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MT6325 > 2S [LEC]: Platelets > Flashcards

2S [LEC]: Platelets Flashcards

1
Q

Normal size of platelets

A

2-4 um in diameter

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2
Q

T/F: Platelets are nucleated cells that are fragments of megakaryocytes

A

False (platelets are anuclear)

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3
Q

Largest cells found in the bone marrow

A

Megakaryocytes

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4
Q

Maturation sequence of megakaryoblast to platelets takes how many days?

A

5 days

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5
Q

The life span of platelets

A

8-11 days (ave. 9 days)

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6
Q

How long is a platelet concentrate viable?

A

5 days at room temp with constant agitation

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7
Q

What cell characteristic mostly differentiates the maturation of the megakaryocytic cell series?

A

Cytoplasmic appearance

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8
Q

Hormone that gives rise to megakaryocytes

A

Thrombopoietin

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9
Q

Where is the thrombopoietin primarily produced?

A

Liver

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10
Q

What maturation stage of the megakaryocytic cell has 2-6 nucleoli with homogenous chromatin?

A

Megakaryoblast (MK-I)

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11
Q

What maturation stage of the megakaryocytic cell has an N:C ratio of 3:1?

A

Megakaryoblast (MK-I)

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12
Q

What maturation stage of the megakaryocytic cell has basophilic cytoplasm with no granules?

A

Megakaryoblast (MK-I)

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13
Q

What maturation stage of the megakaryocytic cell is irregularly shaped with cytoplasmic tags?

A

Megakaryoblast (MK-I)

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14
Q

Earliest thrombocyte stage where endomitosis occurs

A

Megakaryoblast (MK-I)

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15
Q

Process known as the division of nucleus without cytoplasmic division

A

Endomitosis

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16
Q

Invagination of the plasma membrane that becomes the future site of platelet fragmentation

A

Demarcation Membrane System (DMS)

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17
Q

The presence of DMS is seen at what megakaryocytic stage?

i. Megakaryoblast (MK-I)
ii. Promegakaryocyte (MK-II)
iii. Megakaryocyte (MK-III)

A

i, ii, iii

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18
Q

What maturation stage of the megakaryocytic cell has an N:C ratio of 1:2?

A

Promegakaryocyte (MK-II)

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19
Q

What maturation stage of the megakaryocytic cell has an indented or lobulated nucleus, containing variable number of nucleoli with moderately condensed chromatin?

A

Promegakaryocyte (MK-II)

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20
Q

What maturation stage of the megakaryocytic cell has a basophilic cytoplasm with granules beginning to appear?

A

Promegakaryocyte (MK-II)

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21
Q

What maturation stage of the megakaryocytic cell does endomitosis ends?

A

Promegakaryocyte (MK-II)

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22
Q

What maturation stage of the megakaryocytic cell has an N:C ratio of 1:4?

A

Megakaryocyte (MK-III)

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23
Q

What maturation stage of the megakaryocytic cell is the largest cell in the bone marrow?

A

Megakaryocyte (MK-III)

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24
Q

What maturation stage of the megakaryocytic cell contains a multilobed nucleus with deeply and variably condensed chromatin with no nucleoli visible

A

Megakaryocyte (MK-III)

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25
Q

What maturation stage of the megakaryocytic cell has an azurophilic cytoplasm that has many granules that stain purple with Wright’s stain?

A

Megakaryocyte (MK-III)

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26
Q

What maturation stage of the megakaryocytic cell is capable of shedding?

A

Megakaryocyte

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27
Q

How many platelets are formed per megakaryocyte?

A

2 000 to 4 000

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28
Q

Mitosis is seen at what megakaryocytic stage?

i. Megakaryoblast (MK-I)
ii. Promegakaryocyte (MK-II)
iii. Megakaryocyte (MK-III)

A

none

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29
Q

The presence of a-granules is seen at what megakaryocytic stage?

i. Megakaryoblast (MK-I)
ii. Promegakaryocyte (MK-II)
iii. Megakaryocyte (MK-III)

A

i, ii, iii

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30
Q

The presence of dense granules is seen at what megakaryocytic stage?

i. Megakaryoblast (MK-I)
ii. Promegakaryocyte (MK-II)
iii. Megakaryocyte (MK-III)

A

i, ii, iii

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31
Q

Endomitosis occurs at what megakaryocytic stage?

i. Megakaryoblast (MK-I)
ii. Promegakaryocyte (MK-II)
iii. Megakaryocyte (MK-III)

A

i, ii

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32
Q

Which of the following is not a normal maturation stage for platelets?

i. Megakaryoblast
ii. Promegakaryocyte
iii. Micromegakaryocyte
iv. Megakaryocyte
v. Metamegakaryocyte

A

iii

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33
Q

How much platelet is sequestered in the spleen?

