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USMLE

Coagulation

QuestionAnswer
What is found in the alpha granules of platelets? Fibrinogen Fibrinectin VWF Thrombospondin Vitronectin
What is found in the dense bodies? ADP ATP 5HT Ca
Steps of primary hemostasis Injured BV has exposed collagen VWF binds collagen GPIb of platelet binds to VWF, causing conformational change in IIb/IIIA IIb/IIIA is now able to bind fibrinogen Platelets express receptors for factors V and VIII; extend pseudopods
What role does TXA2 play in coagulation and how does it work? TXA2 causes platelet aggregation and vasocontriction. It decreases the level of cAMP, which causes an increase in Ca, which promotes platelet aggregation.
How does PGI2 work in coagulation? Where does it come from? Opposes the action of TXA2 by increasing the levels of cAMP, which decreases the levels of Ca. This inhibits platelet aggregation. It is released by vascular endothelial cells.
What role does ADP play in coagulation? Causes platelets to swell and adhere to each other. It then caauses them to release TXA2 and more ADP in a positive feedback mechanism. The clot formed is large enough to fill the injured area.
What is the tenase reaction? The reaction that causes the formation of Xa (IXa + VIIIa + X) -> Xa
What does factor XIII do? Provides clot strength and normal wound healing. Without it, clots dissolve more quickly
What does ATIII bind to? Heparan sulfate
What does AT III inactivate? IX, X, XI, II
What do proteins C and S inactivate? Va, VIIIa
What does TFPI do? Inactivates VIIa-TF complexes
What does heparin do? Enhances the activity of ATIII (inactivates Ix, X, XI, II)
What does warfarin do? Binds vitamin K, so II, VII, X, XI, protein C and S are all inhibited
What does thrombomodulin do? Causes the activation of protein C Also inactivates all the other serine proteases in coagulation
What does tPA do? Converts plasmingen to plasmin, which then breaks up the clot and releases FSP (D-dimer)
What does urokinase do? converts plasminogen -> plasmin, forms FSP (d-dimer)
What releases tPA and urokinase? Endothelium Fibrin
What does PAI-I do? down-regulates plasmin
What is alpha-2-anti-plasmin? Inhibits fibrinolysis, by collecting free plasmin
IL-11 Allows for increasing the number of circulating platelets
C-MPL TPO receptor on platelets
Treatments for VWD DDAVP Intermediate Purity Factor
What is Intermediate Purity Factor Combination of VWF and factor VIII; used to treat VWD
Created by: Asclepius