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Phys, pharm > Physiology and pathology of clotting > Flashcards

Physiology and pathology of clotting Flashcards

1
Q

What is the equation to find the haematocrit?

A

Haematocrit = Height of RBC’s / Total height

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2
Q

What is the composition blood?

A

Plasma
Erythrocytes
Leukocytes
Platelets

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3
Q

What is the composition of plasma ?

A

Electrolytes
Plasma proteins
Carbohydrates
Lipids

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4
Q

What process are principal protein separated from plasma?

A

Electrophoresis

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5
Q

What are 3 major principal proteins?

A

Albumin
Fibrinogen
Globulins

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6
Q

What is the most abundant element in haemotcrit?

A

Erythrocytes

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7
Q

Structure of an erythrocyte

A

Non-nucleated biconcave discs

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8
Q

How is the cytoskeleton of an erythrocyte anchored to the plasma membrane?

A

Glycophorin
Band 3 Cl- HCO3 exchanger

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9
Q

What are the 3 major functions of erythrocytes?

A

O2 carriage from lungs to systemic system
CO2 carriage from tissue to lungs
Buffering of acids/bases

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10
Q

What are the 2 classification of white blood cells?

A

Granulocytes
Non-granular

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11
Q

Role of a neutrophil?

A

Phagocytose bacteria

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12
Q

Is a neutrophil a granulocyte or non-granular wbc?

A

Granulocyte

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13
Q

Function of Eosinophil?

A

Combat parasites and viruses

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14
Q

Is an eosinophil a granulocyte or non-granular?

A

Granulocyte

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15
Q

Function of a basophil?

A

Release IL-4, histamine, heparin and peroxidase

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16
Q

Is a basophil a granulocyte or non-granular?

A

Granulocyte

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17
Q

Function of a lymphocyte?

A

Mature into T cells and B cells (plasma cells)

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18
Q

Is a lymphocyte a granulocyte or non-granular?

A

Non granular

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19
Q

What is a monocyte?

A
  • Non granular wbc
    Macrophage
    Dendritic cell
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20
Q

Where are platelets formed?

A

Megakaryocytes in bone marrow

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21
Q

What is the feedback mechanism for platelet production?

A

Platelet receptor for TPO ->
Abundant platelets bind TPO ->
So megakaryocytes are not generated ->
Meaning no platelets are produced -?
So receptors no longer bind TPO ->
TPO stimulates megakaryocyte production ->
So platelets are produced

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22
Q

Describe the composition of a platelet?

A

Nucleus free fragments -
- Mitochondria
Lysosomes
Peroxisomes
Alpha granules
Dense core granules

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23
Q

What do alpha granules in platelets contain?

A

Von Willebrand factor
Clotting factor 5

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24
Q

What is the external coat of a platelet covered in?

A

Platelet receptors

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25
Q

Describe the structure of the inner skeleton of a platelet

A

Circumferential band of tubulin microtubules

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26
Q

What is the relationship between blood flow and haematocrit?

A

Blood flow decreases with increasing haematocrit

27
Q

Describe viscosity in terms of blood flow.

A

Resistance to sliding of shearing fluid layers

28
Q

What is blood viscosity dependent on?

A

Haematocrit
Fibrinogen plasma conc
Vessel radius
Linear velocity
Temperature

29
Q

What is a concentric cylinder in terms of blood flow?

A

Different velocities of blood flowing through different layers of the blood vessel at different velocities

30
Q

What happens to velocity as you get closer to the centre of the blood vessel?

A

The velocity increases
- Each concentric layer gets faster than the prior layer

31
Q

Where is concentration of rbc highest in a blood vessel?

A

In the centre

32
Q

Describe plasma skimming

A

Plasma layer around the branching vessel
- Due to no rbc on the outer layer of the vessel
- Lower haematocrit in this region

33
Q

How is skimming prevented?

A

Via arterial cushioning

34
Q

Describe tank treading.

A

Membrane of vessel rolls like a tank tread
Helps achieve plasma spin

35
Q

What are lamina layers limited to?

A

The width of the rbc

36
Q

What happens to rbc in vessels smaller than the rbc?

A

Rbc are deformed and the viscosity falls

37
Q

When does laminar blood flow turn to turbulence?

A

When blood flow is above a critical velocity

38
Q

What happens to the parabolic profile in turbulence?

A

The parabolic profile becomes blunted

39
Q

What is local stenosis?

A

A restriction

40
Q

What combination of factors will cause turbulent flow?

A

Large radius
High velocity
Local stenosis

41
Q

How would you identify turbulence?

A

Produces a murmur whereas laminar is silent

42
Q

What are the 4 methods for haemostasis? (prevention of haemorrhage)

A

Vasoconstriction
Increased tissue pressure
Platelet plug
Coagulation

43
Q

What factors are involved in vasoconstriction?

A

Thromboxane A
Serotonin
Thrombin
Endothelin -1

44
Q

How does increasing tissue pressure prevent haemorrhage?

A

Decreases transmural pressure
- Difference between intravascular pressure and tissue pressure

45
Q

What are the steps involved in a platelet plug?

A

Adhesion
Activation
Aggregation

46
Q

Describe platelet adhesion

A

Mediated by platelet receptors bound to ligands
- Von Willebrand factor is released and binds to collagen and platelets

47
Q

What is the release of Von Willebrand factor triggered by?

A

High shear forces
Cytokines
Hypoxia

48
Q

What does breach of endothelium expose?

A

Collage
Fibronectin
Laminin

49
Q

Describe platelet activation.

A

Ligand binding leads to conformational change ->
Intracellular signalling cascade ->
Release reaction/exocytosis of dense storage granules or ->
Cytoskeletal changes (lamellipodium and filopodia)

50
Q

Describe platelet aggregation

A

Activation leads to conformational change in the receptor ->
Allowing it to bind to fibrinogen, forming molecular bridges between platelets

51
Q

What is a blood clot composed of?

A

A semisolid mass of :
Erythrocytes
Leukocyte
Serum
Mesh of fibrin

52
Q

What is thrombus?

A

An intravascular clot

53
Q

What are the 2 clotting pathways?

A

Intrinsic pathway- surface contact activation on activated platelet membrane
Extrinsic pathway - membrane bound tissue factor activation, from blood contact with material from damaged cell membrane

54
Q

What do the 2 clotting pathways end in?

A

Common pathway that generates Thrombin and stable fibrin

55
Q

What are the blood clot preventions?

A

Homeostatic mechanisms
Paracrine factors
Anticoagulant factors

56
Q

Name 2 paracrine factors which prevent clotting

A

NO (platelet adhesion)
Prostacyclin (promotes vasodilation)

57
Q

Name 2 anticoagulant factors which prevent clotting

A

Tissue factor pathway inhibitors
Antithrombin

58
Q

Describe the mechanism of TFPI

A

Maintain antithrombic surface
Bind and inhibit the pathway
Prevent the downstream cascade when binding to a complex

59
Q

Describe the mechanism of antithrombin

A

Stops activation of various factors
Modulators of clotting to prevent when no injury has occured

60
Q

What is a thrombus?

A

An intravascular blood clot

61
Q

What is venous stasis?

A

Valves of the vasculature aren’t working properly

62
Q

What is hypercoaguability?

A

Coagulation at a higher rate

63
Q

When does arterial thrombosis occur?

A

Following the erosion or rupture of atherosclerotic plaque

Phys, pharm (31 decks)

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