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Hematology > Hema.Mod.A Lec2 > Flashcards

Hema.Mod.A Lec2 Flashcards

1
Q

Meaning of Pancytopenia

Cause

A

Decrease in RBC, WBC, PLATELETS

Due to chemotherapy

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2
Q

Meaning of Petechiae

A

Reddish purple spots

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3
Q

Why does petechiae occur ?

A

Due to THROMBOCYTOPENIA (decrease in platelets)

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4
Q

Primary Hemostasis is related to

Secondary Hemostasis is related to

A

Platelets

Coagulation factors

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5
Q

If platelet count is down what will happen ?

A

Hemorrhage

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6
Q

What happens when injury occurs (3)

A

1- Vasoconstriction

2- Primary Hemostasis (adhesion, aggregation, release reactions)

3- Secondary Hemostasis

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7
Q

Beneath Endothelial Cells there are :

Endothelial cells make

A

1- Basement Membrane

2- Collagen

Lining of blood vessels

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8
Q

Substances released from endothelial cells: (6)

A

1-tissue factor (initiator of coagulation)

2-VWF (carry factor 8, adhesion)

3- Nitric oxide, Prostacyclin (vasodilators, inhibit coagulation)

4- Antithrombin, Protein S, Tissue factor inhibitor (inhibit coagulation)

5- t-pa (tissue plasminogen activator)(fibrinolysis)

6- Thrombomodulin (activates protein C which inhibits coagulation)

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9
Q

Protein S function

A

Helps protein C to inhibit coagulatiob

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10
Q

What are platelets ?

A

Fragments of megakaryocyte cytoplasm.

Megakaryocytes are transformed to platelets by TPO

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11
Q

How long does thrombopoiesis takes ?

A

10 days in BM

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12
Q

t1/2 of platelets in blood:

A

10 days

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13
Q

In normal state 1/3 of platelets go to

A

Spleen

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14
Q

Patients with splenomegaly have

A

Low platelets

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15
Q

Platelet content (2)

A

Dense granules, alpha granules

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16
Q

dense granules (3)

A

Serotonin(vasoconstriction)
ADP(plat. Aggregation)
Ca2+(role in coagulation)

17
Q

alpha granules (7)

A

Fibrinogen

VWF

Factor 5

Fibronectin

B thromboglobulin

Thrombospandin

Heparin antagonist

18
Q

What is prostaglandins ?

A

Phospholipids of platelet plasma membrane

19
Q

What are the platelets functions

A

1-Adhesion
2-release reaction ( by alpha granules , dense granules)
3- aggregation ( to close wound )

20
Q

Adhesion

A

After tissue injury collagen is exposed.

platelets adhere to collagen by vWF by help of GP-1b receptor ( on platelets)

21
Q

release reaction

A

Release of :
1- Serotonin : vasoconstriction
2- ADP : aggregation
3- Prostaglandins : form TXA2 causing (vasoconstriction, ) aggregation

22
Q

platelet aggregation (done by (4), once it occurs)

A

Done by: ADP , PG , TXA2 , GPIIbIIIa
Once platelet aggregation occurs :
fibrinogen is converted to fibrin forming primary hemostatic plug

23
Q

Platelets antigens

A
  1. HPA a or b = ( human platelet Antigen )
  2. ABO antigens
  3. HLA class I
24
Q

VWF

A

vWF is formed as multimer ( which cannot aggregate platelet )
multimers can be broken by protease into monomers and dimers , so become functional and cause platelet aggregation

25
Q

Ecchymosis

A

= bruise زرقان ( due to defect in coagulation factor genes )

26
Q

all coagulation factors are formed in liver except

A

Factor 8 and Tissue factor that are formed in endothelial cells

27
Q

PT measures

A

extrinsic pathway

If Prolonged, it’s due to liver disease – low vit k

28
Q

APTT measures

A

intrinsic pathway and common pathway

If Prolonged, it’s due to hemophilia , factor 11 ,12 deficiency

29
Q

An abnormal PT and a normal APTT would indicate a problem with which factor?

A

Deficiency in factor 7

30
Q

Fibrin cross links by

A

factor 8

31
Q

vit.k dependent factors

A

2,7,9,10

32
Q

factor 10a

A

stabilize fibrin

33
Q

coagulation inhibitors

A
  • Tissue Factor Pathway Inhibitor (TFPI).
  • Anti-thrombin III.
  • Protein C/Protein S/Thrombomodulin (APC).
  • Alpha 2 macroglobulin, alpha2 antiplasmin, c1 esterase inhibitor and alpha 1 antitrypsin.
34
Q

Protein C

A

Needs protein S for its function

inhibit factor 5 and 8

Thrombomodulin , thrombin cause activation of protein C result in inhibition of factor 5 and 8

35
Q

TT (thrombin time) measures:

A

fibrin formation

If Prolonged, it’s due to decreased plasma fibrinogen , increased FDPs

36
Q

fibrinolysis

A

Intrinsic activation:
Factor 12 activates plasminogen into plasmin

Extrinsic activation:
tPA activates plasminogen into plasmin

Streptokinase can also activate plasminogen

Plasmin converts fibrin into FDP

37
Q

inhibitors of fibrinolysis

A

PAI-1 PAI-2 (Plasminogen Activators Inhibitors)

Antiplasmin

Hematology (5 decks)

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