Term
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Definition
refers to formation of platelet plug in a vessel hole |
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Definition
refers to the coagulation cascade and formation of a fibrin plug generated from soluble fibrinogen by enzymatic cleavage |
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Term
clinical difference btwn defect in fibrin plug and platelet plug |
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Definition
fibrin plug: deep muscle or joint bleeds. platelet plug: mucosal bleeding, ecchymosis, petechiae |
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Term
lab difference btwn fibrin and platelet plug defects |
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Definition
fibrin: PT/PTT elevated, quantitive fibrinogen. Platelet: platelet count, bleeding time, platelet fn assays |
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Definition
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Definition
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Definition
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Definition
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Definition
cofactor for the generation of the prothrombinase complex |
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Definition
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Definition
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Definition
deficiency doesn't cause bleeding except under stress (surgery, trauma). Thrombin enhances 11->11a, which enhances thrombin in turn |
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Definition
stabilizes fibrin clot; not reflected in PT or aPTT but by 5M urea clot lysis test. Cross links glutamine and lysine btwn soluble fibrins to make insoluble |
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Definition
thrombin time: add thrombin to pt's plasma, tests fibrinogen adequacy and inhibitors of thrombin (e.g. heparin) or inhibitors of fibrin polymerization |
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Definition
prothrombin time: add active tissue factor (factor III). used primarily to monitor anticoagulation therapy. NORMAL in hemophiliacs! |
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Term
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Definition
activated partial thromboplastin time: tests rxn to negatively charged surface (glass) beginning w/ factor 12. Calcium independent. MAY NOT DETECT some bleeding disorders |
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Term
site of synthesis of coagulation factors |
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Definition
ALL are made in the liver. Platelets make 5, VWF, and PAI-1. Endothelium makes vWF, 7, tPA, uPA. |
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Term
4 steps of platelet plug formation |
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Definition
adhesion, aggregation, granule release/amplification, support of coag. cascade. |
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Term
mechanisms of thrombocytopenia |
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Definition
decreased or ineffective pdxn, destruction, redistribution, dilution |
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Term
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Definition
vWF deficiency or defect, affects 1% of caucasians. Autosomally inherited. |
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Term
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Definition
von Willebrand factor; binds platelets to damaged endothelium. carries F8, complete def. is indistinguishible from hemophilia A |
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Term
2 screening tests for primary hemostasis |
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Definition
PFA100 and bleeding time (less reliable, poor screening test) |
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Term
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Definition
blood is run thru column coated w/ collagen and checks how much time it takes to close aperture. better than bleeding time for checking primary hemostasis. |
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Term
ristocetin cofactor assay |
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Definition
tests ability of vWF to bind platelet GPIb (functional test of vWF, esp. HMW multimers) |
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Term
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Definition
tests platelet response to specific agonists |
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Term
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Definition
widely variable, interobserver reliability is poor, poor predictor of operative outcome |
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Definition
plasma is separated from blood and put into a citrate tube (binds Ca, prevents clotting). Phospholipid is added (partial thromboplastin), and contact activator is added. Ca is added back in and clotting time is measured. |
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Term
minimal hemostatic level of F 8,9,11 |
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Definition
30% and up should all clot normally |
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Term
prolonged aPTT indicates: |
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Definition
deficiency in F12,11,9, 8,10,5, 2 and fibrinogen. most sensitive for 12,11,9,8, less for 2 and fibrinogen |
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Term
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Definition
factor 12- deficiency may cause prolonged aPTT but no disease |
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Term
causes of spurious prolongation of aPTT |
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Definition
elevated plasma citrate, heparin in tube, or clotted sample that pulls out clotting factors |
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Term
Inhibitors of clotting in vitro; promotes clotting in vivo |
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Definition
lupus anticoagulant and anticardiolipin antibodies |
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Term
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Definition
50-50 mixing study will differentiate btwn factor deficiency and inhibitor |
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Term
specific tests for secondary hemostasis |
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Definition
pt's plasma added to factor deficient plasma- clotting time plotted against mix of normal plasma and factor deficient plasma. Must be done once for each factor to be tested. |
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Term
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Definition
rate of conversion of fibrinogen to fibrin, which depends on amount of fibrinogen and quality of fibrinogen |
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Term
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Definition
can confirm that inability to clot is due to heparin |
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Term
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Definition
inhibits polymerization, causes problems in 1' and 2' hemostasis, causes prolonged thrombin time |
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Term
causes of prolonged thrombin time |
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Definition
congenital afibrinogenemia, dysfibrinogenemia, heparin, xs fibrinogen degredation products (as in DIC), paraproteinemia, renal failure, amyloidosis |
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Term
Dilute whole blood clot lysis time |
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Definition
screens for accelerated fibrinolysis; measures time to clot breakdown in a sample of plasma (euglobulin lysis time) or whole blood (DWBCLT). Shortened in advanced cirrhosis, also venous thrombosis and renal dz |
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Definition
receptor for 7a and also vital for angiogenesis, constitutively expressed on subendothelium and bone marrow derived microparticles. induced by cytokines, LPS, and VEGF |
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Term
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Definition
Tissue Factor Pathway Inhibitor complexes F10a and F7a to shut down clotting via their pathway. This forces the TF;F7a complex to activate factor 9 instead |
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Definition
converts glutamic acid into gamma carboxy glutamic acid |
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Definition
