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Hematology 2 Lec > Chapter 1 > Flashcards

Chapter 1 Flashcards

1
Q
  • purplish red, pinpoint hemorrhagic spots in the skin caused by loss of capillary ability to withstand normal blood pressure and trauma.
A

Petechiae

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2
Q
  • produced by hemorrhage of blood into small areas of skin, mucous membranes, and other tissues.
A

Purpura

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3
Q

First appears red-purple the turns brownish yellow

A

Purpura

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4
Q
  • a form of purpura in which blood escapes into large areas of skin or mucous membranes, but not into deep tissue.
A

Ecchymosis

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5
Q

Appears Black/blue then turns greenish brown to yellow

A

Ecchymosis

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6
Q
  • nosebleed
A

Epistaxis

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7
Q
  • leakage of blood into a joint cavity
A

Hemarthrosis

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8
Q
  • vomiting of blood
A

Hematemesis

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9
Q
  • expectoration of blood secondary to hemorrhage in the larynx, trachea, bronchi or lungs
A

Hemoptysis

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10
Q
  • a swelling or tumor in the tissues or a body cavity that contains clotted blood
A

Hematoma

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11
Q
  • in vivo blood clot causing vascular occlusion and tissue ischemia
A

Thrombus

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12
Q
  • formation, presence of a clot in a blood vessel
A

Thrombosis

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13
Q
  • presence of intact red cells in the urine
A

Hematuria

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14
Q
  • presence of hemoglobin in the urine
A

Hemoglobinuria

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15
Q
  • passage of dark tarry stool containing decomposing blood.
A

Melena

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16
Q
  • excessive menstrual bleeding
A

Menorrhagia

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17
Q
  • passage of blood in feces
A

Hematochezia

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18
Q

Hemostasis- a complex mechanism that
1. retains the blood within the[?] during periods of injury
2. localizes the reaction involved to the [?] of injury
3. repairs and re-establishes [?] through the injured vessels

A

vascular system

site

blood flow

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19
Q

Three Hemostatic Components:

A

Extravascular components
Vascular components
Intravascular components

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20
Q

Play a part in hemostasis by providing back pressure on the injured vessel through swelling and entrapment of escaped blood

A

Extravascular components

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21
Q

Extravascular components Depends on the
• [?] of surrounding tissue
• [?] of tissue
• [?] of the surrounding tissue

A

bulk or amount

type

tone

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22
Q

Vascular components Depends on:
Size of the [?]
Amount of [?] within their wall
Integrity of the [?]

A

blood vessels

smooth muscle

endothelial cell lining

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23
Q

Platelets and biochemicals in the plasma

A

Intravascular components

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24
Q

STAGES OF HEMOSTASIS

A

Primary Hemostasis

Secondary Hemostasis

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25
Q

(compare the walls of the arteries from that of the veins and capillaries)

A
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26
Q

Primary Hemostasis Involves

A
  • Vasoconstriction
  • Platelet adhesion, release reaction & aggregation
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27
Q

• Activated by desquamation and small injuries to blood vessels

A

Primary Hemostasis

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28
Q

Procoagulant substances are exposed or released by damaged or activated endothelial cells

A

Primary Hemostasis

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29
Q

• Involves vascular intima and platelets

A

Primary Hemostasis

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30
Q
  • Rapid, short-lived response
A

Primary Hemostasis

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31
Q
  • Ends with platelet plug formation
A

Primary Hemostasis

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32
Q

Do platelets have role in secondary hemostasis?

A
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33
Q

Involves activation of a series of plasma proteins in the coagulation system until fibrin clot formation

A

Secondary Hemostasis

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34
Q

Activated by large injuries to blood vessels and surrounding tissues

A

Secondary Hemostasis

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35
Q

→ Tissue factor exposed on cell membranes

A

Secondary Hemostasis

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36
Q

Involves platelets and coagulation system

A

Secondary Hemostasis

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37
Q

Delayed, long-term response

A

Secondary Hemostasis

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38
Q

Naturally occurring inhibitors in blood will block activated coagulation factors so that widespread coagulation does not occur

