CVR: Haematology Flashcards
When blood is put in a centrifuge, the buffy coat is the very small layer in between the haematocrit and the plasma.
What components of blood would you find in the buffy coat?
Platelets and leucocytes.
Oncotic pressure is the osmotic pressure generated by large molecules in the blood. What is the main blood component that causes oncotic pressure?
Large proteins such as albumin.
How does plasma help regulate temperature?
Plasma acts as a heat sink to stabilise overall body temperature. Moves excess heat from “hot” organs e.g. liver and muscle, and circulates to extremities.
How do proteins buffer hydrogen ions in the plasma, to help maintain normal pH?
Acidic conditions: amino acids bond to H+
Alkaline conditions: amino acids release H+
What is complement (AKA complement system/complement cascade)?
A specialised series of proteins that contribute towards the inflammatory response.
What are the three pathways in the complement system?
Classical pathway
Alternative pathway
Lectin pathway
Which complement pathway is initiated by specific sugars on the surface of microbes?
Lectin pathway
Why does the alternative pathway in complement cascade occur faster than the classical pathway?
It takes time for WBCs to create antibodies, which the classical pathway requires for activation.
Where as the alternative pathway is activated directly by pathogens or damaged cells.
What is opsonisation?
A process by which opsonins such as complement proteins or antibodies coat pathogens to enhance their recognition and ingestion by phagocytes.
What are the main three functions of complement?
Opsonisation.
Cell lysis.
Chemotaxis (causing inflammation by attracting immune cells to site).
Where are plasma proteins such as albumin, complement, and clotting factors produced?
In the liver.
What is haemostasis?
Normal blood clotting in response to an injury.
What are the three pathways of the coagulation cascade?
Intrinsic, extrinsic, and common.
What is the coagulation cascade?
Series of enzymatic reactions that lead to the formation of a stable blood clot.
How is the intrinsic pathway of the coagulation cascade triggered?
Damage to the vascular endothelium exposes collagen, which activates Factor XII, starting cascade.
The intrinsic pathway of the coagulation cascade begins with activation of Factor XII. What other factors are involved in the intrinsic pathway, until activation of Factor X in the common pathway?
XII -> XI -> IX
Activated IX & VIII then both activate Factor X in common pathway.
How is the extrinsic pathway of the coagulation cascade triggered?
External trauma causing Tissue Factor (TF) to be released from damaged tissue.
Tissue factor (III) is expressed on the surface of many cells found outside blood vessels but not on the surface of circulating blood cells or the endothelium. When the endothelium is damaged, tissue factor comes into contact with blood.
How does this start the extrinsic pathway, and how does this then lead to activation of factor X in the common pathway?
Tissue factor combines with Factor VII, which then activates Factor X in common pathway.
Which coagulation cascade pathway is faster, intrinsic or extrinsic? Why?
Extrinsic pathway is faster. Fewer steps and clotting factors involved!
What is the convergent point for both intrinsic and extrinsic pathways in the coagulation cascade?
Factor X - the start of the common pathway.
What is the first step of the common pathway of the coagulation cascade?
Activated factor X + factor V convert prothrombin (factor II) to thrombin (factor IIa).
What are the two main roles of thrombin in the common pathway of the coagulation cascade?
Converts fibrinogen (factor I) to fibrin.
Activates factor XIII and many other factors, providing a positive feedback loop in the intrinsic pathway.
How does fibrin and Factor XIII help form a clot?
Fibrin forms a mesh over the platelet plug, strengthening it and forming a stable clot.
Factor XIII cross-links fibrin to further strengthen the clot.
How does antithrombin III affect the coagulation cascade?
Inhibits thrombin (IIa) and activated factors IX to XII.