AAB Hem/Coag online Flashcards
1,5,8-13 what group
fibrinogen
Fibrinogen group – factors 1, 5, 8, and 13. This group is called the fibrinogen group because thrombin activates all of these factors including fibrinogen. Maybe it should have been called the thrombin
Group not vit k dep, consumed in coagulation, not in serum
1,5,8-13
fibrinogen group
2,7-9,10 what grop
Prothrombin
Which grp is vit K dependent…
What factors…
prothrombin
2,7-9,10
HMWK, PK
11,12 what group
All of these factors are involved in the initial phase of the intrinsic system activation.
contact group
Group that is not vit K dep, activates instrinsic pathway, includes HMWK, 11,12
contact group
Intrinsic and common tested with what test
APTT
factors in intrisic pathway
8,9-11,12
Factors in extrinsic pathyway
7, 3(TF)
Extrinsic and common pathway tested with
PT/INR
factors in common pathway
1,2,5,10
factor not part of coag pathways and doesn’t affect testing
13
what does PT/PTT test for
crosslinked fibrin clot
I
fibrinogen
II
Prothrombin
III
Tissue thromboplastin, TF
IV
calcium
V
labile
VII
stable
VIII
antihemophiliac A
IX
antihemophiliac B
XI
anti hemophiliac C
X
Stuart Prower
XII
Hageman
XIII
fibrin stabilizing
inactive form of plasmin
plasminogen
fibrinolysis is breakdown of fibrin by act of
plasmin
insoluble fibrin breaks down to
D-dimer
soluble fibrin breaks down to
FDPs
Thromboplastin (TF, Ca) used in
PT
ISI is used to calculate the INR for the…
PT
Test that monitors wafarin/coumadin
PT
Two methods for PT, PTT, TT
optical and electromechanical
PT ref range
10-13sec
Increased PT associated with factors…
7 extrinsic
1,2,5,10 common
Activated partial thromboplastin reagent in aPTT is a
phospholipid
Two reagents in aPTT
activated partial thromboplastin/phospholipid and CaCL
PTT range
30-36sec
Increased aPTT associated with factors…and also this….
8,9,11,12 intrinsic
1,2,5,10 common
inhibitor
Test that tests amt of time it takes for fibrinogen to convert to fibrin
thrombin time
thrombin helps convert
Thrombin reagent used in these two tests
TT, fibrinogen
TT ref
10-15 sec
Similar to PT
increased TT due to
A/hypo/dys-fibrinogenemia
Heparin
Uses up fibrinogen…
-FDPs
-Thrombolytic therapy
Test that tests fibrin clot formation by using Thrombin and plotting clot times w/1:10 std dilution
Plasma diluted 1:10, thrombin added, clot time noted, calibration curve gives concentration with mean value
fibrinogen
In testing fibrinogen, concentration is…. …. to clotting time
ref range
inversely proportional to clotting time, longer time means less fibrinogen
200-400mg/dL
Increased fibrinogen in these 4
inflammation/tissue death
heart attack
prego
birth CTRL
decreased fibrinogen in these 4
-DIC (excess plasmin breaks down fibrinogen)
-thrombolytic therapy/ -fibrinolysis(same as DIC)
liver dysfuction
hypofibrinogemia
Test that differentiates factor def from lupus inhibitor using 1:2 dilution of PT plasmsa to normal pooled plasma running PT/APTT
mixing study
If PT/PTT is correct in a mixing study, this indicates a…follow up with a … …
factor def
factor assay
If PT/PTT is not corrected with mixing study,
indicated an….
inhibitor
Factor assay normal range
50-100% activity
Test where you do PT,APTT and get std curve from dilutions; times are converted to % activity
factor assay
Factory assay graphs should be…
linear
Nonlinear in a factor assay indicates
inhibitor
Test which uses monoclonal ab to detect fragments
D dimer
D dimer ref
<=0.50mg/mL
Increased Ddimer in these 4
DIC, DVT
Pulmonary embolism
Arterial thromboembolism
Test that tests for soluble fibrinogen, FDP with latex agglutination
FDP/FSP/fibrin monomer
Most common coagulation disorder,
autosomal dominant disease
vWD
vWD lacks
F8:vWD
vWD:
PTT…
PFA100/PLT agg…
PLT CT…
PTT increased
PFA100/PLT agg abnormal
PLT ct normal
Condition thats recessive sexlinked; hemorragic;
F8 def with normal PLT function
Hemophilia A
Hemophilia A:
PTT..
