Guided Lecture Notes
Chapter 10: Alterations in Hemostasis
Learning Objective 1. State the five stages of hemostasis.

Define hemostasis, thrombocyte, megakaryocyte, and thrombopoietin (refer to
PowerPoint Slides 2–3).

Identify the five stages of hemostasis, and explain the importance of each stage
(refer to the Understanding Hemostasis display).
Learning Objective 2. Describe the formation of the platelet plug.

Define the role of the platelet plug in the process of hemostasis.

Describe the importance of von Willebrand factor in the formation of the platelet
plug.

Identify the purpose of ADP and TXA2.
Learning Objective 3. State the purpose of coagulation.

Define the role of coagulation in the process of hemostasis.

Describe the two coagulation pathways (refer to PowerPoint Slide 12 and Fig.
10-2).

Explain the importance of factor X, prothrombin, and fibrinogen to the
coagulation process (refer to Fig. 10-2).
Learning Objective 4. State the function of clot retraction.

Define the role of clot retraction in the process of hemostasis (refer to
PowerPoint Slide 13).

Describe the roles of actin and myosin in clot retraction.
Learning Objective 5. Trace the process of fibrinolysis.

Define the role of clot dissolution/lysis in the process of hemostasis.

Explain the importance of plasmin and tissue plasminogen activator to
fibrinolysis.
Learning Objective 6. Compare normal and abnormal clotting.

Define hypercoagulability (refer to PowerPoint Slide 15).

Identify conditions associated with hypercoagulability states (refer to Chart 101).
Learning Objective 7. State the causes and effects of increased platelet function.

List the conditions associated with increased platelet function.

Describe the result of increased platelet function.

Define thrombocytosis.

Explain how atherosclerosis promotes platelet adherence.
Learning Objective 8. State two conditions that contribute to increased clotting activity.

Identify hereditary clotting disorders.

Identify acquired clotting disorders.
Learning Objective 9. Describe the manifestations of thrombocytopenia.

Define thrombocytopenia, and identify diagnostic platelet levels.

Identify the causes of and clinical manifestations associated with
thrombocytopenia.

Discuss treatment for thrombocytopenia.
Learning Objective 10. State the mechanisms of drug-induced thrombocytopenia and
idiopathic thrombocytopenia and the differing features in terms of onset and resolution of
the disorders (refer to PowerPoint Slide 19).

Identify drugs that may cause thrombocytopenia, and explain how platelets are
destroyed.

Tell how long it takes for platelet levels to drop.

Explain how drug-induced thrombocytopenia is treated.

Identify possible causes of idiopathic thrombocytopenia.

Discuss treatments for idiopathic thrombocytopenia.
Learning Objective 11. Describe the role of vitamin K in coagulation.

Explain the importance of vitamin K to the clotting process.

Discuss the effects of increased and decreased levels of vitamin K.

Identify sources of vitamin K.
Learning Objective 12. Differentiate between the mechanisms of bleeding in
hemophilia A and von Willebrand disease.

Describe the types of genetic defects that lead to hemophilia A and von
Willebrand disease.

Identify the clotting factors that are affected in hemophilia A and von Willebrand
disease.

Explain where bleeding typically occurs in hemophilia A and von Willebrand
disease, and discuss treatments for each disorder.
Learning Objective 13. Describe the physiologic basis of acute disseminated
intravascular coagulation.

Describe the paradox in hemostatic sequence that results in DIC.

Identify conditions that are associated with DIC (refer to Chart 10-2).

Describe the pathophysiology of DIC (refer to Fig. 10-4).

Discuss the treatment of DIC.
Learning Objective 14. Describe the effect of vascular disorders on hemostasis.

Identify the source of bleeding in vascular disorders.

List several causes of vascular disorders.

Describe signs and symptoms of vascular disorders.