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intro to coagulation
SCC coagulation
| Question | Answer |
|---|---|
| 1. Define blood coagulation | The process whereby blood changes from a liquid state to a solid state at the site of injury |
| 2. Define hemostasis | the process whereby the blood is ready and able to become a solid in a needed area and remain flowing as a liquid elsewhere |
| 3. Define fibrinolysis/lysis | removal of the clot when the tissue has been repaired and the clot is no longer needed |
| 4. Define zymogen/proenzyme/procoagulant | describe the 14 plasma factors (coagulation factors) and platelet factor III (the ONLY coagulation factor not found in the plasma) in the inactive state. |
| What are most coagulation factors made of? What state do they circulate in when in the blood. | Most of the coagulation factors are proteins which circulate constantly in the blood in an inactive state (nonfunctional). |
| 5. Define activated state | once there is an injury the coagulation factors must be altered (activated) to become functional in order for bleeding to stop. |
| 6. Define inactive state | Most of the coagulation factors are proteins which circulate constantly in the blood in an inactive state (nonfunctional). They are only activated when injury occurs. |
| 7. Define coagulation/clotting factors | The coagulation mechanism is composed of 14 plasma factors (coagulation factors) and platelet factor III (the ONLY coagulation factor not found in the plasma), that comprise the coagulation cascade or scheme |
| What elicits a bleeding disorder? | A deficiency in any one or more of these coagulation/clotting factors will elicit a bleeding disorder |
| 8. Define fibrin | also known as a clot |
| 9. Define clot | fibrin meshwork |
| 10. Define anticoagulant | blood thinner to prevent thrombosis (clotting) |
| 11. Define hemorrhage | bleeding |
| 12. Define inhibitors | one type of substance, found in circulation, that “blocks” the coagulation factors from becoming activated |
| 13. Define circulating anticoagulants | types of substances, also found in the circulation, that again, keep the coagulation factors from becoming activated |
| 14. What are the four components of hemostasis? | - Platelets - Vascular System - Coagulation factors (plasma proteins) - Fibrinolysis |
| 15. List the coagulation (clotting) factors. (first 3) | • Fibrinogen or factor I • Prothrombin or factor II • Tissue factor/Tissue thromboplastin or factor III |
| List the coagulation (clotting) factors. (second 3 of 12) | • Calcium or factor IV • Proaccelerin/labile factor or factor V • Proconvertin/stabile factor or factor VII |
| List the coagulation (clotting) factors. (third 3 of 12) | • Antihemophilic A (AHF) factor or factor VIII • Antihemophilic B factor (also called plasma thromboplastin component - PTC, Christmas factor) or factor IX • Stuart-Prower factor or factor X |
| List the coagulation (clotting) factors. (last 3 of 12) | • Antihemophilic C factor (also called plasma thromboplastin antecedent - PTA) or factor XI • Contact factor (also called Hageman factor) or factor XII • Fibrin stabilizing factor or factor XIII |
| List the coagulation (clotting) factors not represented with roman numerials? | • Prekallikrein(PK)/Fletcher factor • High molecular weight kininogen (HMWK)/Fitzgerald factor. |
| 16. List the three coagulation (clotting) factor groups. | • Fibrinogen (thrombin sensitive) group • Prothrombin group (vitamin K sensitive) • Contact group |
| 17. List the coagulation (clotting) factors that belong to each of the clotting factor groups: | • Fibrinogen group - I, V, VIII, XIII • Prothrombin group - II, VII, IX, X • Contact group - XI, XII, prekallikrein, HMWK |
| 18. What are the three known pathways found in the coagulation cascade? | • Extrinsic/tissue Pathway • Intrinsic Pathway • Common Pathway |
| 19. Briefly explain primary hemostasis | There is a constriction of damaged blood vessels, which decreases the blood flow through the injured blood vessels. Platelets clump together and adhere to the injured vessels to form a platelet plug and further inhibit bleeding |
| 20. Briefly explain secondary hemostasis | coag factors in blood 7 tissue factor III form clot, during which natural occurring inhibitors in the blood block activated coag. factors so that widespread coagulation doesn't once formed, slowly lysis of the clot begins |
| the basic principle of the coagulation test procedures (how do analyzers determing the final result of a coagulation test? | By detecting clot formation |
| 22. What is the preferred anticoagulant for coagulation testing? Why? What color is the vacutainer top on this tube? | Sodium Citrate. It binds calcium which is needed for clot formation, the top is light blue |
| 23. What is the proper ratio of blood to anticoagulant in the vacutainer tube? Why is it important to maintain this ratio? | Ratio – 9:1 This ratio is important to maintain so that patient results will be accurate. This means it is VERY IMPORTANT that coagulation tubes be COMPLETELY filled. |
| 24. When coagulation testing must be delayed beyond the 2-4 hour post collection time limit, how should the specimen be handled? Why? | To separate the plasma from the red blood cells and put it into a PLASTIC tube, and then refrigerate the plastic tube until testing can be performed and |
| Why collect blood in a plastic container? | If the plasma is placed in a glass tube, it will activate the platelets |
| hemolyzed/lipemic/icteric specimens be used for coagulation testing? | Some coagulation analyzers may not be able to detect the correct endpoint for these types of specimens – they would not produce the proper clot detection time. |
| what appears to be the temperature range that is acceptable in MOST coagulation studies? | 35 – 38C – body temperature |
| 27. How is a normal patient range established for coagulation and other laboratory tests? | A minimum of 20 values are collected, the mean and 2SD (confidence intervals) are calculated. This represents the range. |
| 28. How are quality control ranges established for coagulation and other laboratory tests? | The same method is used to calculate quality control ranges as is used for normal patient ranges. EXCEPT both normal and abnormal quality control ranges are established. Each laboratory establishes its own ranges. |
| 29. Why should both normal and abnormal coagulation controls be tested with patient specimens? | The two controls should test the linearity of the method being used for patient testing.When control ranges fall within the established ranges then you can report out patient results because you know the method is working properly. |
| 30. List sources of error in coagulation testing. Which sources cause decreased clotting times? Which cause increased clotting times? | . Decreased clotting times 2. Increased clotting times: |
| What are some errors that cause a decrease in clotting times? | • dirty test tubes • specimens contaminated with tissue fluids • air bubbles • hemolyzed plasma • glass contact |
| What are some errors that cause a increase in clotting times? | • testing temperature less than 36C • testing temperature greater than 38C • incorrect blood/anticoagulant ratio • use of other anticoagulants • excessive hemostasis with tourniquet |
| 31. The prothrombin (PT) test evaluates which pathway? | Extrinsic/tissue pathway |
| 32. The activated partial thromboplastin time (APTT) test evaluates which pathway? | Intrinsic pathway |
Created by:
nizhoni