clin path 10

Question 1

hemostasis

Answer 1

stopping hemorrhages

Question 2

requirements for hemostasis

Answer 2

intact and healthy vessel walls
normal platelet numbers-low platelet number=thrombocytopenia
normal platelet function-abnormal platelet function=thrombopathia
normal amount and function of clotting factors

Question 3

platelets

Answer 3

granules with chemicals which initiate primary hemostasis-megakaryocyte-nucleus never divides
granules contain TOX2a and ADP-activate platelet
vWF-likes to grab a hold and can go wrong
fibrinogen-crossliking, can go wrong

Question 4

automated platelet count

Answer 4

hematology analyzer
pros-quick and easy
cons-platelet clumping and false decrease in reported platelet numbers

Question 5

estimated platelet count

Answer 5

stained blood smear
pro-cheap and small sample volume and subjective if platelet clumping
cons-platelet clumping and time and technical skill

Question 6

thrombopathy

Answer 6

platelet not working right
external cause
internal-hereditary or acquired

Question 7

causes of thrombopathy

Answer 7

extrinsic-von Willebrands disease- normal platelet count and prolonged buccal mucosal bleeding time
most common inherited bleeding disorder and necessary for platelet adhesion
intrinsic heredity-uncommon, various mechanisms, specialized testing, suspect in patients with bleeding for poor clot formation or retraction and normal platelet counts
intrinsic acquired-drugs, uremia, DIC

Question 8

intrinsic acquired

Answer 8

drugs-cyclooxygenase inhibitors, aspirin, NSAID and COX-2, beta-lactam antibiotics and calcium channel blockers
uremia-renal failure and impairs platelet adhesion
DIC-expressed FDP-competitively inhibit fibrinogen binding to platelet receptor, impairing aggregation

Question 9

thromboytopenia

Answer 9

S-sequestration-platelet entrapped in spleen
P-decreased production-usually severe decreased <50k/ul and selective and generalized marrow injury
U-utilization/consumption-usually moderate 50-120K/ul-disseminated intravascular coagulation
D-destruction-usually severe <50k/UL-idiopathic immune mediate process