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Physiology > Lecture 21 - Hemostasis > Flashcards

Lecture 21 - Hemostasis Flashcards

1
Q

what are blood groups determined by?***

A

presence or absence of specific marker molecules on the cell membrane of RBCs

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2
Q

what are antigens?

A

substances that the body does not recognize as belonging to the “self

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3
Q

what do antigens trigger?

A

defensive response from the immune system

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4
Q

what are antigens made of

A

generally large proteins, but can include carbohydrates, lipids and nucleic acids

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5
Q

what are antibodies also called

A

immunoglobulins

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6
Q

what are antibodies produced by

A

plasma cells

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7
Q

what do antibodies do

A

attach to specific antigens

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8
Q

our bodies produce antibodies in response to what?

A

in response to foreign antigens

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9
Q

is the antibody-antigen response induced?

A

yes

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10
Q

name 2 groups of antigens on RBCs that may cause significant harm to patients

A

ABAO blood group and Rh blood group

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11
Q

ABO blood typing designates the presence/absence of which 2 antigens

A

A and B antigens

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12
Q

what type of proteins are A and B antigens

A

glycoproteins

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13
Q

how are ABO blood types determined

A

genetically

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14
Q

Blood type A has antibodies to….

A

antibodies to B antigen in blood plasma: anti-B antibodies

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15
Q

an individual with type B blood has which tupe of naturally formed antibodies

A

anti-A antibodies

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16
Q

an individual with blood type AB has which naturally formed antibodies

A

they have both A and B antigens so do not have naturally formed antibodies to either of these

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17
Q

people with blood type O have which kind of antibodies and antigens presence

A

lack A and B antigens on their erythrocytes, both have both anti-A and anti-B antibodies circulating in blood plasma

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18
Q

what initiates the formation of antibodies

A

body must first be exposed to the foreign antigen before an antibody can be produced

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19
Q

how is the human immune system exposed to A and B antigens at an early age

A

ABO blood group antigens are found in foods and microbes throughout nature, exposed at an early age –> antibodies are formed naturally

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20
Q

describe the series of events following a transfusion of incompatible blood

A
  • RBCs with foreign antigens appear in the blood stream –> trigger an immune response
  • antibodies attach to the antigens on the membranes of the transfused RBCs

-agglutination: Y shaped antibodies attach randomly to more than one foreign RBC –> form clumps

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21
Q

what are the consequences of agglutination in the body

A
  • clumps block small blood vessels throughout the body –> deprive tissues of oxygen and nutrients
  • hemolysis: as erythrocyte clumps degrade –> hemoglobin released into blood stream

-load of hemoglobin released can be toxic to the kidney –> quickly develop kidney failure

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22
Q

anti-B antibodies will cause agglutination and hemolysis if…

A

they ecounter erythrocytes with B antigens

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23
Q

anti-A antibodies will cause agglutination and hemolysis if…

A

they encounter erythrocytes with A antigens

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24
Q

if a blood sample agglutinates with both anti A and anti B antibodies, what is the ABO type?

A

AB

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25
Q

if a blood sample agglutinates with anti-B antibodies but not anti-A antibodies, what is the ABO blood type?

A

B

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26
Q

if a blood sample only agglutinates with anti-A antibodies, what is the bloodtype?

A

A

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27
Q

If the blood sample does not agglutinate with anti B nor anti A antibodies, what is the blood type

A

O

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28
Q

Type A…
antigens on blood cells:
antibodies in plasma:
Donates to:
receives from:

A

antigens on blood cells: A
antibodies in plasma: B
Donates to: A, AB
receives from: A, O

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29
Q

Type B…
antigens on blood cells:
antibodies in plasma:
Donates to:
receives from:

A

Type B…
antigens on blood cells: B
antibodies in plasma: A
Donates to: B, AB
receives from: O, B

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30
Q

Type AB…
antigens on blood cells:
antibodies in plasma:
Donates to:
receives from:

A

Type AB…
antigens on blood cells: A, B
antibodies in plasma: none
Donates to: AB
receives from: universal acceptor

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31
Q

Type O…
antigens on blood cells:
antibodies in plasma:
Donates to:
receives from:

A

antigens on blood cells: none
antibodies in plasma: A, B
Donates to: universal donor
receives from: O

