107 Questions
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.
False
The Extrinsic Pathway begins when damage occurs to the surrounding tissues.
True
The principal initiator of coagulation in vivo is tissue factor (TF).
True
TF-FVIIa complex activates Factor VIII of the Intrinsic Pathway.
False
The Extrinsic Pathway involves interaction between tissue factor (as cofactor), FVII and Ca++.
True
The Intrinsic Pathway begins when blood comes into contact with collagen in damaged blood vessel wall.
True
Both intrinsic & extrinsic pathways activate the common pathway, resulting in production of fibrin to seal off the breach in blood vessel wall.
True
Traditional Coagulation Cascade Model fully explains how blood clots in vivo.
False
Factor VIII or IX deficiency leads to a serious bleeding tendency, although the extrinsic pathway is intact.
False
Secondary haemostasis occurs in distinct, but non-overlapping, steps: Initiation, Amplification, and Propagation.
False
Fibrinolysis is the process that dissolves & removes the fibrin clot following secondary haemostasis.
True
The size of both the primary & secondary hemostatic plugs must be restricted to keep blood vessel patent.
True
Endothelium is a physiological regulator of global hemostasis by acting as a physical barrier.
True
Surface heparin-like glycosaminoglycans (GAGs) enhance ATIII & TFPI activity in primary hemostasis.
True
Plasminogen activator inhibitor-1 is produced in the liver.
True
Antithrombin III inhibits only factor VIIa.
False
Protein C is activated by heparin.
False
Protein S is produced in endothelial cells.
False
Thrombin-activatable Carboxypeptidase B binds to lysine residues in fibrin, promoting plasminogen binding and activation.
False
Plasminogen activator binds and inactivates tissue plasminogen activator.
False
Alpha2-Antiplasmin is produced in the liver.
True
Polyphosphates form a loose fibrin network that is easily degraded by plasmin.
False
Extracellular nuclear material promotes fibrin degradation.
False
Plasminogen activator inhibitor-1 complex is not inhibited by thrombin-thrombomodulin.
False
Which pathway requires a factor that is not normally present in the blood?
Extrinsic pathway
Which pathway involves interactions between tissue factor, Factor VII, and Ca++?
Extrinsic pathway
Which factor deficiency leads to a serious bleeding tendency, although the extrinsic pathway is intact?
Factor VIII deficiency
What are the components involved in the Common pathway?
Factor X, Factor V, Factor II (Prothrombin)
What is true about the Intrinsic pathway?
All components occur in the bloodstream
What promotes plasminogen binding and activation by binding to lysine residues in fibrin?
Thrombin-activatable Carboxypeptidase B
Which physiological regulator inhibits the TF-FVIIa & TF-FVIIaFXa complexes?
Antithrombin III
What is the mechanism of action of Thrombin-activatable Carboxypeptidase B (TAFI)?
Binds to lysine fibrinolytic inhibitor residues in fibrin
What is the role of Plasminogen activator inhibitor-1 (PAI-1) in fibrinolysis?
Binds and inactivates tissue plasminogen activator
What is the function of Extracellular nuclear material in the context of haemostasis?
Promotes PAI-1 inhibition of tPA
What is the role of Alpha2-Antiplasmin in haemostasis?
Binds and inactivates plasmin
Which physiological regulator is a cofactor for both Thrombin-activatable Carboxypeptidase B (TAFI) & activated protein C?
Protein S
Which physiological regulator is enhanced by heparin (exogenous) & heparin-like glycosaminoglycans (GAGs) on endothelial cells?
Antithrombin III
What is the function of Polyphosphates released from dense granules in platelets during activation?
Form a dense fibrin network
What is the role of Protein C in haemostasis?
Inactivates Fva & FVIIIa
What does the Thrombin-activatable Carboxypeptidase B (TAFI) bind to, promoting fibrinolysis?
Lysine residues in fibrin
What is the principal initiator of coagulation in vivo?
Tissue factor (Factor III)
Which of the following forms a primary complex with high-molecular-weight kininogen (HMWK) & prekallikrein on collagen in the Intrinsic Pathway?
Factor XII
Which of the following pathways is slower-responding and begins when blood comes into contact with collagen in damaged blood vessel wall?
The Intrinsic Pathway
Which pathway involves interactions between tissue factor (as cofactor), Factor VII, and Ca++?
The Extrinsic Pathway
Which factor deficiency leads to a serious bleeding tendency, although the intrinsic pathway is intact?
Factor VII deficiency
What is the main process that dissolves & removes the fibrin clot following secondary hemostasis?
Fibrinolysis
What process occurs in distinct, but overlapping, steps known as Initiation, Amplification, and Propagation?
Secondary Hemostasis
What does the prothrombinase complex convert prothrombin (FII) to?
Thrombin (FIIa)
Which of the following is involved in the primary complex formation with FVIIIa, Ca++, and phosphatidylserine in the Intrinsic Pathway?
Factor IXa
Which of the following is released by endothelial cells to enhance antithrombin III (ATIII) & Tissue Factor Pathway Inhibitor (TFPI) activity in primary hemostasis?
Nitric Oxide
What must be restricted to keep blood vessels patent during hemostasis?
Primary & secondary hemostatic plugs size
Which physiological regulator acts as a physical barrier in global hemostasis?
Endothelium
Which factor is involved in the Extrinsic pathway and requires a cofactor to be activated?
Factor VII
In which pathway does the principal initiator of coagulation in vivo act?
Extrinsic pathway
Which physiological regulator is a cofactor for both Thrombin-activatable Carboxypeptidase B (TAFI) and activated protein C?
Protein C
Which factor deficiency leads to a serious bleeding tendency, although the extrinsic pathway is intact?
