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What are the three complexes of fibrin formation?
- Initiation
- Tenase
- Prothrombinase
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What cells can store factors V and VIII?
Alpha-granules within platelets
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Where is the Tissue Factor found for the initiation complex?
Subendothelial cells
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Where are the tenase and prothrombinase complexes found?
Platelets
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What is the name for factors I, II, III, IV, XIII?
- I: Fibrinogen
- II: Prothrombin
- III: Tissue Factor
- IV: Ca2+
- XIII: transglutaminase
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What two factors do not need to be cleaved in order to be activated?
III (TF) and IV
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What four factors are K sensitive and what is their order of sensitivity? What proteins are K sensitive?
- VII>IX>X>II
- Proteins: C & S
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What drug can be used to inhibit Vitamin K usage for GLA residues?
Warfarin (Coumadin)
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What fibrinopeptides must be removed from fibrinogen to activate the binding between D and E sites?
Fibrinopeptide A and B
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What two molecules line up to bind fibrinogens together?
Glycine and Leucine
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What factor builds cross-linking between fibrinogen?
XIIIa (transglutaminase)
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What factor destroys fibrin clots?
plasmin
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What three factors activate plasmin?
- Urokinase
- t-PA
- Streptokinase
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What factor inhibits the plasmin activators?
PAI
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What factor inhibits free plasmin?
alpha-antiplasmin
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What clotting factors are inhibited by ATIII?
IX, X, II
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What is the order of sensitivity to ATIII?
IX, X, II
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What two factors are inhibited by TFPi?
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How is protein C activated for platelet degradation?
- Thrombin binds thrombomodulin
- Thrombin comes in to close vicinity of Protein C
- Thrombin cleaves protein C
- APC is activated with Protein S cofactor
- APC binds to Factors V and VIII
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What is the Leiden mutation?
- When factor V is not susceptible to APC degradation
- ***problem b/c they are prone to hyperthrombosis
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What is Hemophilia A and B?
- A: Deficient VIII factor (tenase complex)
- B: deficient IX factor (tenase complex)
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Which hemophilia is more common, A or B?
A
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What is the difference b/t a white clot and a red clot?
- White clot: just platelet plug/aggregation
- Red Clot: fibrin w/ trapped RBC, generally venous thrombi
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What is Disseminated intravascular coagulation? (DIC)
- inflammation induced coagulation
- Two problems:
- 1) formation of fibrin clots
- 2) high platele aggregation steals clotting factors so excessive bleeding can occur in other parts of the body
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