (ATIII)</p> Signup and view all the answers

The coagulation cascade is traditionally divided into 4 interacting pathways – intrinsic, extrinsic, common, and unique pathways. Which pathway involves interactions between tissue factor, Factor VII, and Ca++?

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

Which factor deficiency leads to a serious bleeding tendency, although the intrinsic pathway is intact?

<p>Factor VII deficiency</p> Signup and view all the answers

What does the prothrombinase complex convert prothrombin (FII) to?

<p>Thrombin (FIIa)</p> Signup and view all the answers

Which physiological regulator inhibits the TF-FVIIa & TF-FVIIaFXa complexes?

<p>Plasminogen activator inhibitor-1 (PAI-1)</p> Signup and view all the answers

What is the function of Polyphosphates released from dense granules in platelets during activation?

<p>Form a dense fibrin network, resisting lysis</p> Signup and view all the answers

What is true about the Intrinsic pathway?

<p>Begins when blood comes into contact with damaged blood vessel wall</p> Signup and view all the answers

What are the components of the Common Pathway in the coagulation cascade?

<p>Factor X, Factor V, Factor II (Prothrombin), Factor I (Fibrin)</p> Signup and view all the answers

What is the role of Alpha2-Antiplasmin in haemostasis?

<p>It inhibits the action of plasmin and prevents excessive fibrinolysis.</p> Signup and view all the answers

Which physiological regulator is a cofactor for both Thrombin-activatable Carboxypeptidase B (TAFI) and activated protein C?

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

What promotes plasminogen binding and activation by binding to lysine residues in fibrin?

<p>Tissue Plasminogen Activator (tPA)</p> Signup and view all the answers

In which pathway does the principal initiator of coagulation in vivo act?

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

What is true about the Intrinsic pathway?

<p>It involves reactions with a specific group of clotting factors that are only present in the blood stream.</p> Signup and view all the answers

What is the role of thrombin-activatable carboxypeptidase B (TAFI) in the haemostasis process?

<p>Binds to lysine residues in fibrin, preventing plasminogen binding and activation</p> Signup and view all the answers

How does protein C contribute to haemostasis?

<p>Inactivates Fva &amp; FVIIIa</p> Signup and view all the answers

What is the mechanism of action of alpha2-antiplasmin in haemostasis?

<p>Binds and inactivates plasmin</p> Signup and view all the answers

What is the function of plasminogen activator inhibitor-1 (PAI-1) in fibrinolysis?

<p>Binds and inactivates tissue plasminogen activator</p> Signup and view all the answers

How does thrombin-activatable carboxypeptidase B (TAFI) promote fibrinolysis?

<p>Binds to lysine residues in fibrin, preventing plasminogen binding and activation</p> Signup and view all the answers

What is the role of extracellular nuclear material in the context of haemostasis?

<p>Binds to the fibrin network, inhibiting fibrin degradation, promotes PAI-1 inhibition of tPA</p> Signup and view all the answers

What is the main process that dissolves and removes the fibrin clot following secondary haemostasis?

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

What is the principal initiator of coagulation in vivo?

<p>Tissue factor (TF)</p> Signup and view all the answers

What physiological regulator acts as a physical barrier in global haemostasis?

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

What process occurs in distinct, but overlapping, steps known as Initiation, Amplification, and Propagation?

<p>Coagulation cascade</p> Signup and view all the answers

What is the principal initiator of coagulation in vivo?

<p>Tissue factor (TF)</p> Signup and view all the answers

What is the alternate name for the TF-FVIIa complex in the extrinsic pathway?

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

Which factor forms a primary complex with high-molecular-weight kininogen (HMWK) & prekallikrein on collagen in the Intrinsic Pathway?

<p>Factor XII (FXII)</p> Signup and view all the answers

What is the role of Factor IX (FIX) in the Common Pathway?

<p>FIXa forms a complex with FVIIIa, Ca++, &amp; phosphatidylserine to activate FX (Common Pathway)</p> Signup and view all the answers

What is the function of the prothrombinase complex?

<p>The prothrombinase complex converts prothrombin (FII) to thrombin (FIIa)</p> Signup and view all the answers

What are the distinct, overlapping steps of secondary haemostasis in the modern cell-based model?

<p>Initiation, amplification, propagation</p> Signup and view all the answers

What is the main enzyme that mediates fibrinolysis?

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

What is the role of plasminogen activators in fibrinolysis?

<p>Plasminogen activators convert plasminogen to plasmin</p> Signup and view all the answers

How is the size of the primary and secondary haemostatic plugs restricted to keep blood vessels patent?

<p>Regulation by multiple endogenous antithrombotic &amp; antifibrinolytic systems</p> Signup and view all the answers

What is the mechanism of action of thrombomodulin in secondary haemostasis?

<p>Thrombomodulin binds thrombin and activates protein C</p> Signup and view all the answers

Which two cell types are required for the process of secondary haemostasis as proposed by the modern cell-based model?

<p>TF-bearing cells, platelets</p> Signup and view all the answers

What is the function of Alpha2-Antiplasmin in haemostasis?

<p>Alpha2-Antiplasmin inhibits plasmin activity</p> Signup and view all the answers

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