A

1/3

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34
Q

Effect of splenomegaly in platelet count

A

Decrease

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35
Q

Effect of splenectomy in platelet count

A

Increase

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36
Q

Indicate premature release of platelet from the bone marrow and result from increased demand

A

Giant platelets

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37
Q

Which of the following would not exhibit giant platelets?

i. Bernard Soulier Syndrome
ii. Gray Platelet Syndrome
iii. May-Hegglin Anomaly
iv. All will exhibit giant platelet

A

iv

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38
Q

Common CD markers for megakaryocytes

A

CD41, CD61

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39
Q

Size of the cell recognized by automation to be platelets

A

2-20 fL

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40
Q

Normal MPV range

A

6.8-10.2 fL

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41
Q

Microscope that is most optimal in platelet counting

A

Phase-contrast microscope

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42
Q

Reference value of platelet

A

150 000 - 400 000/uL (cumm)

150 - 400 x 10^9 / L

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43
Q

Normal platelet estimate per oil immersion field is ___

A

8-20

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44
Q

Factor for platelet estimate is ___

A

20 000

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45
Q

The use of Rees-Ecker diluting fluid in platelet count must be completed within how many minutes?

A

30 mins

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46
Q

A platelet diluting fluid that remains stable for 8 hours

A

1% ammonium oxalate

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47
Q

Excess of this anticoagulant often leads to platelet fragmentation and satellitosis

A

EDTA

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48
Q

Uncontrolled malignant proliferation of platelets

A

Primary Thrombocytosis

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49
Q

What is the approximate platelet count in patients with primary thrombocytosis?

A

> 1000 x 10^9/ L

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50
Q

T/F: Thrombocytosis is associated with either hemorrhagic or thrombotic complications

A

True

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51
Q

T/F: In essential thrombocytopenia, there is an excess of functional platelets

A

False (non-functioning PLT)

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52
Q

Increased platelet production in response to thrombopoietin

A

Secondary thrombocytosis

53
Q

What is the approximate platelet count in patients with secondary thrombocytosis?

A

< 1000 x 10^9 / L

54
Q

Thrombocytosis is a characteristic of:

i. DIC
ii. Splenomegaly
iii. Polycythemia vera
iv. Idiopathic thrombocytopenia purpura

55
Q

Identify whether the condition would cause thrombocytopenia or thrombocytosis:

Inflammatory disease

A

Thrombocytosis

56
Q

Identify whether the condition would cause thrombocytopenia or thrombocytosis:

Blood regeneration, especially in hemolytic anemia and acute blood loss

A

Thrombocytosis

57
Q

Identify whether the condition would cause thrombocytopenia or thrombocytosis:

Post-operative state from tissue damage

A

Thrombocytosis

58
Q

Identify whether the condition would cause thrombocytopenia or thrombocytosis:

Splenectomy

A

Thrombocytosis

59
Q

Identify whether the condition would cause thrombocytopenia or thrombocytosis:

Chemotherapy

A

Thrombocytopenia

60
Q

Identify whether the condition would cause thrombocytopenia or thrombocytosis:

Marrow replacement by malignant cells

A

Thrombocytopenia

61
Q

Identify whether the condition would cause thrombocytopenia or thrombocytosis:

Aplastic anemia

A

Thrombocytopenia

62
Q

Identify whether the condition would cause thrombocytopenia or thrombocytosis:

Megaloblastic anemia

A

Thrombocytopenia

63
Q

Identify whether the condition would cause thrombocytopenia or thrombocytosis:

Severe hemorrhage and massive transfusion

A

Thrombocytopenia

64
Q

A condition characterized by microthrombi formation due to fragmentation of RBC, causing thrombocytopenia

A

Microangiopathic Hemolytic Anemia (MAHA)

65
Q

A condition characterized by fibrin degradation product causing systemic clotting followed by fibrinolysis, causing thrombocytopenia

A

Disseminated Intravascular Coagulation (DIC)

66
Q

A condition characterized as an accumulation of large vWF, causing hemolytic anemia with schistocytes and thrombocytopenia

A

TTP (Thrombotic thrombocytopenia purpura)

67
Q

In splenomegaly/ hypersplenism, the result of platelet sequestration can be as high as ___

68
Q

When platelet adheres to neutrophils due to EDTA exposure, this is called ___

A

Platelet satellitosis

69
Q

Effect of platelet satellitosis on platelet count

A

Falsely decreased

70
Q

To correct platelet satellitosis, which anticoagulant and factor for dilution is used?

