1 Flashcards
HEMOSTASIS
1. if there’s a presence of injury, there will be formation of clot or _____ and then will be removed by the process of ______
2. cells involved ruing this (4)
3. systems/ processes involve (3)
4. stages of hemostasis
- reduction of blood vessel diameter to reduce blood flow
- formation of temporary platelet plug
- for the coagulation system
- removal of fibrin clot (different with platelet plug)
- thrombosis: fibrinolysis
- vascular intima, platelets, extravascular tissue factors, tissue factors
- hemorrhage, thrombosis, fibrinolysis
- stages of hemostasis
- vasoconstriction
- primary hemostasis
- secondary hemostasis
- fibrinolysis
- involvement with blood vessels (vascular intima) and platelets
- primary function
- response is _____
- for ____ injuries - involves the activation of series of plasma proteins in the coagulation
system until fibrin clot is formed
- primary function is for
- response is _____
- for _____ injuries
- subdivided into (3)
- Primary Hemostasis
- formation of platelet plug
- rapid but short lived
- small vessel injuries - Secondary Hemostasis
- coagulation cascade
- delayed and for longer response
- large vessel injuries
- intrinsic, extrinsic, common pathways
Key events of Primary Hemostasis
Endothelial Injury
1. ____ & ____ are exposed once there’s an injury
2. vWF binds to ____ to provide scaffold for platelet adhesion
3. this when _____ happens to limit the blood flow
Platelet Adhesion
1. platelets adhere to the exposed sub endothelial matrix via _______
2. These receptors are particularly _____ which binds to vWF
Endothelial Injury
1. sub endothelial collagen & von Willebrand factor
2. collagen
3. vasoconstriction
Platelet Adhesion
1. glycoprotein (Gp) receptors
2. Gp Ib/IX/V
Key events of Primary Hemostasis
Platelet Activation
1. aka
2. ____ & ___ granules release substances that will contribute to aggregation and activation of coagulation system
3. During this time, this will undergo ____ in order for the cell to conform
itself on the site of injury
Platelet Aggregation
1. activated platelets aggregate to form a _____
2. with the presence of _____ & ______
Platelet Activation
1. Platelet Release Rxn
2. Alpha & Dense granules
3. Heat change
Platelet Aggregation
1. temporary platelet plug
2. fibrinogen & Gp IIb-IIIa
Key events of Primary Hemostasis Additional
- now we have plug formation but not a ____ which is under secondary
- these cells act as barrier between procoagulants
that are present in inside of epithelial cell and to the platelets in the blood
- they also act as an _____ - At the basement of EC, there are ______
- FIBRIN CLOT
- ENDOTHELIAL CELLS
- ANTICOAGULANT - INTERNAL ELASTIC LAMINA
Substances released from Endothelial cells
1. controls the activation of extrinsic pathway during
secondary hemostasis
- hemostasic role
2. requires for platelet adhesion to site of vessel injury
- hemostatic role
- organelles in here that are free floating which stores this
3. these help in binding together the platelets and myocytes
- hemostatic role
- two adhesion molecules
- Tissue Factor Pathway Inhibitor
- anticoagulant - von Willebrand Factor
- procoagulant
- weibel-palace bodies - Adhesion molecules
- procoagulant
- P selectin & Intercellular adhesion molecules
Hereditary Connective Tissue Defects
- sex linked which is caused by defect in enzyme that converts procollagen to collagen
- what sex linked
- what enzyme
- 3 chracterized by
- lab findings ____ & ____ - This have the same s/s with the first one
- different as this extends to ____ & ____
- in here, enzyme is not defective but the ___ inside - sex linked where where calcified and structurally
abnormal elastic fibers
- what sex linked
- build up of ____
- common sign
- Ehlers-Danlos Syndrome
- autosomal dominant
- peptidase
- hyperextensive joints, hyperplastic skin, fragile tissues
- normal coagulation test and platelet function studies - Marfan Syndrome
- ocular and skeletal
- FBN1 gene - Pseudoxanthoma elasticum
- autosomal recessive
- calcium
- bleeding tendency
Acquired Connective Tissue Defects
- w/o VitC, there will be no intact structure of vascular
basement membrane
- aka
- characterized by ____
- lab findings - related with normal aging process
- discoloration of skin ____ (?)
- lab findings
- assess the tendencies of capillaries to rupture
- ability of capillaries under _____ & _____
- positive of this is related with
- presence of ____
- Vitamin C Deficiency
- Scurvy
- gingival bleeding
- CFT positive - Senile Purpura
- black discoloration
- CFT positive; bleeding time delayed
- Capillary Fragility Test
- increased hypoxia and hydrostatic pressure
- Nutritional defects
- Petechiae
Hereditary Alteration of Vesel Wall Structure
- characterized by thin-walled, fcally disorganized and dilated blood
vessel with discontinuous endothelium appearing as red pinpoint lesions
- sex linked
- aka
- dilated superficial vessels that creates small or focal red lesions most common on face
- lab findings are all normal but positive in _____ - associated with tumors composed of many large vessels
- aka
- _____, _____ & _____ secondary to vascular obstruction occur at the site of tumor
- Hereditary Hemorrhagic Telangiectasia
- autosomal dominant
- Rendu-Osler Weber Syndrome
- telangiectasia
- epistaxis - Hemangiomata
- Kasabach-Merritt Syndrome
- fibrin clots, platelet consumption, red cell destruction
Acquired Alterations of Vessel Wall Structure
1. deposition of glycosylated proteins leading to thickening of capillary basement membrane affecting often the capillaries
- these have longer for treatment when there’s bleeding due to ____ which can impair the platelet function by altering the receptor expression on the surface of platelet
2. excessive amyloid deposits in small vessels
- Diabetes Mellitus
- hyperglycemia - Amyloidosis
Endothelial Damage:
- What are the two Purpura under this
- two under the first one
- Common drugs that can
alter the or develop antibodies (3) - associated w/ certain food and drugs, cold temperature, insect bites and vaccinations
- aka
- associated w/ abdominal pain secondary to GIT hemorrhaging
- associated with joint, especially in the knees,
ankles and wrist
- combination of the two - associated with bacterial ; viral, rickettsial & protozoal infections or
substance it produces
- Autoimmune Vascular Purpura & Infectious Purpura:
- Drug Induced Purpura; Allergic Purpura
- penicillin, aspirin, sedatives
- Allergic Purpura
- Anaphylactoid Purpura
- Henoch’s Purpura:
- Schonlein’s Purpura
- Henochschonlein Purpura - Infectious Purpura
- purplish red, pinpoint hemorrhagic spots in the skin caused by loss of capillary ability to
withstand normal blood pressure and trauma
- diameter - produced by hemorrhage of blood into small areas of skin, mucous membranes, and other tissues
- diameter - form of purpura in which blood escapes into large areas of skin or mucous membranes,but not into deep tissue
- diameter - passage of blood in feces
- pain and swelling as the primary symptoms, but without visible discoloration or external signs of bleeding; leakage of blood into joint cavity
- Petechiae
- <3mm - Purpura
- 3mm to 1cm - Ecchymosis
- >1cm - Hematochezia
- Hemarthrosis
