Blood and Hemostasis Flashcards
role of factor 5
cofactor for 10—>2
role of factor 9
9a activates 10
low iron, high transferrin, low ferritin, low rtcs
iron deficiency
anemia compensation for rtc
rtc * hgb(patient) / hgb(control). if cells are nucleated this is worse (even less mature) so divide corrected rtc by 2.
most common cause of b12 deficiency
pernicious anemia = autoimmune destruction of parietal cells
why is clotting present in hemolytic anemia
1) stop the bleed; 2) high free hemoglobin
role of factor 2
2a activates conversion of fibrinogen to fibrin, which actively forms clots
factor 8 deficiency
hemophilia A
DIC
disseminated intravascular coagulation, too much coagulation, uses up the platelets, causes clot AND bleeding
low iron, low transferrin, high ferritin
chronic disease (sequestration by macrophages); total iron levels are normal so body doesn’t think to take in more (via transferrin), but being extensively stored in macrophages so high ferritin
factor 9 deficiency
hemophilia B
high aPPT
activated partial prothrombin time, bleeding, factor 8, 9, 11, 12 problems, heparin
peripheral smear most important for which anemias
hemolytic (includes sickle cell, fragmented d/t turbulence or valvulopathies, etc)
Thalassemia alpha vs beta (hgbH precipitates vs no) + target cells
normal to high iron, normal to high transferrin, normal to high ferritin
thalassemia (poor hgb synthesis); may try to correct for bad hemoglobin with more iron (ineffectively), but this isn’t the problem so end up storing it
high PT and aPPT
factor 2, 5, 10 problems, vitamin k antagonists, heparin, liver disease, DIC, fibrinogen deficiency …
low iron, high transferrin, low ferritin, high rtcs
hemolytic anemia
role of protein c
APC inhibits 8 and 5, acting as an anticoagulant
expected lab results in hemolytic anemia aside from standard blood ones
high bilirubin (degradation product), high haptoglobin (salvage protein), high co2, high free hemoglobin (leads to clotting)
mcv in b12 and b9 deficiency?
high, can’t mature
role of protein s
cofactor for APC, anticoagulant
is alpha or beta thalassemia worse
alpha; it is present in fetal hemoglobin in addition to adult; often fatal in utero (now have in utero blood transfusions so less so)
b12 or b9 deficiency more common
b9
abnormal thrombocyte level
<150,000
clinical relevance (bleeding) kicks in well below that usually
most common cause of b9 deficiency
pregnancy
