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Hematology 2 Lab > LABORATORY ACTIVITY 5 AND LABORATORY ACTIVITY 6 > Flashcards

LABORATORY ACTIVITY 5 AND LABORATORY ACTIVITY 6 Flashcards

1
Q

Within [?] after whole blood is allowed to clot in a clean glass tube at [?], the clot will begin to shrink and retract from the walls of the tube.

A

1 hour

37OC

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2
Q

Serum is expressed and the clot becomes [?].

A

denser

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3
Q

This retraction process is maximal at [?], by which time it occupies almost half of the original blood volume

A

24 hours

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4
Q

PROCEDURE:

A

Modified MacFarlane Serum method

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5
Q
  1. Collect [?] of venous blood samples. Note the time of collection.
A

5 ml

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6
Q
  1. Dispense into a [?] noting exact amount of blood used.
A

graduated centrifuge tube

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7
Q
  1. Place an [?] at the center of tube.
A

applicator stick

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8
Q
  1. Incubate test tubes at [?] in a water bath for [?].
A

370C

2 hours

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9
Q
  1. Examine and record degree of retraction (?)
A

partial, complete, or no retraction

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10
Q
  1. Pull [?] with clotted blood and describe the clot.
A

applicator stick

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11
Q
  1. Serum expressed is centrifuged for [?] at [?].
A

3-5 minutes

3,500 rpm

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12
Q
  1. Calculate % of serum expressed as follows:

Volume of Serum =

% serum expressed =

A

total volume of serum in tube – volume of packed red cells

Volume of serum in ml/Volume of blood used in ml x (100)

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13
Q
  1. Report results in
A

%

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14
Q

This measures the time required for blood to clot after it has been removed from the body.

A

WHOLE BLOOD COAGULATION TIME

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15
Q

This is a measure of the overall intrinsic and common pathways of coagulation.

A

WHOLE BLOOD COAGULATION TIME

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16
Q

Micro Method –

A

capillary blood

slide method

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17
Q

Macro Method –

A

Whole blood

Lee and White Method

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18
Q
  1. Do a finger puncture. Start stopwatch at the time of appearance of [?] from the puncture
A

blood

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19
Q
  1. Place on a clean glass slide [?]
A

3 separate drops of blood.

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20
Q
  1. Allow to stand for [?] at room temperature. Check clot formation by drawing the blood with a needle or lancet and observe for thread formation.
A

2 minutes

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21
Q
  1. Record [?] from the start to fibrin thread formation.
A

clotting time

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22
Q
  1. Label three uniformly sized tubes [?].
A

1, 2 and 3

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23
Q
  1. Make a clean venipuncture using [?] and note the time at which blood enters the syringe. Draw [?] of blood.
A

20-gauge needle

four (4) ml

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24
Q
  1. Carefully dispense [?] to tube 3, then [?] to tube 2 and [?] to tube 1. [?] the remaining blood.
A

1 ml

Discard

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25
Q
  1. Incubate all tubes in a water bath at
A

37 0C (+ 0.5 0C )

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26
Q
  1. At exactly [?], tilt tube number 1 to a [?] angle and observe for clotting. Repeat every [?] until tube can be completely inverted without spilling contents. Note time of clotting.
A

5 minutes

450

30 seconds

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27
Q
  1. After[?], tube 1 is clotted, proceed to tube 2 and repeat the preceding procedures. Repeat procedures with tube 3.
A

30 seconds

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28
Q
  1. Record coagulation time as the time elapsed between the [?] and the [?] in tube 3.
A

withdrawal of blood

completion of coagulation

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29
Q

CLOT RETRACTION - otherwise known as

A

“contraction of clot”

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30
Q

CLOT RETRACTION - otherwise known as

A

“contraction of clot”

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31
Q
  • requires great amount of ATP and Calcium
A

CLOT RETRACTION

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32
Q
  • requires great amount of ATP and Calcium
A

CLOT RETRACTION

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33
Q

: compress to become denser

A

Contraction

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34
Q

: moves out of surface

A

Retraction

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35
Q

Mainly involves platelet

A

CLOT RETRACTION

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36
Q

In vivo or in vitro indication of plt function test (normal platelet function and number)

A

CLOT RETRACTION

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37
Q

Affected by both qualitative (inability to adhere) and quantitative (thrombocytopenia)

A

CLOT RETRACTION

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38
Q

based on platelet normal function

A

CLOT RETRACTION

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39
Q

: released by plt when activated; dense granules

A

ATP and Calcium

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40
Q

plt trapped in the clot releases [?] found in the cytoplasm of plt

A

factor XIII

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41
Q

= denser and more compact clot to be able to retract from the vessel wall

A

continuous cross-linking of XIII

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42
Q

: plays a role in contraction (retraction from the wall)

A

Calcium

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43
Q

allows platelet to go back to its original shape after contraction

A

Calcium

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44
Q

: produces energy

A

ATP

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45
Q

nonspeific screening test for in vivo plt function

A

CLOT RETRACTION

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46
Q

CLOT RETRACTION Principle:

When [?] is complete, clot normally undergoes [?].