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32
Q

Rh blood group is classified according to what

A

presence, or absence of a erythrocyte antigen Rh

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33
Q

in what animal was the Rh antigen first discovered

A

rhesus macaque

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34
Q

which Rh antigen is clinically important

A

although dozens have been identified, only D is clinically important

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35
Q

What determines wether someone is Rh+ vs. Rh -ve

A

Rh+ = D antigen present on erythrocytes
Rh- = lack D antigen on erythrocytes

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36
Q

when are Rh antibodies produced? contranst this to ABO antibodies

A

antibodies to Rh antigen are produced in Rh- individuals only after exposure to the antigen vs. ABO group antibodies which are preformed

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37
Q

what are 2 ways in which Rh antibodies may be formed in an Rh negative individual

A

following a transfusion with incompatible blood, or birth of an Rh+ baby to an Rh- individual

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38
Q

what happens when an Rh- individual gives birth to an Rh+ baby, given that this is their second Rh+ve baby

A

immediately after the first birth, the Rh- parent would be exposed to baby’s Rh+ cells –> immune system of parent begins to generate anti-Rh antibodies after exposure –> during second pregnancy, Rh antibodies produced can cross the placenta into fetal blood stream and destroy fetal RBCs

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39
Q

describe the action and mechanism of RhoGAM

A

action: temporarily prevent the development of Rh antibodies in the Rh- parent
MechanismL antibodies destroy any fetal Rh+ erythrocytes that may cross the placental barrier

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40
Q

how many blood groups are there in dogs

A

more than 12, their RBCs may contain any combination of these b/c each blood group is inherited independently

41
Q

what is the most important dog blood group

A

Dog erythrocyte antigen (DEA) 1.1

42
Q

do dogs normally have antibodies against other canine blood group antigens

A

normally, dogs do not have any antibodies against any of the antigens present in their own blood or other canine blood group antigens unless previously exposed to them via. transfusion

43
Q

how many known blood types are there in cats? name them!

A

4: A, B, AB, mic

44
Q

what is the most common blood group in cats? what about the others?

A

A = most common
B = higher in certain breeds
AB = rare

45
Q

do cats have antibodies against blood group antigens they lack

A

yes

46
Q

what is the universal donor amongst cats

A

there is no universal donor

47
Q

How many blood groups are there in horses? name them!

A

7: A,C,D,K,P,Q,U.

48
Q

each blood group in horses can have multiple cell membrane proteins. what are they referred to as?

A

A to G

49
Q

how many allelic combinations of blood types can horses have

A

400,000

50
Q

do horses possess antibodies against RBC antigens that they do not possess

A

no, unless they are exposed to a different blood type (ex. transfusion)

51
Q

which animals is crossmatching for blood types not necessary for the first transfusion?

A

dogs, horses

52
Q

Define hemostasis

A

process by which the body seals a ruptured blood vessel and prevents further loss of blood

53
Q

what is hemostasis effective in dealing with

A

small, simple wounds

54
Q

name the 3 steps of hemostasis in sequence… what happens when there is a failure in any one of these steps

A

1.vascular spasm,
2.formation of a platelet plug,
3. coagulation (blood clotting )

failure = hemorrhage

55
Q

describe vascular spasm

A

platelets secrete vasoconstrictors that cause vascular spasms in broken vessels

56
Q

describe the formation of temporary platelet plugs to stop bleeding

A
  • collagen fibers are exposed
  • platelets become sticky and release chemicals to attract more platelets
  • ‘plug’ is formed that slows loss of blood within 3-5 minutes
57
Q

describe coagulation

A
  • clotting factors in blood reinforce platelet ‘plug’
  • calcium needed
    chemical reactions –> form thrombin (enzyme)
  • thrombin joins fibrinogen into netlike fibrin
  • blood cells are trapped in fibrin meshwork to form a hard clot
58
Q

different precursors of fibrin polymer

A

fibrinogen –> fibrin –> fibrin polymer

59
Q

what are 4 critical components to coagulation***

A

prothrombin –> thrombin –> fibrinogen –> fibrin

60
Q

how many stages are there in coagulation

A

3

61
Q

when are clotting factors activated

A
  • blood vessels are broken
62
Q

are clotting factors active or inactive in blood

A

inactive

63
Q

clotting factors are primarily secreted by ____ and _____

A

liver and platelets

64
Q

what does the the liver require to produce clotting factors

A

fat soluble vitamin K

65
Q

what is a common cofactor required by clotting factors

A

calcium ion as a cofactor

66
Q

What happens in stage 1 of the coagulation pathway

A

production of active thrombokinase by the extrinsic and intrinsic pathway

67
Q

describe where chemicals are released from in the extrinsic pathway

A

chemicals are released from damaged tissues

68
Q

describe where chemicals are released from in the intrinsic pathway

A

chemicals present in blood

69
Q

do both pathways need to be activated for effective homeostasis?

