GMS 6530 Coagulation exam with |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
correct answers |||\\\
Haemostasis - correct answer✔✔1) vasoconstriction |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
2) platelet phase - plug formation
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3) plasmatic phase - fibrin clot formation
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4) fibrinolytic phase - plasmin degradation of fibrin
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Platelet aggregation - correct answer✔✔- tissue damage (exposed collagen) > platelet
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recruitment to collage (via vWF) > platelet degranulation (activation) > ADP + 5-HT + TxA2 >
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GPIIv/LLLa receptor activation > platelet aggration |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Thrombin - correct answer✔✔- last enzyme in common pathway
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- converts soluble fibrinogen to insoluble fibrin mesh trapping blood cells and forming clot
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Vitamin K depenent factors - correct answer✔✔- II
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- VII
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- IX
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-X
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tPA - correct answer✔✔- tissue plasminogen activtor
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- activates plasminogen to plasmin
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Plasmin - correct answer✔✔- chops up fibrin and fibrinogen
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, aPTT - correct answer✔✔- activated partial thromboplastin time
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- measure of intrinsic pathway
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- norm. 25-35 sec
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PT - correct answer✔✔- prothrombin time
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- measure of extrinsic pathway
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- norm. 11-15 sec
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- where INR comes from
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INR - correct answer✔✔- normal = 1.0
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- higher = bleeding problem
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Heparin and LMWH - correct answer✔✔- activates antithrombin III in plasma|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- blocks Xa, thrombin, and IXa
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- antidote - protamine
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LMWH - correct answer✔✔- smaller |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- better bioavailability
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- longer half-life
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- given sub-q
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- contraindications - renal disease
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- lovenox, fragmin, fondapurinux
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Warfarin - correct answer✔✔- indirect anticoagulant |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- inhibits synthesis of vitamin-k dependent factors
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- II, VII, IX, & X
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correct answers |||\\\
Haemostasis - correct answer✔✔1) vasoconstriction |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
2) platelet phase - plug formation
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
3) plasmatic phase - fibrin clot formation
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
4) fibrinolytic phase - plasmin degradation of fibrin
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Platelet aggregation - correct answer✔✔- tissue damage (exposed collagen) > platelet
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
recruitment to collage (via vWF) > platelet degranulation (activation) > ADP + 5-HT + TxA2 >
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
GPIIv/LLLa receptor activation > platelet aggration |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Thrombin - correct answer✔✔- last enzyme in common pathway
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- converts soluble fibrinogen to insoluble fibrin mesh trapping blood cells and forming clot
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Vitamin K depenent factors - correct answer✔✔- II
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- VII
|||\\\
- IX
|||\\\
-X
|||\\\
tPA - correct answer✔✔- tissue plasminogen activtor
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- activates plasminogen to plasmin
|||\\\ |||\\\ |||\\\ |||\\\
Plasmin - correct answer✔✔- chops up fibrin and fibrinogen
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
, aPTT - correct answer✔✔- activated partial thromboplastin time
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- measure of intrinsic pathway
|||\\\ |||\\\ |||\\\ |||\\\
- norm. 25-35 sec
|||\\\ |||\\\ |||\\\
PT - correct answer✔✔- prothrombin time
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- measure of extrinsic pathway
|||\\\ |||\\\ |||\\\ |||\\\
- norm. 11-15 sec
|||\\\ |||\\\ |||\\\
- where INR comes from
|||\\\ |||\\\ |||\\\ |||\\\
INR - correct answer✔✔- normal = 1.0
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- higher = bleeding problem
|||\\\ |||\\\ |||\\\ |||\\\
Heparin and LMWH - correct answer✔✔- activates antithrombin III in plasma|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- blocks Xa, thrombin, and IXa
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- antidote - protamine
|||\\\ |||\\\ |||\\\
LMWH - correct answer✔✔- smaller |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- better bioavailability
|||\\\ |||\\\
- longer half-life
|||\\\ |||\\\
- given sub-q
|||\\\ |||\\\
- contraindications - renal disease
|||\\\ |||\\\ |||\\\ |||\\\
- lovenox, fragmin, fondapurinux
|||\\\ |||\\\ |||\\\
Warfarin - correct answer✔✔- indirect anticoagulant |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- inhibits synthesis of vitamin-k dependent factors
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
- II, VII, IX, & X
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\