AABHemOnline2.1.24 Flashcards
1,5,8-13 what group
fibrinogenFibrinogen 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 serum1,5,8-13
fibrinogen group
2,7-9,10 what grop
Prothrombin
Which grp is vit K dependent…What factors…
prothrombin2,7-9,10
HMWK, PK11,12 what groupAll 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 extrinsic1,2,5,10 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 intrinsic1,2,5,10 commoninhibitor
Test that tests amt of time it takes for fibrinogen to convert to fibrin
thrombin time
Thrombin reagent used in these two tests
TT, fibrinogen
TT ref
10-15 secSimilar to PT
increased TT due to
A/hypo/dys-fibrinogenemiaHeparinFDPsThrombolytic therapy
Test that tests fibrin clot formation by using Thrombin and plotting clot times w/1:10 std dilution
fibrinogen
In testing fibrinogen, concentration is…. …. to clotting timeref range
inversely proportional to clotting time, longer time means less fibrinogen200-400mg/dL
Increased fibrinogen in these 3
inflammationpregobirth CTRL
decreased fibrinogen in these 3
DICliver dysfuctionhypofibrinogemia
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 deffactor 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 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, DVTPulmonary embolismArterial 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…
PTT increasedPFA100/PLT agg abnormal
Condition thats recessive sexlinked; hemorragic;F8 def with normal PLT function
Hemophilia A
Hemophilia A:PTT..PLT func…
PTT increasedPLT 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 PTTOnly vWD has abnormal PLT function
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…
F13positive is clot dissolves
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 upBT, PT, APTT: decreased, coag factors used upFSP/Ddimer…pos
In Liver disease, all but…are decreased
all but F8
In vit K def, what factors are decreased
2,7,9,10 vit k dependent
What diff liver from vit k def
F8
Lupus anticoagulant seen in…ab against aPTT is…
SLEantiphospholipid ab
Lupus anticoag:PTT…rest are…mixing study…
PTT is increased but rest are normalmixing study isn’t corrected
Hemotopoetic order
HSC, MPP, Common, CFU
Where does hemotopoeisis begin
yolk sac
order of hemotopoiesis organs
yolk sac, liver, spleen, BM
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
Proerthyroblast
What cell comes after Pronormoblast/Proerthythroblast
Basophlic normoblast/erythroblast
Polychromotaphilic normoblast is also
Polychromotaphilic erythroblast
Orthochromatic normoblast also
Orthochromatic erthythoblast
Retic is also
Polychromatic ertythrocyte
RBC also
ertythrocyte
RBC:1.)Pro, 2.)Basophilic, 3.)Polychromatophilic 4.)Orthochromatic…./…..
normoblast/erythroblast
Last nucleated red cell, NRBC called these two
orthochromatic normoblast, erythroblast
RBC5.)Retic or6.)RBC or
5.)polychromatic erythrocyte6.)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.)Megakaryoblast2.)Promegakaryocyte3.)Megakaryocyte4.)PLT
…
Largest cell in BM, can make 1000 PLTs
Megakaryocyte
Diff between mono and promono
chromatin is finer/lacy in promono
Hmg:2…2…chains4……ring with…
2 alpha, 2 beta4 heme grpsprotoporphyrin 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,epsilonGower2:alpha, epsilonPortland:zeta,gamma
….
Hmg F chains
2 alpha2 gamma
Adult Hmg and %
A 97-98A2 2-3F 1
polypedtide chain that is only seen in embryonic
epsilon
polypeptide chain thats in both fetal and adult, curve will have sharp incline before birth and be dominant in adult
alpha (hmg A,F)