A

yes

70
Q

what happens in stage 2 of the blood coagulation pathway

A

conversion of prothrombin to thrombin by the thrombokinase produced in stage 1

71
Q

what happens in stage III of the blood coagulation pathway

A

conversion of fibrinogen to fibrin and production of fibrin clot by thrombin produced in stage II

72
Q

Fibrinogen:
Type of molecule: ?
Source: ?
Pathways: ?

A

Fibrinogen:
Type of molecule: plasma protein
Source: Liver
Pathways: common, converted into fibrin

73
Q

Prothrombin:
Type of molecule: ?
Source: ?
Pathways: ?

A

Prothrombin:
Type of molecule: plasma protein
Source: liver*
Pathways: common; converted into thrombin

73
Q

What are 2 conditions that hasten clotting?

A
  • rough spot in the blood vessel lining
  • abnormally slow blood flow
73
Q

what are 2 conditions that oppose clotting

A
  • smooth surface of lining of blood vessels does not allow platelets to stick
  • antithrombins: substances in blood that oppose or inactivate thrombin (ex. heparin)
74
Q

Thrombosis

A

abnormal clotting of blood in an unbroken vessel

75
Q

thrombus:

A

a clot that attaches to the wall of the blood vessel

76
Q

embolus

A

a clot that comes off the wall of the blood vessel and travel in blood stream (travels to small vessel and blocks flow)

77
Q

embolism

A

blockage of blood flow by an embolus that lodges in a blood vessel

78
Q

infarction

A

cell death that results from embolism
- is responsible for most strokes and heart attacks

79
Q

what are 3 bleeding disorders

A
  1. thrombocytopenia
  2. deficiency of clotting factors due to impaired liver function
  3. hemophilias
80
Q

what is thrombocytopenia

A

the number of circulating platelets is deficient (<50,000/ul)

81
Q

what does thrombocytopenia cause

A

spontaneous bleeding from small vessels all over the body

82
Q

what are hemophilias

A

hereditary bleeding disorders due to deficiency of clotting factors

83
Q

what does aspirin do

A

thins blood, can prevent heart attack and stroke

84
Q

what is the aPTT test used to evaluate

A

intrinsic pathway: evaluates the coagulation factors XII, XI, IX, VIII, X, V, II (prothrombin and fibrinogen)

85
Q

what is the PT test used to evaluate

A

extrinsic pathway: evaluates coagulation factors VII, X, V, II and I (fibrinogen)

86
Q

how is a PT test conducted

A
  • a sample of patients blood is obtained and centrifuged.
  • PT test is performed by adding patients plasma to some source of tissue factor
  • kept in a water bath at 37*
  • test is timed until the plasma clots (prothrombin time)
87
Q

what does a prolonged prothrombin time indicate?

A

indicates a deficiency in any factors VII, X, V, prothrombin or fibrinogen

88
Q

how is an aPTT test conducted

A
  • activating substances added to plasma to start the intrinsic pathway of the coagulation cascade
  • measure partial thromboplastin
89
Q

what is partial thromboplastin

A

the time it takes for a clot to form, measured in seconds

90
Q

how long should prothrombin time be

A

~12 seconds

91
Q

how long should partial thromboplastin time take

A

25-39 seconds

92
Q

what does aPTT measure***

A

measures the integrity of the intrinsic system and common clotting pathways

93
Q

GIRL you better know everything about PT and PTT tests!!

A
94
Q

increased levels of PT or aPTT means…?

A

a clotting factor may be missing or defective

95
Q

which pathway is affected if PT is prolonged but aPTT is normal

A

extrinsic

96
Q

which pathway is affected if PT is normal but aPTT is prolonged

A

intrinsic (and common????????????????? lmk if you know the definite answer)

97
Q

which pathway is affected if both PT and aPTT are affected

A

common or …?????? ( again lmk if another one is affected)

Physiology (52 decks)

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