A

Sodium citrate
x 1.1

71
Q

Which of the following is not a cause of thrombocytopenia?

i. Splenomegaly
ii. Chemotherapy
iii. Increased thrombopoietin
iv. Aplastic anemia

72
Q

The exterior coat and contain glycoprotein receptor sites

A

Glycocalyx

73
Q

The receptor for vWF

74
Q

The cofactor for VWF

A

Ristocetin

75
Q

The receptor for fibrinogen

A

GPIIb/IIIa

76
Q

Identify the anatomic area:

Responsible for platelet adhesion and aggregation

A

Peripheral zone

77
Q

The submembrane area of the peripheral zone contains the ___, which serves as a surface for interaction of coagulation factors in secondary hemostasis during aggregation

A

Phospholipid membrane (PF3)

78
Q

Identify the anatomic area:

Contains cytoskeleton microtubules and microfilaments

A

Sol-gel (structural) zone

79
Q

Contracts the thrombus at the end of the coagulation process

A

Actomyosin/ thrombosthenin

80
Q

Responsible for clot retration

A

Thrombosthenin

81
Q

Identify the anatomic area:

Contains the granules, lysosomes, mitochondria, peroxisomes, and glycogen

A

Organelle zone

82
Q

Part of the membrane system that regulates the intracellular calcium concentration

A

Dense Tubular System (DTS)

83
Q

Part of the membrane system the releases granular contents through channels leading to the surface of the platelet

A

Open Canalicular System (OCS)

84
Q

Which of the following promote aggregation:

i. Ca2+
ii. Serotonin
iii. Thromboxane A2
iv. ADP
v. PDGF
vi. Beta-thromboglobulin

85
Q

Which of the following promote vasoconstriction:

i. Ca2+
ii. Serotonin
iii. Thromboxane A2
iv. ADP
v. PDGF
vi. Beta-thromboglobulin

86
Q

Which of the following promote vascular repair:

i. Ca2+
ii. Serotonin
iii. Thromboxane A2
iv. ADP
v. PDGF
vi. Beta-thromboglobulin

87
Q

Process where platelet adhere to vascular surfaces

88
Q

A plasma protein that binds platelets to exposed subendothelial collagen

A

von Willebrand factor

89
Q

A qualitative platelet defect where GPIb/IX/V receptor is absent

A

Bernard Soulier Syndrome

90
Q

Most common hereditary hemorrhagic disorder

A

von Willebrand disease

91
Q

A qualitative platelet defect where the vWF is missing or defective

A

Von Willebrand Disease

92
Q

T/F: In von Willebrand disease, both the primary and secondary hemostasis are affected

93
Q

vWF is a carrier protein to which coagulation factor?

A

Coagulation factor VIII

94
Q

Which of the following is not true with von Willebrand disease?

i. Prolonged bleeding time
ii. Decreased aggregation with ADP, Epinephrine/Adrenaline, Collagen
iii. Prolonged clotting time, APTT
iv. Normal PT
v. Normal platelet count

95
Q

Which of the following is not true with Bernard-Soulier Syndrome?

i. Prolonged bleeding time
ii. Decreased aggregation with ADP, Epinephrine/Adrenaline, Collagen
iii. Prolonged clotting time, APTT
iv. Normal PT
v. High MPV

96
Q

The reference for mean platelet volume (MPV) is approximately

i. 2-4 fL
ii. 5-7 fL
iii. 8-10 fL
iv. 11-14 fL

97
Q

Which of the following are dense granules:

i. Fibrinogen
ii. vWF
iii. ADP
iv. ATP
v. PDGF

98
Q

Which of the following are alpha granules:

i. Beta-thromboglobulin
ii. vWF
iii. Calcium
iv. Serotonin
v. PDGF

99
Q

Qualitative defect of the storage pool that is characterized as large platelets and thrombocytopenia due to absence of alpha granules

A

Gray-platelet syndrome

100
Q

Qualitative defect of the storage pool where patients are prone to lifelong mild bleeding tendencies