PLT func…
PTT increased
-because factor 8 is in intrinsic
PLT func normal
What do vWD and Hemophilia A have in common…
How do you diff between vWD and Hemophilia A:
Both have F8 def and have increased PTT, intrinsic
Only vWD has abnormal PLT function(adhesion)
Hem A only has factor def, PLTs ct/fnc ok
Recessive, sexlinked F9 def
Hemophilia B
autosomal recessive F11 def
Hemophilia C
Def that is part of common pathway where both PT and PTT is increased
fibrinogen def
Term when fibrinogen levels are below analytical range
A-fibrinogenemia
Term where fibrinogen is <200
Hypo-fibrinogenemia
Term where amt of fibrinogen is normal but PT/PTT are increased
Dys-fibrinogenemia
Factor def where all tests will be normal because it’s not part of coag pathway
F13 def
5M urea solubility test uses urea to dissolve clot, which def is tested using this…
positive…
F13
positive is clot dissolves because no F13
Def thats part of intrinsic, theres no history of bleeding and only the PTT is abnormal
F12 def
Disorde where theres formation of microthrombi followed by systemic fibrinolysis
Disseminated Intravascular
coagulation
DIC:
PLT ct, fibrinogen..
BT, PT, APTT..
FSP/Ddimer…
PLT ct, fibrinogen: decreased, all used up
BT, PT, APTT: decreased, coag factors used up
FSP/Ddimer…pos
In Liver disease, all but…are decreased
all but F8
Liver disease is associated with markedly elevated plasma factor VIII (FVIII) levels, whereas the synthesis of many other coagulation factors and proteins is reduced.
Factor VIII is produced by endothelial cells and tends to be upregulated in cirrhosis, augmenting coagulation
In vit K def, what factors are decreased
2,7,9,10 vit k dependent
What diff liver from vit k def
F8 is increased in liver disease,
Lupus anticoagulant seen in…
ab against aPTT is…
SLE
antiphospholipid ab
aPTT reagent is a phospholipid
Lupus anticoag:
PTT…
rest are…
mixing study…
PTT is increased but rest are normal because PTT has phospholipid which lupus anticoag is an ab against
mixing study isn’t corrected
Hemotopoetic order
HSC, MPP, Common, CFU
Where does hemotopoeisis begin
yolk sac
order of hemotopoiesis organs
-yolk sac(fetus only)
-liver, spleen
-(BM adult only)
Medullary/BM/red marrow production of cells in adults in …bones of … and …
flat bones of illiac crest and sternum
extramedullary production of cells in adult are… and ….
liver and spleen
Pronormoblast is called these two
Proerthyroblast, rubriblast
What cell comes after Pronormoblast/Proerthythroblast.. Two names
Basophlic
normoblast/erythroblast
Prorubricyte
Polychromotaphilic normoblast is also these two
Polychromotaphilic erythroblast
Rubricyte
Orthochromatic normoblast also these two
Orthochromatic erthythoblast
Metarubricyte
Retic is also
Polychromatic ertythrocyte
RBC also
ertythrocyte
RBC:
1.)Pro,
2.)Basophilic (blue, young)
3.)Polychromatophilic(blue, red)
4.)Orthochromatic(red)
…./…..
normoblast/erythroblast
Last nucleated red cell, NRBC called these two
orthochromatic normoblast, erythroblast
Metarubricyte
RBC
5.)Retic or
6.)RBC or
5.)polychromatic erythrocyte
6.)erythrocyte
Retic called
polychromatic erythrocyte
Myeloid cell with red, azurphilic primary granules
Promyeloctye
Myeloid with 50% nucleus and specific granules
myelocyte
Lymphoid cell that one large prominent nucleoli
prolymphocyte
1.)Megakaryoblast
2.)Promegakaryocyte
3.)Megakaryocyte
4.)PLT
…
Largest cell in BM, can make 1000 PLTs
Megakaryocyte
Diff between mono and promono
chromatin is finer/lacy in promono, nucleus more round,oval in pro
Hmg A:
2…2…chains
4…
…ring with…
2 alpha, 2 beta
4 heme grps
protoporphyrin ring w/iron
3 embroyonic hmg
Gower 1,2,Portland
2 zeta, 2 epsilon
gower 1
2 zeta, 2 gamma
Portland
2 alpha, 2 epsilon
Gower 2
Gower 1: zeta,epsilon
Gower2:alpha, epsilon
Portland:zeta,gamma
….
Hmg F chains
2 alpha
2 gamma
Adult Hmg and %
A 97-98
A2 2-3
F 1
2 polypedtide chains that is only seen in embryonic
epsilon, zeta
polypeptide chain thats in both fetal and adult, curve will have sharp incline before birth and be dominant in adult
alpha (hmg A,F)
chain with curve thats the lowest and in adults
delta
Type of EDTA used in hematoloby
Di-potassium
anticoag in Coagulation, ratio
3.2% citrated plasma
1:9
