NURS 231 Pathophysiology Exam 4 Questions With
Verified Answers
function of blood
Transportation materials to and from cells
Transports nutrients, carries O2, waste products, hormones to their target cells,
regulates body temperature, protects against bacteria and viruses
three stages of hemostasis
Vascular constriction, platelet plug formation, blood coagulation
What is vitamin K needed to synthesize?
Factors II, VII, IX, and X, prothrombin, and protein C
Discuss the intrinsic and extrinsic pathways
both form prothrombin activator.
Both pathways converge to activate factor X, the conversion of prothrombin to thrombin.
Thrombin then converts fibrinogen to fibrin, the material needed to stabilize a clot.
Both methods are needed for successful hemostasis.
intrinsic pathway
The intrinsic pathway begins with activation of factor XII and can cause clotting in 1 to 6
minutes, considered the slower process.
extrinsic pathway
The extrinsic pathway can cause clotting in 15 seconds and begins with the release of
tissue thromboplastin from the subendothelial cells. It is the quicker of the two
pathways, forming a clot in approximately 15 seconds.
Natural anticoagulants
Antithrombin III, protein C, protein S
Drug therapy anticoagulants
warfarin, heparin, Dabigatran, Rivaroxaban, Apixaban
peripheral vascular resistance
The collective resistance of all the vessels in the peripheral circulation
Hemodynamics or blood flow is affected by what factors?
Pressure, resistance, flow, radius, blood viscosity, compliance, wall tension
cardiac output
The efficiency of the heart's pump is measured by the cardiac output. The cardiac
output (CO) is the amount of blood the heart pumps each minute. It is the product of the
stroke volume (SV) and the heart rate (HR). CO = SV x HR.
preload
Preload is the end-diastolic pressure when the ventricle has been filled and represents
the volume work of the heart.
afterload
pressure the heart must generate to move blood into the aorta.
cardiac contractility
ability of the heart to change its force of contraction without changing its resting
(diastolic) length.
inotrope
An inotropic influence is one that increases the strength of the muscular contraction.
, mean arterial pressure
average pressure in the arterial system during ventricular contraction and relaxation. It
is a good indicator of tissue perfusion. MAP = CO x PVR
Understand the renin-angiotensin-aldosterone system in figure 4.9.
The renin-angiotensin-aldosterone system plays a vital role in blood pressure
regulation. If there are changes in extracellular fluid, extracellular sodium levels, a drop
in blood pressure, or increased sympathetic activity, the kidney will release renin. Once
in the bloodstream, renin converts angiotensinogen (a plasma protein) to angiotensin I.
Angiotensin I is then converted to angiotensin II in the lungs by the angiotensin-
converting enzyme (ACE). Angiotensin II is a potent vasoconstrictor, mainly of the
arterioles, and to some extent, the veins. Arteriole constriction will increase the PVR,
regulating blood pressure for a short period of time. Angiotensin II also stimulates the
adrenal gland to secrete aldosterone. Aldosterone will increase salt and water retention
by the kidney contributing to the long-term regulation of blood pressure. Figure 4.9
summarizes the control of blood pressure by the renin-angiotensin-aldosterone system.
Be familiar with hypercoagulability states in table 4.2.
Increased Platelet Function:
Reactive disorders (iron deficiency anemia, splenectomy, chronic inflammation)
Myeloproliferative disorders (polycythemia vera)
Atherosclerosis
Diabetes mellitus
Smoking
Elevated cholesterol levels
Increased platelet levels
Accelerated Activity of the Clotting System
Inherited disorders (primary):
Mutation of factor V Leiden
Mutation in the prothrombin gene
Acquired disorders (secondary):
Pregnancy and the puerperium
Use of oral contraceptives
Postsurgical state
Immobility
Congestive heart failure
Malignant diseases
thrombocytosis
an elevated platelet count above 450,000/µL.
common causes of inherited disorders of hypercoagulability
Factor V gene and prothrombin gene
What are acquired (or secondary) factors of hypercoagulability that lead to
venous stasis?