Factor IX
What does the prothrombinase complex convert prothrombin (FII) to?
Fibrin
What is the function of Polyphosphates released from dense granules in platelets during activation?
Form a loose fibrin network
What is the main initiator of coagulation in vivo?
Tissue factor
Which factor forms a primary complex with high-molecular-weight kininogen (HMWK) & prekallikrein on collagen in the Intrinsic Pathway?
Factor XII
Which of the following is true about the Common Pathway?
Conversion of prothrombin (FII) to thrombin (FIIa)
Which pathway begins when blood comes into contact with collagen in damaged blood vessel wall?
Intrinsic Pathway
What are the components involved in the Common Pathway?
Fibrin and Fibrinogen
Plasminogen activator inhibitor-1 is produced in the liver.
False
Alpha2-Antiplasmin is produced in the liver.
True
Both intrinsic & extrinsic pathways activate the common pathway, resulting in production of fibrin to seal off the breach in blood vessel wall.
True
What is the mechanism of action of Thrombin-activatable Carboxypeptidase B (TAFI)?
Binds to lysine residues in fibrin, preventing plasminogen binding
What is the role of Alpha2-Antiplasmin in haemostasis?
Binds and inactivates plasmin
What promotes plasminogen binding and activation by binding to lysine residues in fibrin?
Thrombin-activatable Carboxypeptidase B (TAFI)
Which physiological regulator is enhanced by heparin (exogenous) & heparin-like glycosaminoglycans (GAGs) on endothelial cells?
Antithrombin III (ATIII)
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++?
Extrinsic pathway
Which factor deficiency leads to a serious bleeding tendency, although the intrinsic pathway is intact?
Factor VII deficiency
What does the prothrombinase complex convert prothrombin (FII) to?
Thrombin (FIIa)
Which physiological regulator inhibits the TF-FVIIa & TF-FVIIaFXa complexes?
Plasminogen activator inhibitor-1 (PAI-1)
What is the function of Polyphosphates released from dense granules in platelets during activation?
Form a dense fibrin network, resisting lysis
What is true about the Intrinsic pathway?
Begins when blood comes into contact with damaged blood vessel wall
What are the components of the Common Pathway in the coagulation cascade?
Factor X, Factor V, Factor II (Prothrombin), Factor I (Fibrin)
What is the role of Alpha2-Antiplasmin in haemostasis?
It inhibits the action of plasmin and prevents excessive fibrinolysis.
Which physiological regulator is a cofactor for both Thrombin-activatable Carboxypeptidase B (TAFI) and activated protein C?
Thrombomodulin
What promotes plasminogen binding and activation by binding to lysine residues in fibrin?
Tissue Plasminogen Activator (tPA)
In which pathway does the principal initiator of coagulation in vivo act?
Extrinsic Pathway
What is true about the Intrinsic pathway?
It involves reactions with a specific group of clotting factors that are only present in the blood stream.
What is the role of thrombin-activatable carboxypeptidase B (TAFI) in the haemostasis process?
Binds to lysine residues in fibrin, preventing plasminogen binding and activation
How does protein C contribute to haemostasis?
Inactivates Fva & FVIIIa
What is the mechanism of action of alpha2-antiplasmin in haemostasis?
Binds and inactivates plasmin
What is the function of plasminogen activator inhibitor-1 (PAI-1) in fibrinolysis?
Binds and inactivates tissue plasminogen activator
How does thrombin-activatable carboxypeptidase B (TAFI) promote fibrinolysis?
Binds to lysine residues in fibrin, preventing plasminogen binding and activation
What is the role of extracellular nuclear material in the context of haemostasis?
Binds to the fibrin network, inhibiting fibrin degradation, promotes PAI-1 inhibition of tPA
What is the main process that dissolves and removes the fibrin clot following secondary haemostasis?
Fibrinolysis
What is the principal initiator of coagulation in vivo?
Tissue factor (TF)
What physiological regulator acts as a physical barrier in global haemostasis?
Endothelium
What process occurs in distinct, but overlapping, steps known as Initiation, Amplification, and Propagation?
Coagulation cascade
What is the principal initiator of coagulation in vivo?
Tissue factor (TF)
What is the alternate name for the TF-FVIIa complex in the extrinsic pathway?
Extrinsic tenase
Which factor forms a primary complex with high-molecular-weight kininogen (HMWK) & prekallikrein on collagen in the Intrinsic Pathway?
Factor XII (FXII)
What is the role of Factor IX (FIX) in the Common Pathway?
FIXa forms a complex with FVIIIa, Ca++, & phosphatidylserine to activate FX (Common Pathway)
What is the function of the prothrombinase complex?
The prothrombinase complex converts prothrombin (FII) to thrombin (FIIa)
What are the distinct, overlapping steps of secondary haemostasis in the modern cell-based model?
Initiation, amplification, propagation
What is the main enzyme that mediates fibrinolysis?
Plasmin
What is the role of plasminogen activators in fibrinolysis?
Plasminogen activators convert plasminogen to plasmin
How is the size of the primary and secondary haemostatic plugs restricted to keep blood vessels patent?
Regulation by multiple endogenous antithrombotic & antifibrinolytic systems
What is the mechanism of action of thrombomodulin in secondary haemostasis?
Thrombomodulin binds thrombin and activates protein C
Which two cell types are required for the process of secondary haemostasis as proposed by the modern cell-based model?
TF-bearing cells, platelets
What is the function of Alpha2-Antiplasmin in haemostasis?
Alpha2-Antiplasmin inhibits plasmin activity
Test your knowledge of the coagulation cascade in MPharm Programme Haemostasis with this quiz. Explore the intrinsic, extrinsic, and common pathways, as well as the specific clotting factors involved.
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