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N5315 Advanced Pathophysiology Exam (Hypersensitivities, Hemostasis Part II, Arachidonic Pathway, Solid Organ Transplant Rejection, AIDS) | Questions with Answers Verified 100% Correct
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N5315 Advanced Pathophysiology Exam (Hypersensitivities, Hemostasis Part II, Arachidonic Pathway, Solid Organ Transplant Rejection, AIDS) | Questions with Answers Verified 100% Correct

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N5315 Advanced Pathophysiology Exam
(Hypersensitivities, Hemostasis Part II,
Arachidonic Pathway, Solid Organ Transplant
Rejection, AIDS) | Questions with Answers
Verified 100% Correct
Warfarin - ✔✔What drug inhibits vitamin K reduction?


It blocks the genetic coding for vitamin K oxide reductase thus decreasing the amount available
to reduce vitamin K; a lack of reduced vitamin K prevents the process of carboxylation and
decreases the amount of functional vitamin K dependent coagulation factors; increases the risk
of bleeding - ✔✔How does warfarin work on the coagulation process?



A deficient amount of coagulation factors and an increased risk of bleeding. - ✔✔What does
a vitamin K deficiency lead to?


a measure of the extrinsic pathway (tissue factor and FVII) and the common pathway (factors II,
V, X, I). - ✔✔What is prothrombin time (PT)?


Vitamin K deficiency, liver diseases, deficiency of factors VII, II, V or fibrinogen, and use of
warfarin; primarily used to monitor warfarin therapy - ✔✔When are prolonged PT values
seen?


A measure of the intrinsic pathway (factors XII, XI, IX, VIII) and the common pathway (factors II,
V, X & I) - ✔✔What is the aPTT?


Any deficiency or inhibitor of any coagulation factors except factor VII; primarily used to
monitor heparin therapy. - ✔✔What can cause a prolonged aPTT?

,Accelerates the rate at which antithrombin neutralizes thrombin and activated factor Xa by
4000 fold - ✔✔How does heparin work?


It binds with thrombomodulin which is a protein found on the endothelial cells; this binding
deactivates thrombin and leads to the activation of protein C; activated protein C and protein S
then go on to deactivate Va and VIIIa - ✔✔What does thrombin do during clot formation?


It circulates in plasma in low concentrations; binds to Xa and then together they inactivate
TF/VIIa; serum levels of TFPI increases following administration of IV heparin products; this may
enhance effects of heparin - ✔✔What does Tissue Factor Pathway Inhibitor (TFPI) do?



Prostacyclin is made via the COX 2 pathway and inhibits platelet aggregation - ✔✔What is
prostacyclin and what is it's function?


Nitric oxide is released by the endothelial cells and causes vasodilation and inhibits platelet
aggregation. - ✔✔How is nitric oxide released and what does this cause?


An endothelial cell enzyme which circulates in plasma bound to its inhibitor PAI-1; it is released
in response to thrombin, epinephrine, cytokines, serotonin, and bradykinin; it activates
plasminogen, which then activates plasmin and plasmin dissolves fibrin, fibronectin, vWF, and
thrombospondin - ✔✔What is tissue type plasminogen activator (tPA)?



Plasminogen - ✔✔What does urokinase activate?


Made by the endothelial cells and inhibit tPA. Alpha 2 antiplasmin secreted by liver and is
present in platelets; it is integrated into the clot by XIIIa and makes thrombus resistant to
plasmin - ✔✔What are plansminogen activator inhibitors and alpha 2 antiplasmin?


It is activated by the thrombin-TM complex and prevents the activation of plasminogen and
thereby delays clot lysis - ✔✔How is thrombin activatable fibrinolysis inhibitor activated and
what is it's function?

,A hypercoagulable state because it inhibits the production of protein S and protein C. -
✔✔What does warfarin cause at the initiation of administration and why?


Fondaparinux, apixiban, rivaroxaban; they increase antithrombin's affinity for Xa; antithrombin
neutralizes Xa and thereby prevents formation of the prothrombinase complex and thrombin. -
✔✔Name some drugs that are Xa inhibitors?


Dabigatran and argatroban; the inhibition of thrombin prevents activation of fibrinogen and
XIII; the active form of fibrinogen is fibrin which supports the platelet plug; XIIIa cross links with
fibrin to provide stabilization to the platelet plug - ✔✔Name some drugs that are direct
thrombin inhibitors?


A pathological immune response to an antigen which causes tissue and cellular damage to the
host - ✔✔What is a hypersensitivity?



4 types; Types 1-4 - ✔✔How many types of hypersensitivities are there?


It implies an intolerance of our immune system to our own (endogenous) antigens -
✔✔What does autoimmunity imply?



Implies the formation of antibodies to foreign antigens (exogenous antigens) - ✔✔What
does alloimmunity imply?



The pathologic consequence of autoimmunity - ✔✔What is an Autoimmune Disease?



A pathogen which triggers the immune response - ✔✔What often precipitates autoimmune
disease?

, It then turns against our own antigens - ✔✔What happens to the immune response that was
initiated against the pathogen?



The pathologic consequence of alloimmunity - ✔✔What is alloimmune disease?



An immediate hypersensitivity response to an environmental allergen - ✔✔What it Type I
hypersensitivity?



Allergies to food, medication, pollen, etc. - ✔✔What are most Type I hypersensitivity
reactions attributed to?



The coagulation cascade - ✔✔What is the 2nd arm of hemostasis?



12 - ✔✔How many coagulation factors are there?



They are plasma proteins; most produced in the liver - ✔✔What are the coagulation factors
made of?



In order of discovery. - ✔✔How are the coagulation factors named?



Zymogens - ✔✔What are coagulation factors in an inactive form?



With a after factor roman numeral (ex. Va is activated factor V). - ✔✔How is an activated
zymogen noted as?



Extrinsic pathway - ✔✔What is considered the primary pathway of coagulation?

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