WorksheetsClotting Disorders Part 1
Total questions: 50
Worksheet time: 30mins
Which of the following are true about hemostasis?
is the balance
keeps blood fluid and clot-free in healthy vessels
form a plug in injured vessels to heal and prevent blood loss
solid mass of blood components that forms locally and blocks blood flow
What is Thrombus?
is the balance
keeps blood fluid and clot-free in heavy vessels
form a plug in injured vessels to heal and prevent blood loss
solid mass of blood components that forms locally and blocks blood flow
Which of the following are true about Thrombosis?
Pathological state
inappropriate activation of hemostatic processes
substance (or air) that travels through blood and causes blockage away from site of origin
What is embolus?
Pathological state
inappropriate activation of hemostatic processes
substance (or air) that travels through blood and causes blockage away from site of origin
Thromboembulus happens when the thrombus breaks free (most common)
true
false
Reflex mechanism is the response to secreted vasoconstrictors (released by damaged cells and platelets)
true
false
Which of the following are substances released during reflex mechanism?
epinephrine
serotonin
endothelin
TxA2
Which of the following are true about reflex mechanism?
occurs immediately
transient effect
occurs within 2 days
Platelets activate and adhere to sub endothelial matrix
Primary hemostasis
Secondary hemostasis
Resolution
Activation of coagulation cascade leads to formation of fibrin matrix (recruitment of more platelets)
Primary hemostasis
Secondary hemostasis
Resolution
Formation of stable plug, activation of antithrombotic mechanisms to restrict plug to site of injury
Primary hemostasis
Secondary hemostasis
Resolution
Which of the following are true about the coagulation cascade?
its purpose is to form a stable fibrin clot at the site of injury
has and intrinsic and extrinsic pathway that merge into a common one
its pathways can occur simultaneously (and at the same tie as primary hemostasis)
its pathways do not occur simultaneously (occur at different times than the primary hemostasis)
Proenzymes are synthesized by the liver
true
false
The reactions of the coagulation cascade occur at phospholipid protein complexes, which of the following are required?
phosphatidylserin
calcium
sodium
phospholipids
One Xa molecule can active ~40thrombin molecules
true
false
Primary pathway for in vivo coagulation
Extrinsic pathway
Intrinsic pathway
Primary pathway for in vitro coagulation
Extrinsic pathway
Intrinsic pathway
Factors are contained within the blood
Extrinsic pathway
Intrinsic pathway
Which of the following are true about the extrinsic pathway?
initiating factor (TF) is "outside of" blood
tissue factor (TF) is on exposed, damaged endothelium
TF calcium complex initiates pathway
also plays a role in platelet activation
factors are contained within blood
What are the key functions of Thrombin?
induction of platelet recruitment/activation
conversion of soluble fibrinogen to insoluble fibrin
activation of proenzymes -> amplification of coagulation cascade
The coagulation cascade are a largely interdependent processes that are stimulated by tissue injury
true
false
Thrombin has multiple roles and drives negative feedback
true
false
The end result of the coagulation cascade in erythrocytes trapped in fibrin mesh
true
false
Fibrin polymerization occurs with loss of solubility
true
false
Which of the following occur during the resolution stage?
fibrinolysis
plasminogen is converted to plasmin by tissue type and urokinase type plasminogen activators
plasmin digests fibrin, fibrinogen factor V, factor VIII,prothrombin and factor XII
Tissue-type and urokinase-type plasminogen activators are unstable and are rapidly inactivated
true
false
Plasmin is rapidly inactivated, it limits its activity to the local clot
true
false
Which of the following are true about pro-coagulant factors?
often membrane bound
localized activity
are soluble and secreted
Which of the following are true about anticoagulant factors?
often membrane bound
localized activity
are soluble and secreted
Which of the following are important substances for clot formation?
Antithrombin III
protein C and S
tissue type plasminogen activator (t-PA)
Prostacyclin (PGI2
Tissue factor pathway inhibitor
Inactivates thrombin and other factors, its activity is enhanced by heparin-like molecules
Antithrombin III
protein C and S
tissue type plasminogen activator (t-PA)
Prostacyclin (PGI2
Tissue factor pathway inhibitor
Vitamin K-dependent proteins that inactivate factors Va and VIIIa
Antithrombin III
protein C and S
tissue type plasminogen activator (t-PA)
Prostacyclin (PGI2
Tissue factor pathway inhibitor
White clots
arterial clots
venous clots
Red clots
arterial clots
venous clots
Which of the following are true about arterial clots?
contain many platelets
often caused by atherosclerosis
treated with antiplatelets
treated with anticoagulants
Which of the following are true about venous clots?
large size; contain mostly fibrin and RBC components
associated with blood stasis and/or medications (such as oral contraceptives)
treated with anticoagulants
treated with antiplatelets
Which of the following are thromboembolic conditions?
Deep Vein Thrombosis (DVT)
Pulmonary Embolism (PE)
stroke
MyocardiaI infarction (MI)
Disseminated Intravascular coagulation
Which of the following are associated with venous clots?
Deep Vein Thrombosis (DVT)
Pulmonary Embolism (PE)
stroke
MyocardiaI infarction (MI)
Disseminated Intravascular coagulation
Which of the following are associated with arterial clots?
Deep Vein Thrombosis (DVT)
Pulmonary Embolism (PE)
stroke
MyocardiaI infarction (MI)
Disseminated Intravascular coagulation
What are the predisposing factors of Virchow's Triad?
Endothelial injury
Stasis (or abnormal blood flow->turbulent)
hypercoagulable state
hypocoagulable state
Usually associated with arterial thrombosis
Endothelial injury
Stasis (or abnormal blood flow->turbulent)
hypercoagulable state
hypocoagulable state
Usually associated with venous thrombosis
Endothelial injury
Stasis (or abnormal blood flow->turbulent)
hypercoagulable state
hypocoagulable state
Associated to arterial and venous thrombosis
Endothelial injury
Stasis (or abnormal blood flow->turbulent)
hypercoagulable state
hypocoagulable state
Often associated with inadequate disease management: hypertension, hyperlipidemia, diabetes
Endothelial injury
Stasis (or abnormal blood flow->turbulent)
hypercoagulable state
hypocoagulable state
May be associated with atrial fibrillation or atherosclerotic plaques
Endothelial injury
Stasis (or abnormal blood flow->turbulent)
hypercoagulable state
hypocoagulable state
Stasis increases endothelial cell activation and platelet proximity, and activated coagulation factors "overstay" their welcome
true
false
May be genetic or acquired (secondary)
Endothelial injury
Stasis (or abnormal blood flow->turbulent)
hypercoagulable state
hypocoagulable state
What are the common causes of hypercoaguable state?
malignancy
oral contraceptives
heparin-induced thrombocytopenia (HIT)
NSAIDs
Which of the following are treatment strategies?
inhibit platelet activity
dissolve clot ("blot busters")
anticoagulants (prevent clots/enhace endogenous anti clotting system)
stimulate platelet activity
Which of the following are true about anticoagulants?
used as treatment and prevention
inhibit factors in the clotting cascade
bleeding is always an ADR
bleeding is sometimes an ADR