A

Secondary Hemostasis

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39
Q

Fibrinolysis

A

Secondary Hemostasis

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40
Q

Slow breakdown & removal of fibrin clot as healing of the injured vessel occurs

A

Fibrinolysis

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41
Q

Inhibits platelet activation

A

Prostacyclin (PGI2)

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42
Q

Stimulates vasodilation

A

Prostacyclin (PGI2)

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43
Q

Anticoagulant

A

Prostacyclin (PGI2)

Heparan sulfate

Thrombomodulin (Endothelial protein C receptor)

Tissue factor pathway inhibitor (TFPI)

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44
Q

Fibronolytic

A

Thrombomodulin (Endothelial protein C receptor)
Tissue plasminogen activator (tPA)

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45
Q

Reduces blood flow rate’

A

Adenosine

46
Q

Procoagulant

A

von Willebrand factor (VWF) (Weibel-Palade bodies)

Adhesion molecules

47
Q

• Coats the endothelial cell surface and weakly enhances activity of antithrombin-Ill

A

Heparan sulfate

48
Q

• Endothelial surface receptor for thrombin (binds and inactivates thrombin)

A

Thrombomodulin (Endothelial protein C receptor)

49
Q

• Enhances anticoagulant and fibrinolytic action of protein C

A

Thrombomodulin (Endothelial protein C receptor)

50
Q

• Controls activation of the extrinsic pathway

A

Tissue factor pathway inhibitor (TFPI)

51
Q

• Converts plasminogen to plasmin

A

Tissue plasminogen activator (tPA)

52
Q

• Stimulates vasodilation

A

Adenosine

53
Q

• Required for platelet adhesion to site of vessel injury

A

von Willebrand factor (VWF)
(Weibel-Palade bodies)

54
Q

• P-selectin; Intercellular adhesion molecules (ICAMs)

A

Adhesion molecules

55
Q

• Platelet endothelial cell adhesion molecules (PECAMs)

A

Adhesion molecules

56
Q
  • help cells stick to each other and to their surroundings
A

• Platelet endothelial cell adhesion molecules (PECAMs)

57
Q

BLEEDING DISORDERS CAUSED BY VASCULAR DEFECTS

A
58
Q

Hereditary Connective Tissue Defects

A
59
Q

• Sex-linked

A
  1. Ehlers-Danlos Syndrome
60
Q

Caused by a defect in peptidase enzyme that converts procollagen to collagen

A
  1. Ehlers-Danlos Syndrome
61
Q

• Characterized by hyperextensive joints and hyperplastic skin

A
  1. Ehlers-Danlos Syndrome
62
Q

Laboratory findings: Normal Coagulation test and platelet function studies

A
  1. Ehlers-Danlos Syndrome
63
Q

• Autosomal recessive

A
  1. Pseudoxanthoma elasticum
64
Q

Characterized by calcified and structurally abnormal elastic fibers

A
  1. Pseudoxanthoma elasticum
65
Q

Acquired Connective Tissue Defects

A
66
Q

Importance of vitamin C: for the formation of the intact structure of the vascular basement membrane

A
  1. Vitamin C Deficiency (Scurvy)
67
Q

Characterized by gingival bleeding

A
  1. Vitamin C Deficiency (Scurvy)
68
Q

hemorrhage into subcutaneous tissues and muscles

A
  1. Vitamin C Deficiency (Scurvy)
69
Q

Large hemorrhagic areas may develop just below the eyes

A
  1. Vitamin C Deficiency (Scurvy)
70
Q

splinter-like hemorrhage may also appear in the fingernail beds

A
  1. Vitamin C Deficiency (Scurvy)
71
Q

• Laboratory findings: CFT= usually positive

A
  1. Vitamin C Deficiency (Scurvy)
72
Q

• Related with normal aging process

A
  1. Senile Purpura
73
Q

• Laboratory findings: CFT= positive

A
  1. Senile Purpura
74
Q

Bleeding time= normal or only slightly prolonged

A
  1. Senile Purpura
75
Q

Hereditary Alteration of Vessel Wall Structure

A
76
Q

Autosomal dominant trait characterized by thin-walled, focally disorganized and dilated blood vessels with a discontinuous endothelium appearing as red pinpoint lesions most commonly on the face, lips, tongue, mucous membranes of the mouth and nose, the ears, conjunctiva, palms and soles

A
  1. Hereditary Hemorrhagic Telangiectasia (Rendu-Osler-Weber Syndrome)
77
Q

Laboratory findings: Bleeding time, platelet function tests, Capillary Fragility test and coagulation tests are all normal

A
  1. Hereditary Hemorrhagic Telangiectasia (Rendu-Osler-Weber Syndrome)
78
Q

What are telangiectasias?