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Definition
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Term
thrombin amplifies its own production how? (2 ways) |
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Definition
activates factor 11, activates platelets leading to increased surface for coag cascade |
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Term
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Definition
important anticoagulant; major scavenger of xs thrombin. knockout -> death! deficiency-> clots! activated by GAGs on endothelial surface. can neutralize F10a and F9a |
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Term
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Definition
cofactor for APC; allows APC to clip factors 8a and 5a |
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Term
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Definition
APC comes from PC that has been converted by the thrombin-TM complex on ET. Inhibits F5 and F8, and PAI-1 (to increase fibrinolysis). Inhibited by APCI |
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Term
Dense granules (platelet) |
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Definition
contain ADP, ATP, serotonin, and Ca (platelet agonists!) |
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Term
alpha granules (platelet) |
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Definition
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Term
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Definition
thrombopoietin, mpl ligand on plateletes and megakaryocytes, secreted constitutively by liver. cellular levels vary w/ platelet and MK size |
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Term
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Definition
an error in diagnosis of thrombocytopenia, look at the edge of a PBS to see the platelets in these cases |
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Term
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Definition
antibodies to platelets reduce their amount, but more young platelets are made, allowing sufficient clotting for most pts |
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Term
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Definition
Idiopathic (immune) Thrombocytopenic Purpura is caused by antibodies against common platelet antigens (i.e. platelet transfusions are of little use). May be caused by drugs, infection, or autoimmune dz. Splenic MPs phagocytose platelets. Often cured by splenectomy. |
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Term
3 As of platelet function |
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Definition
Adhesion to disrupted endothelium, Activation (become sticky), Aggregation (recruit other platelets to clot) |
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Term
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Definition
ptn on the surface of platelets that reversibly binds vWF on damaged endothelium. Induced by fast flow in bloodstream |
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Definition
ptn on surface of platelets that stably binds endothelium |
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Term
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Definition
storage for vWF multimers in endothelium |
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Definition
cuts HMW vWF into smaller, less sticky pieces for constitutive circulation. deficiency--> thrombotic thrombocytopenic purpura (TTP) with lots of clotting |
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Term
platelet agonists in vivo |
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Definition
collagen w/ GP6, cWF w/ GP9B, thrombin, ADP, and epinephrine |
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Term
Platelet suppressors in vivo |
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Definition
endothelial NO, endothelial prostacyclin, and CD39 (breaks down ADP) |
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Term
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Definition
expressed on platelets, upregulated in activation, binds fibrinogen or vWF, vital for platelet aggregation |
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Term
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Definition
vWF Ag quantification detects circulating levels from lo and hi MW multimers. Ristocetin cofactor assay gives functional assessment of vWF action. vWF multimer assay looks at proportions of each multimer. F8 level. Ristocetin induced platelet aggregation (RIPA) uses pt's plasma and platelets checks sensitivity of platelet vWF binding |
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Term
ristocetin induced platelet aggregation (RIPA) |
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Definition
uses pt's platelets and plasma and assesses sensitivity of platelet vWF binding |
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Term
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Definition
1: too little vWF. 2:dysfunctional vWF (several subtypes). 3: complete lack of vWF |
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Term
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Definition
gel electrophoresis separates multimers of vWF, checks for appropriate proportions of HMW vWF |
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Term
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Definition
X linked disorder of Factor 8 |
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Term
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Definition
synthetic desmopressin stimulates endothelial release of vWF is great for treating vW dz in anticipation of bleeding (period, dentist) but can only be used a couple days at a time (tachyphylaxis) |
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Term
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Definition
DDAVP, Cryoprecipitate, purified vWF:8, anti fibrinolytics, and estrogen |
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Term
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Definition
autosomal recessive, platelet GP 1B9 deficiency. PBS: mild to moderate thrombocytopenia, large platelets. Low RIPA, nl RCo . Corresponds with vWD |
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Term
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Definition
lifelong mucocutaneous bleeding, autosomal recessive def of alpha granules |
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Term
Glanzmann's thrombasthenia |
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Definition
autosomal recessive defect in platelet GP IIb/IIIa. Normal platelet count, severe mucocutaneous bleeding, Fe deficiency, prolonged bleeding time, absent aggregation to any agonist except ristocetin. |
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Term
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Definition
irreversibly inhibits COX1 , prevents formation of TXA2. |
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Term
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Definition
Thrombomodulin, Ptn S, and F5a |
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Term
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Definition
MCV is over 100 fL, indicates dfx in DNA pdxn and cell division, could be B12 or folate def. Retics will be lo, bili hi, cells all over body have trouble dividing. |
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Term
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Definition
GAG that activates antithrombin to prevent thrombin from promoting clotting |
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Term
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Definition
induces ET to release tPA, ET derived relaxing factor and prostacyclin; induces monocytes to express uPA receptors; complexes with TM to activate ptn C; induces platelet mediated clot retraction |
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Term
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Definition
a very active serine protease from plasminogen; degrades fibrin, F5, F8, and deactivates platelets. a-2-PI inhibits it, uPA and tPA activate it. Active in angiogenesis. |
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Term
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Definition
tissue plasminogen activator; comes from ET, dissolves clots, converts plasminogen to plasmin. released in response to increased venous pressure |
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Term
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Definition
Plasminogen Activator Inhibitor. Does whjat it says. |
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Term
