Coagulation

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24 Questions

What is the centerpiece of a blood clot?

Fibrin

Which of the following is produced by mast cells and basophils to enhance the activity of antithrombin III?

Heparin

In what way does coumadin act to inhibit the production of clotting factors in the liver?

Competes with vit K

What is the activator that leads to the conversion of plasminogen to plasmin?

Plasminogen activator

What do deficiencies in either platelets or coagulation factors lead to?

Excessive bleeding

Which of the following is NOT a predisposing factor to hypercoagulability?

Tissue factor inhibitors

What does vitamin K deficiency lead to?

Decreased synthesis of prothrombin and other clotting factors

What serves as checks and balances in the clotting system?

(protein C, S, Antithrombin III)

'Petechiae, platelet dysfunction, low platelets' are associated with which disorder?

(thrombocytopenia)

What does liver disease cause in terms of hemostasis disorders?

Defects in coagulation, fibrinolysis, and platelet function

What results from a deficiency in clotting factors?

Excessive bleeding from minor trauma

What genetic disease leads to clotting factor deficiency?

Hemophilia

Which blood test measures the time it takes for blood to clot in a glass test tube?

Whole blood clotting time

Which factor is required throughout the entire clotting sequence?

Factor IV

What is the carrier for factor VIII in circulation?

Von Willebrand Factor

Which factor is synthesized in the liver in the presence of vitamin K?

Factor V

What is the purpose of homeostasis?

To decrease blood loss

Which blood test measures the time needed for recalcified citrated plasma to clot in the presence of tissue thromboplastin?

PT (prothrombin time)

What do platelet function tests assess?

The number of platelets

What leads to vasoconstriction after an injury?

Thromboxane A2

Which pathway is activated when the Hageman factor contacts subendothelial substances exposed by vascular injury?

Intrinsic pathway

What does ADP stimulate in platelet activation?

Platelet aggregation

What is the normal range for INR (international normalized ratio) for those on anticoagulant therapy such as warfarin?

2-3

What do platelets release during the activation process?

Various potent biochemicals

Study Notes

Blood Clotting and Hemostasis

  • The centerpiece of a blood clot is a platelet plug.
  • Heparin is produced by mast cells and basophils to enhance the activity of antithrombin III.
  • Coumadin (warfarin) inhibits the production of clotting factors in the liver by blocking vitamin K.
  • Tissue plasminogen activator (tPA) is the activator that leads to the conversion of plasminogen to plasmin.
  • Deficiencies in either platelets or coagulation factors lead to bleeding disorders.

Hypercoagulability

  • Cancer is not a predisposing factor to hypercoagulability.
  • Vitamin K deficiency leads to impaired clotting factor synthesis.

Clotting System Regulation

  • The clotting system has internal checks and balances to prevent excessive clotting.

Hemostasis Disorders

  • Petechiae, platelet dysfunction, and low platelets are associated with thrombocytopenia.
  • Liver disease causes impaired clotting factor synthesis and platelet dysfunction.
  • A deficiency in clotting factors results in bleeding disorders.
  • Hemophilia A is a genetic disease that leads to clotting factor deficiency.

Blood Tests

  • The whole blood clotting time (WBCT) measures the time it takes for blood to clot in a glass test tube.
  • The prothrombin time (PT) measures the time needed for recalcified citrated plasma to clot in the presence of tissue thromboplastin.
  • Platelet function tests assess platelet aggregation and secretion.

Platelet Activation

  • Thromboxane A2 (TXA2) leads to vasoconstriction after an injury.
  • The intrinsic pathway is activated when the Hageman factor contacts subendothelial substances exposed by vascular injury.
  • ADP stimulates platelet activation and secretion.
  • Factor VIII is the carrier for factor VIII in circulation.

Vitamin K and Clotting Factors

  • Vitamin K is required for the synthesis of clotting factors II, VII, IX, and X in the liver.

Homeostasis

  • The purpose of homeostasis is to maintain a balance between bleeding and clotting.

Anticoagulant Therapy

  • The normal range for INR (international normalized ratio) for those on anticoagulant therapy such as warfarin is 2-3.
  • Platelets release granules containing ADP, calcium, and serotonin during the activation process.

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