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clinical pathology > exam 1 > Flashcards

exam 1 Flashcards

1
Q

what is the major regulatory enzyme for thrombopoiesis?

A

thrombopoietin (TPO)

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2
Q

where does TPO come from and how does it work?

A

continually produced by the liver, BM, endothelium etc.
it binds to Receptors of PLTs…if there is a decrease in PLT then increased free TPO will go back to BM and will increase megaK production to push out more PLTl

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3
Q

why do we get increased PLT is IMHA?

A

beacuse EPO will cross stimulate to megaK

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4
Q

what role do platelets have in hemostasis?

A

increased metabolic activity, primary hemostasis (inital clot cover), support secondary hemostasis (serve as increased surface area), clot retraction (contract, facilitate wound closure)

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5
Q

how is primary hemostatic plug formed?

A

adhesion, activation, secretion, aggregation

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6
Q

what lab tests are used to access platelet concentration?

A

blood smear and hematology analyzer

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7
Q

when does spontaneous hemorrhage occur?

A

<20,000/uL

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8
Q

when do you get falsely decreased platelet concentrations on the analyzer?

A

analyzer does not measure platelets because

  • too big (macrothrombocytes)
  • clumped
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9
Q

what lab test are used to access platelet morphology?

A

blood smear and hematology analyzer

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10
Q

what does an increased MPV mean?`

A

thrombopoeisis

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11
Q

what does the presence of macrothrombocytes suggest?

A

increased PLT production

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12
Q

what test are used to access platelet production?

A

BM aspirate

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13
Q

in a thrombocytopenic patient, how should healthy bone marrow respond?

A

should increase and see megaK and immature ones, if not then you should suspect a disease such as immune mediated thrombocytopenia

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14
Q

what are you major mechanisms for thrombocytopenia?

A

production, destruction, sequestration, loss, consumption

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15
Q

thrombocytopenia-production

A

decreased: bone marrow hypoplasia, neoplasia, myleonecrosis, degree depends one extent of bone marrow disease

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16
Q

thrombocytopenia-destruction

A

IMMUNE MEDIATED THROMBOCYTOPENIA. primary or secondary: get a little ab that attach to platelets get ID by spleen and get phagocytized. get severe thrombocytopenis**

  • alloimmune thrombocyto in piglets/foals
  • MLV
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17
Q

thrombocytopenia- sequestration

A

in large vascular beds: splenomegally, splenic torsion, neoplasia, hepatomegally, portal hypertension

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18
Q

thrombocytopenia-loss

A

hemorrhage (alone does not cause signif thrombocto, except severe)

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19
Q

thrombocytopenia- consumption

A

utlization of PLT during coagulation, especially DIC, vasculitis (ricketsial, FIP) ,viral infection,,,usually mild to moderate, hemorrhage if other coagulation defects and vasculitis

20
Q

signs of platelet bleeding

A
  • mucosal bleeding
  • petechiation
  • ecchymosis
  • spontaneous hemorrhae <20,000
21
Q

what are you two ddx for sevocyto

A

1) evans- immune mediated

2) DIC

22
Q

2 major mechs for thrombocytosis

A

increased production

increased distribution

23
Q

3 dz’s that may cause a reactive thrombocytosis

A
  • chronic inflamm dz*
  • iron def anemia
  • IMHA
  • some neoplasm
24
Q

3 situations of thrombocytosis

A
  • rebound from thrombocytopenia
  • post-splenectomy
  • response to some drugs (vincristine)
  • excitement and exercise (epi)
25
Q

aquired qualitative disorder

A

uremia, drugs, fibrin degradation, paraproties

26
Q

inherited qualitative disorder

A

absence of glycoprtoein R, absence or reduction in PLT granuled, signal transduction defects, vW dz

27
Q

what changed see in wVF dz

A
  • normal PLT
  • buccal mucosal bleeding time prolong
  • if suspect then analyze plasma
  • PTT/ACT usually normal, but can prolong if VII is def
28
Q

expression of what cofactor iniated coagul?

A

tissue factor III aka thromboplastin

29
Q

what factor drive amplificatin?

A

thrombin (IIa)

30
Q

what are the 4 vit K dep factor

A

II, VII, IX, X

31
Q

what coag factor has shortest half life?

A

VII

32
Q

what are 3 components contribute to coag efficiency

A

Ca 2+, platelet membrane, nonenzymation factors

33
Q

antithrombin inhibits?

A

Xa, thrombin and fibrin

34
Q

what cofactor is required for antithrombin to inactivate thrombin?

A

heparain

35
Q

what are two major end produce of fibrinolysis?

A

FDP, and D-Dimer(more specific)

36
Q

Intrinsic

A

12,11,9,8

37
Q

extrinsic

A

7

38
Q

common

A

10,5,2,1

39
Q

what are two test that do intrinsic pathway?

A

aPTT, ACT

40
Q

what test is extrinsic?

A

PT

41
Q

what two test access fibrinolytic activity?

A

FDP and D-dimers

42
Q

how does CBC of warfarin look?

A
  • PT prolong
  • aPTT, ACT prolong
  • PIVKA pos
  • platelet count is normal
  • not forming FDP beacuse no clots happening
43
Q

how does CBC for DIC look?

A
  • thrombocytopenia
  • prlong PT, aPTT
  • decreased fibrinogen concentration
  • increased FDP and D-dimer
44
Q

two phases of DIC

A

1) hypercoagulable phase

2) consumptive phase

45
Q

what two tests do you run before liver biopsy?

A

PT & aPTT

46
Q

why might you get a coagulopathy in liver dz?

A
  • decreased synthesis of coag factors

- production of dysfunctional factor

clinical pathology (3 decks)

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