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Definition
binds ET and allows conversion of plasminogen to plasmin |
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Term
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Definition
excessive fibrinolysis by plasmin that mimics hemophilia symptomatically w/ bleeding into joints |
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Term
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Definition
cross linked fibrins from clot breakdown; its presence tells you 3 things: you have functional thrombin that made fibrin, F13 cross linked it, and plasmin was activated to break down the clot. |
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Term
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Definition
Thrombin activated fibrinolysis inhibitor; cuts off lysine residues that plasminogen and tPA would bind to, making the clot more stable. |
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Term
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Definition
disorder of hemostasis resulting from excess generation of thrombin (usually from triggering of intrinsic system by TF) |
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Term
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Definition
Thrombocytopenia, ^D-Dimer, ^fibrin monomer, low-nl fibrinogen, positive protamine test |
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Term
Kasabach Merritt syndrome |
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Definition
localized DIC syndrome, livable |
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Definition
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Term
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Definition
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Term
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Definition
epsilon amniocaproic acid, binds lysine residues, acts as an antifibrinolytic. blocks tPA and plasminogen |
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Term
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Definition
Deficiency in AT, Ptn C, or Ptn S; APC resistance, PT gene mutation, homocysteinemia, or elevated F8, F11. |
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Term
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Definition
(factor 5 leiden) arginine target of ptn S/APC cleavage is mutated, preventing breakdown of f5a and increasing risk of thrombus 5x |
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Term
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Definition
hallmark of factor 13 deficiency; pts will bleed, clot, and then begin bleeding again later |
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Term
factors unique to the intrinsic pathway |
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Definition
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Term
factors in the common pathway |
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Definition
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Term
factors unique to the extrinsic pathway |
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Definition
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Term
factors requiring Ca and vitamin K |
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Definition
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Term
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Definition
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Term
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Definition
refers to the complex of F9 and F8 together |
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Term
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Definition
refers to complex of F10a and F5a |
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Term
what test is used for coumadin/warfarin monitoring? |
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Definition
PT tests levels of F7, which has the shortest halflife of the vitamin K dependent factors |
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Term
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Definition
Plavix; blocks ADP receptor on platelets |
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Term
platelet collagen receptor |
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Definition
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Term
conformational change in platelet exposes |
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Definition
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Term
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Definition
glycoprotein IIb/IIIa receptor irreversible inhibitor |
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Term
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Definition
abciximab, eptifabitide, tirofiban |
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Term
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Definition
clopidogrel and ticlopidine |
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Term
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Definition
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Term
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Definition
small bleeds (petechiae, purpura, epistaxis, mucocutaneous bleeds) |
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Term
Sx of secondary hemostasis disorder |
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Definition
bleeding into joints, large ecchymoses |
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Term
unfractionated heparin vs. LMW heparin |
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Definition
unfractionated: effective, reversible, rapid, short t/2, unpredictable, inpatient, more HIT. LMW:effective, fixed dosing, more predictable, less HIT, subQ, not fully reversible, difficult for obese or renal pts |
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Definition
pentasaccharide; selective inhibitor of F10a, can be used in pts with HIT |
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Definition
blocks vitamin K epoxide reductase, oral, outpatient, dietary precautions, unpredictable. OD may cause warfarin necrosis w/ microvascular clots |
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Term
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Definition
oral factor 10a inhibitor, broad therapeutic index |
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Term
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Definition
argatroban, lepirudin, bivalrudin, dibagitran |
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Term
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Definition
ticlopidine and clopidogren irreversibly inhibit ADP receptor on platelets; both prodrugs activated in hepatic metabolism |
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Term
First line anti-platelet therapy |
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Definition
aspirin blocks COX1 irreversibly and blocks platelet aggregation for up to 5 days |
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Term
level of TPO in aplastic anemia |
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Definition
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Term
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Definition
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Term
normal distribution of platelets |
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Definition
1/3 of platelets are in a normal spleen at any given time |
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Term
daily platelet turnover rate |
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Definition
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Term
normal platelet survival time |
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Definition
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Term
Infections associated with autoimmune thrombocytopenia |
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Definition
H. pylori, Hep C, and HIV |
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Term
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Definition
gain of function mutation to the GP1b9, "mops up" vWF from the body |
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Term
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Definition
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Term
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Definition
inhibits phospholipid dependent in vitro coagulation tests, esp. PTT. Causes arterial and venous thrombosis, fetal death. It is an antibody against clotting proteins that, when combined, develops affinity for phospholipid. |
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