Prolonged bed rest and immobility, myocardial infarction, cancer, hyperestrogenic
states, oral contraceptives, smoking, and obesity
thrombocytopenia
Verified Answers
function of blood
Transportation materials to and from cells
Transports nutrients, carries O2, waste products, hormones to their target cells,
regulates body temperature, protects against bacteria and viruses
three stages of hemostasis
Vascular constriction, platelet plug formation, blood coagulation
What is vitamin K needed to synthesize?
Factors II, VII, IX, and X, prothrombin, and protein C
Discuss the intrinsic and extrinsic pathways
both form prothrombin activator.
Both pathways converge to activate factor X, the conversion of prothrombin to thrombin.
Thrombin then converts fibrinogen to fibrin, the material needed to stabilize a clot.
Both methods are needed for successful hemostasis.
intrinsic pathway
The intrinsic pathway begins with activation of factor XII and can cause clotting in 1 to 6
minutes, considered the slower process.
extrinsic pathway
The extrinsic pathway can cause clotting in 15 seconds and begins with the release of
tissue thromboplastin from the subendothelial cells. It is the quicker of the two
pathways, forming a clot in approximately 15 seconds.
Natural anticoagulants
Antithrombin III, protein C, protein S
Drug therapy anticoagulants
warfarin, heparin, Dabigatran, Rivaroxaban, Apixaban
peripheral vascular resistance
The collective resistance of all the vessels in the peripheral circulation
Hemodynamics or blood flow is affected by what factors?
Pressure, resistance, flow, radius, blood viscosity, compliance, wall tension
cardiac output
The efficiency of the heart's pump is measured by the cardiac output. The cardiac
output (CO) is the amount of blood the heart pumps each minute. It is the product of the
stroke volume (SV) and the heart rate (HR). CO = SV x HR.
preload
Preload is the end-diastolic pressure when the ventricle has been filled and represents
the volume work of the heart.
afterload
pressure the heart must generate to move blood into the aorta.
cardiac contractility
ability of the heart to change its force of contraction without changing its resting
(diastolic) length.
inotrope
An inotropic influence is one that increases the strength of the muscular contraction.
, mean arterial pressure
average pressure in the arterial system during ventricular contraction and relaxation. It
is a good indicator of tissue perfusion. MAP = CO x PVR
Understand the renin-angiotensin-aldosterone system in figure 4.9.
The renin-angiotensin-aldosterone system plays a vital role in blood pressure
regulation. If there are changes in extracellular fluid, extracellular sodium levels, a drop
in blood pressure, or increased sympathetic activity, the kidney will release renin. Once
in the bloodstream, renin converts angiotensinogen (a plasma protein) to angiotensin I.
Angiotensin I is then converted to angiotensin II in the lungs by the angiotensin-
converting enzyme (ACE). Angiotensin II is a potent vasoconstrictor, mainly of the
arterioles, and to some extent, the veins. Arteriole constriction will increase the PVR,
regulating blood pressure for a short period of time. Angiotensin II also stimulates the
adrenal gland to secrete aldosterone. Aldosterone will increase salt and water retention
by the kidney contributing to the long-term regulation of blood pressure. Figure 4.9
summarizes the control of blood pressure by the renin-angiotensin-aldosterone system.
Be familiar with hypercoagulability states in table 4.2.
Increased Platelet Function:
Reactive disorders (iron deficiency anemia, splenectomy, chronic inflammation)
Myeloproliferative disorders (polycythemia vera)
Atherosclerosis
Diabetes mellitus
Smoking
Elevated cholesterol levels
Increased platelet levels
Accelerated Activity of the Clotting System
Inherited disorders (primary):
Mutation of factor V Leiden
Mutation in the prothrombin gene
Acquired disorders (secondary):
Pregnancy and the puerperium
Use of oral contraceptives
Postsurgical state
Immobility
Congestive heart failure
Malignant diseases
thrombocytosis
an elevated platelet count above 450,000/µL.
common causes of inherited disorders of hypercoagulability
Factor V gene and prothrombin gene
What are acquired (or secondary) factors of hypercoagulability that lead to
venous stasis?
Prolonged bed rest and immobility, myocardial infarction, cancer, hyperestrogenic
states, oral contraceptives, smoking, and obesity
thrombocytopenia