A

blood coagulation

retraction

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47
Q

[?] is expressed and clot becomes [?]

A

Serum

denser

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48
Q

Normal clot retraction:

A

30 mins (initial)/24 hrs (completely/maximal)

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49
Q

contracts the clot

A

Platelet

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50
Q

Indication that clot has been retracted

A

Serum is expressed

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51
Q

Clot settles at the [?] or attaches to the applicator stick

A

bottom

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52
Q

happens before fibrinolysis

A

Clot retraction

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53
Q

before it dissolves

A

clot retracts

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54
Q

retraction does not mean the clot has been removed from the bv, but it simply [?] and proceeds to the bottom of the bv initiating plasmin to dissolve the clot = healing of bv

A

detaches

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55
Q

to preven thrombosis and establish blood flow

A

Fibrinolysis (dissolution of clot)

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56
Q

to give space for blood to start flowing again

A

Retraction

57
Q

initially restores blood flow

A

Retraction

58
Q

restored after fibrinolysis

A

Retraction

59
Q

Factors affecting clot retraction

A

Adequate amount of plt

Calcium

ATP

Fibrinogen

normal interaction of plt and fibrinogen

60
Q

(form platelet and bones)

A

Calcium

61
Q

(from food, other cells, muscle breakdown)

A

ATP

62
Q

adhesion of platelet to bv:

A

Ib-IX-V

63
Q

adhesion of platelet to platelet:

A

fibronectin and fibrinogen

64
Q

: plt will not aggregate = weak release of XIII

A

↓ Fibrinogen

65
Q

plt needs to attach to the fibrin clot (no problem in the fibrin-plt interactiom)

A

normal interaction of plt and fibrinogen

66
Q

normal interaction of plt and fibrinogen

A

qualitative defect

67
Q

Other factors

A

thrombostenin

plasma volume: red cell mass

nature of the surface where CRT is being measured

68
Q

contains actomyosin for muscle

A

thrombostenin

69
Q

provides contractile force for plt

A

thrombostenin

70
Q

stretches the plt

A

thrombostenin

71
Q

equal in proportion

A

plasma volume: red cell mass

72
Q

affects clot retraction if unequal

A

plasma volume: red cell mass

73
Q

preferably glass = slower retraction in plastic; normal in glass(in vitro)

A

nature of the surface where CRT is being measured

74
Q

prosthetic heart valve and fistula are dangerous since attachment of clot will not retract leading to obstruction of bv

A

nature of the surface where CRT is being measured

75
Q

Process of Clot Retraction

A

Platelets → Thrombostenin → Actin/Myosin (Myosin II) → Clot retraction → BV edge retracts

76
Q

[?] are entrapped in fibrin threads while continuously releases ?

A

Platelets

FXIII along w/ Ca and ATP

77
Q

plt changes in shape once denser via [?]

A

Thrombostenin

78
Q

: releases microfilaments

A

Actin

79
Q

(small filaments in plt that maintains shape; released by actin force)

A

microfilaments

80
Q

: assembles microfilaments only in the surrounding/border of plt for support during change of shape

A

Myosin II

81
Q

encodes Myosin II in the platelet

A

MYH9 gene

82
Q

can make platelet have self-aggregation w/o fibronectin/fibrinogen

A

Myosin II

83
Q

Once assembled, microfilaments will work on the

A

adhesion complex

84
Q

(dissector of plt; connects plt to bv)

A

adhesion complex

85
Q

to down-regulate it to help plt retract from the bv

A

adhesion complex

86
Q
  • adhesion complex; lacks in BSS; dissector of plt, down-regulating it; connects plt to bv
A

Gp Ib-IX-V complex

87
Q

– plt starts to attach to fibrin links; bv is capable of contraction; plt, fibrin clot, bv

A

platelet spicules attached to fibrin

88
Q

– by the help of FXIII

A

firbin meshwork

89
Q

bv - conrtacts to help clot from detaching itself; capable of

A

contraction (bv vasoconstriction)

90
Q

: action of plt, fibrin clot, and bv

A

blood retraction

91
Q

to help eject the clot, the bv needs to constrict

A

BV edge retracts

92
Q

CRT is poor when plt count is

A

<100,000/ul (thrombocytopenia)

93
Q

Normal:

