BL- Platelet disorders Flashcards
4 events in the formation of a platelet plug
Platelet adhesion
Platelet activation
Platelet aggregation
Fibrin formation and support of local coagulation
Platelet Precursor
Megakaryocyte in bone marrow
How long do platelets circulate
Bud off, circulate 7-10 days
TPO: thrombopoietin
main growth and maturation factor for megakaryocytes
Platelet adhesion
Platelet activation
Platelet aggregation
Fibrin formation and support of local coagulation
4 events in the formation of a platelet plug
- inhibits coagulation
- prevents platelet aggregation
- promotes clot breakdown
- provides barrier to reactive elements in the vessel wall
Normal Endothelium:
main growth and maturation factor for megakaryocytes
TPO: thrombopoietin
Glycoproteins on _____ are receptors for adhesive proteins present in the vessel wall and in plasma
platelet surface
Who attracts platelets well?
Von Willebrand factor
*Temporary bond between GPIb (platelet) and vWF
Granules of Plts
Dense Granules
Lysosomes
Alpha granles
_______granules release serotonin ( vasoconstriction) , ADP platelet activation, calcium (further activation, adhesions and aggregation) of other platelets
Dense
_________stick to activated platelets and are themselves activated through release of compounds that further amplify platelet activation
New platelets
Platelets adhere to damaged vessel wall directly via collagen or indirectly via von Willebrand factor
Plt Adhesion
Excitatory agonists (collagen, thromboxane A2, etc.) cause a conformational change in platelet to expose Glycoprotein IIbIIIa binding sites for fibrinogen
Plt activation
Platelets are laced together through fibrinogen bridges
plt Aggregation
Locally, thrombin converts the fibrinogen to fibrin stabilizing
Fibrin formation
Thrombocytopenia
(decreased numbers of platelets)
Normal platelet count between
150,000-400,000/ul
may see spontaneous hemorrhage and increased risk of hemorrhage with trauma or surgery
Platelets 20–50,000
*Platelets <10,000-20,000: can see life-threatening spontaneous hemorrhage
- Decreased production of platelets
- Increased destruction of platelets
- Distribution disorders (Increased sequestration of platelets due to splenomegaly)
- Dilution (massive transfusion)
Causes of Thrombocytopenia
Low platelets in the setting of pancytopenia
~In the elderly think of Myelodysplastic syndrome (high MCV) and other hem malignancies (non-Hodgkin’s Lymphoma)
~Nutritional deficiencies (B12/Folate)
Very common cause of low platelets
Can be seen in bacterial and viral infections
Viral: HIV, hepatitis C
Infection- common cause of low platelets
Disease of children or young adults following viral infection
Sudden onset severe thrombocytopenia with petechiae and nosebleeds
Recovery in 2-6 weeks without treatment or after steroids
Acute ITP