A
79
Q

Disorders associated with tumors composed of many vessels.

A
  1. Congenital Hemangiomata (Kasabach-Merritt Syndrome)
80
Q

Formation of fibrin clots, platelet consumption and red cell destruction secondary to vascular obstruction occur at the site of tumor

A
  1. Congenital Hemangiomata (Kasabach-Merritt Syndrome)
81
Q

Acquired Alterations of Vessel Wall Structure

A
82
Q

Deposition of glycosylated proteins leading to thickening of capillary basement membrane affecting often the capillaries of the renal glomeruli and retina

A
  1. Diabetes Mellitus
83
Q

Excessive amyloid deposit in small vessels

A
  1. Amyloidosis
84
Q

Endothelial Damage

A
85
Q
  1. Autoimmune Vascular Purpura
A
86
Q
  • Common drugs that induce purpura:
A

sulfonamides & iodides quinine, procaine, penicillin, aspirin, sedatives, coumarin

87
Q
  • May be due to development of antibodies to vessel wall components, development of immune complexes, and changes in vessel wall permeability.
A

a. Drug Induced Purpura

88
Q

b. Allergic purpura/Anaphylactoid purpura

A
89
Q
  • associated with certain foods and drugs, cold temperature, insect bites and vaccinations.
A

b. Allergic purpura/Anaphylactoid purpura

90
Q

Associated with bacterial; viral, Rickettsial and protozoal infections.

A
  1. Infectious Purpura
91
Q

= associated with abdominal pain secondary to GIT hemorrhaging

A

Henoch’s Purpura

92
Q

= associated with joint, especially in the knees, ankles and wrists

A

Schonlein’s Purpura

93
Q

• Diameter:

A

2 - 4 um

94
Q

• MPV (Mean Platelet Volume):

A

8 - 10 fL

95
Q

• Reference platelet count:

A

150,000 - 450,000/pL

96
Q

• Daily turnover:

A

35 X 10%/L (+/- 4.3)

97
Q

• Lifespan:

A

8 - 11 days

98
Q

• Function: maintenance of vascular integrity and blood coagulation

A
99
Q

Platelet Factors

A
100
Q

Plasma coagulation factor V

A

PF1

101
Q

A globulin that inhibits antithrombin III; increases platelet aggregation and accelerates interaction of thrombin and fibrinogen (fibrinoplastic platelet factor)

A

PF2

102
Q

A lipoprotein (phospholipid) found in platelet granules & membrane and required in 2 steps of the coagulation process

A

PF3

103
Q

A glycoprotein stored in the alpha granules and is extruded during the platelet release reaction

A

PF4

104
Q

Platelet fibrinogen

A

PF 5

105
Q

A plasma inhibitor associated with platelets

A

PF 6

106
Q

Cothromboplastin

A

PF7

107
Q

Antithromboplastin factor

A

PF 8

108
Q

Accelerator globulin stabilizing factor

A

PF9

109
Q

Serotonin found in the dense granules

A

PF 10

110
Q

aids in ADP-induced platelet aggregation and inhibits effect of heparin

A

P F 4

111
Q

HMWK

Promote coagulation
Fibrinogen
Alpha granules

Factor V

Von Willebrand factor

ADP
Dense bodies
Promote aggregation
Calcium

Platelet factor 4
Alpha granules

Thrombospondin

Promote
Serotonin
Dense bodies
vasoconstriction
Promote vascular
Thromboaxane Az
precursors
Membrane phospholipids
Alpha granules
Platelet-derived growth factor
repair
Beta- thromboglobulin

Plasminogen
Alpha granules
Other systems
affected
02 - antip/asmin

C1 esterase inhibitor

A

Hematology 2 Lec (29 decks)

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