A

Gray-platelet syndrome

101
Q

Qualitative defect of the storage pool where there is a lack of dense body granules

A

Hermansky-Pudlak Syndrome

102
Q

Qualitative defect of the storage pool where patient exhibit oculocutaneous albinism and are prone to hemorrhage

A

Hermansky-Pudlak Syndrome

103
Q

Qualitative defect of the storage pool where there is a decreased amount of alpha granules and dense bodies

A

Wiskott-Aldrich Syndrome

104
Q

Qualitative defect of the storage pool where patients are prone to hemorrhage and recurrent infections

A

Wiskott-Aldrich Syndrome

105
Q

Triad of Wiskott-Aldrich syndrome includes:

i. Thrombocytosis
ii. Immunodeficiency
iii. Eczema
iv. Thrombocytopenia

A

ii, iii, iv

106
Q

The process of platelet attaching to each other forming platelet plug

A

Aggregation

107
Q

Which of the following are platelet release agonist:

i. Thromboxane A2
ii. ADP
iii. PF4
iv. Serotonin
v. Ca2+
vi. PF3

A

ii, iii, iv, v

108
Q

Which enzyme converts arachidonic acid into thromboxane A2?

A

Cyclooxygenase enzyme

109
Q

Causes Ca2+ to be released from the dense tubules, promoting platelet aggregation and vasoconstriction

A

Thromboxane A2

110
Q

Drug commonly used for its antiplatelet effect

A

Aspirin/ Salicylate/ Acetylsalycilic acid

111
Q

The mechanism of action of aspirin and NSAIDs is that it blocks ___

A

Cyclooxygenase enzyme

112
Q

T/F: Aspirin affects both primary and secondary hemostasis

A

False (primary only)

113
Q

Medicine that blocks the IIb/IIIa platelet receptor, preventing platelet aggregation

A

Plavix/ Clopidogrel bisulfate

114
Q

An aggregation defect caused by lack of GP IIb/IIIa receptor

A

Glanzmann thrombasthenia

115
Q

An aggregation defect caused by the absence of fibrinogen

A

Afibrinogenemia

116
Q

An aggregation defect where clot retraction is abnormal due to lack of contractile proteins

A

Glanzmann thrombasthenia

117
Q

Which of the following are true with Glanzmann thrombasthenia?

i. Prolonged bleeding time
ii. Decreased aggregation with ADP, Epinephrine/Adrenaline, Collagen
iii. Prolonged clotting time
iv. Normal PT and PT
v. Decreased aggregation with ristocetin

118
Q

Which of the following are true with Fibrinogen Deficiency?

i. Prolonged bleeding time
ii. Decreased aggregation with ADP, Epinephrine/Adrenaline, Collagen
iii. Prolonged clotting time
iv. Normal PT and PT
v. Decreased aggregation with ristocetin

A

i, ii, iii

119
Q

In storage pool disease, platelets are primarily deficient in:

i. ADP
ii. PF3
iii. Thrombosthenin
iv. Thromboxane A2

120
Q

In vitro test to determine the ability of platelets to aggregate with certain agonist

A

Platelet aggregation test

121
Q

Anticoagulant of choice in platelet aggregation test

A

Sodium citrate

122
Q

Platelets interacting with and binding to other platelets is referred to as:

i. Adhesion
ii. Aggregation
iii. Release
iv. Retraction

123
Q

Of the following therapeutic agents, those considered to be antiplatelet medications are:

i. Aspirin and Plavix
ii. Coumadin and heparin
iii. Heparin and protamine sulfate
iv. Tissue plasminogen activator and streptokinase

124
Q

A potent inhibitor of platelet aggregation released by endothelial cells is:

i. Epinephrine
ii. Postacyclin
iii. Ristocetin
iv. Thromboxane A2

125
Q

A clot retraction defect is more likely due to:

i. Lack of platelet receptor glycoprotein Ib
ii. Lack of platelet receptor glycoprotein IIb/IIIa
iii. Insufficient ADP in dense bodies
iv. Absence of von Willebrand factor

126
Q

In platelet aggregation studies, certain aggregating agents induce a biphasic aggregation curve. This second phase of aggregation is directly related to:

i. Formation of fibrin
ii. Changes in platelet shape
iii. Release of endogenous ADP
iv. Release of PF3

127
Q

Reference range for bleeding time

128
Q

Reference range for ivy method

129
Q

Reference range for template bleeding time

MT6325 (14 decks)

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