A

150-400uL

94
Q

few plt trapped, few

A

thrombostenin

95
Q

Clinical significance

A

Dysfibrinogenia

Hypofibrinogenemia

Paraproteinemias

96
Q

: abnormal fibrinogen

A

Dysfibrinogenia

97
Q

: low fibrinogen

A

Hypofibrinogenemia

98
Q

: abnormal proteins

A

Paraproteinemias

99
Q

plt needs to adhere to fibrinogen to allow interaction between them)

A

Dysfibrinogenia

100
Q

plt has nowhere to attach to for fibrin-meshwork formation; no retraction will take place)

A

Hypofibrinogenemia

101
Q

Abnormal thrombostenin: actin-myosin function will not occur (release and assembly of filaments)

A

Paraproteinemias

102
Q

Methods

A

a. Hirschboeck Method (Castor oil Method)

b. Stefanini Method (Test tube)

c. Mac Farlane Method

103
Q

Qualitative: Test for the presence or absence of retraction

A

Hirschboeck Method (Castor oil Method)

104
Q

Formation of dimpling/droplet like serum on the surface of blood drop

A

Hirschboeck Method (Castor oil Method)

105
Q

Normal Values = 15 - 45 minutes

A

Hirschboeck Method (Castor oil Method)

106
Q

Normal: clot retraction begins within 1 hour, complete within 18 to 24 hours

A

Stefanini Method (Test tube)

107
Q

Provides quantitative estimate of the degree of retraction

A

Mac Farlane Method

108
Q

Degree of serum expressed = Degree of retraction

A

Mac Farlane Method

109
Q

Normal Values = 44% - 67 %

A

Mac Farlane Method

110
Q

COAGLULATION TIME - otherwise known as

A

“clotting time”

111
Q

COAGLULATION TIME - Principle: measures the [?] for blood to clot after it has been removed from the body within [?]

A

time requires

1 hour

112
Q

COAGLULATION TIME Indication

A

Factor deficiency

Hemophilia A and B

Does not diagnose mild coagulation disorder

Traumatic

Not reliable

113
Q

it is a nonspecific screening test for intrinsic and common pathway factor deficiencies = prolongs coagulation time

A

Factor deficiency:

114
Q

: severe deficiency of factor VIII (A) and IX (B) = prolongs coagulation time in intrinsic pathway

A

Hemophilia A and B

115
Q

screening test: not affected by mild deficiency (nonspeific)

A

Does not diagnose mild coagulation disorder

116
Q

normal coagulation time in minimal factor deficiencies

A

Does not diagnose mild coagulation disorder

117
Q

puncture of finger

A

Traumatic

118
Q

not reproducible; cannot be done on the same person

A

Not reliable

119
Q

cannot detect mild factor deficiencies

A

Not reliable

120
Q

after the prick, blood will automatically suck in the capillary

A

Capillary method

121
Q

break the capillary and note the time

A

Capillary method

122
Q

NV: 2-4 minutes

A

Capillary method

123
Q

add the blood and start the timer

A

Tube method

124
Q

keep on tilting the tube every 30 seconds to see clot formation

A

Tube method

125
Q

NV: 7-15 mins

A

Tube method

126
Q

Factors affecting Clotting Time

A

Macromethod

127
Q

Excessive agitation of the tube:

A

shortens clotting time

128
Q

:
(allowing FXII to have contact with glass = activation of negative surface or glass)

A

Excessive agitation of the tube

129
Q

no quality control: no comparison to a basis; not reliable

A

Macromethod

130
Q

not considered as adequate test: affected by factors such as the glass surface

A

Macromethod

131
Q

Causes Of Prolonged Clotting Time Are

A

Coagulation factors deficiencies which may be: Congenital or Acquired
Severe deficiency of any known plasma clotting factors except XIII (fibrin-stabilizing factor) and VII
Drugs like heparin and thrombin inhibitors
Marked hyperheparinemia
Afibrinogenemia

132
Q

(extrinsic pathway; in vivo)

A

VII

133
Q

(normal clotting time; does not help in clot formation)

A

XIII

134
Q

: does not cause bleeding disorder but may cause prolonged clotting time

A

FXII

135
Q

Anti-thrombin (heparin, warfarin, Coumarin)

A

prolongs clotting time

136
Q

Excessive heparin in the system - attacks thrombin = coagulation cascade failure =

A

prolongs clotting time

137
Q

No fibrinogen = No plt plug = No conversion of fibrinogen to fibrin =

A

Prolongs clotting time

138
Q

Blood clotting mechanism

Three stages

A

Vascular spasm
Platelets plug formation
Congulation factors activation

139
Q

Stages of blood clotting

A

Formation of protrombinase:
1. Intrinsic pathway
2. Extrinsic pathway

Prothrombin —-> Thrombine (enzyme)

Fibrinogen (soluble) ——> Fibrin (insoluble)

Hematology 2 Lab (7 decks)

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