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CV Perf Tech III > Platelet Gel- Exam 3 > Flashcards

Platelet Gel- Exam 3 Flashcards

1
Q

Young, fecund, robust, inactivated platelets are _______ um discoids.

A

1-3

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2
Q

Humans: Normally how many platelets in blood?

A

150,000-300,000 / ul of blood

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3
Q

What is the life span of a platelet?

A

About a week

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4
Q

What do alpha granules contain?

A

Clotting factors, growth factors, and various other proteins

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5
Q

What do dense granules contain?

A

ADP, ATP, serotonin, calcium

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6
Q

How do young and old platelets compare?

A

Young platelets are large and heavy (dense)

Old platelets are small and light

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7
Q

Do young or old platelets aggregate faster? How much faster?

A

Young large platelets aggregate much faster; about 3-5x faster than older platelets

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8
Q

Do young or old platelets release more ATP? ADP?

A

Young platelets release more ATP (4-8x more)

Young platelets release more ADP (4-6x more)

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9
Q

Do young or old platelets require substantially greater amounts of ADP to be activated?

A

Older platelets require more ADP to be activated

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10
Q

What are the 3 phases that occur after tissue injury?

A

Primary Hemostasis
Secondary Hemostasis
Fibrinolysis

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11
Q

Primary Hemostasis

A

Vasoconstriction
Platelet adhesion
Platelet aggregation

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12
Q

Secondary Hemostasis

A

Activation coagulation factors

Fibrin formation

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13
Q

Fibrinolysis

A

Activation fibrinolytic system

Clot lysis

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14
Q

Fibrinolysis

A

Activation fibrinolytic system

Clot lysis

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15
Q

Wound –> Exposes what?

A

Subendothelial Collagen

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16
Q

When subendothelial collagen is exposed, what binds?

A

von Willebrand Factor

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17
Q

After vWF binds, platelet adhesion to blood vessel wall occurs via what?

A

Glycoprotein IIb/IIIa receptors

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18
Q

When platelet adhesion to blood vessel wall occurs, what happens next?

A

Platelet activation

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19
Q

What happens when platelets are activated?

A

Platelet cytoskeleton (via actin and myosin) expands to form a disc to a multi-pseudopodal sticky blob leading to platelet aggreagation

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20
Q

What does serotonin do?

A

vasoconstriction

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21
Q

What does ADP do?

A

Recruits other platelets to aggregate and degranulate

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22
Q

What does thromboxane do?

A

Platelet aggregation and PGF release

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23
Q

PDGF

A

Platelet Derived Growth Factor

24
Q

What does PDGF do?

A

Strongly mitogenic and chemotactic for leukocytes
By itself, application doubles the rate of collagen deposition in a wound (plus a bunch of tother stuff that aggressively accelerates healing)

25
TGF-B
Transforming Growth Factor Beta
26
What does TGF-B do?
``` Also strongly mitogenic Allows damaged (irradiated, corticosteroid-treated) tissues to revert to normalized collagen deposition ```
27
What do attracted neutrophils and macrophages release?
A host of other healing factors
28
Are granulocytes (neutrophils) good?
Good/bad/indifferent
29
Where are cells expressing CD34 protein concentrated?
IN the mononuclear layer of platelet concentrate
30
What are CD34 proteins?
Cells are stem cell "markers" and are important for other cells' adhesion/chemotaxis
31
What are CD34 proteins?
Cells are stem cell "markers" and are important for other cells' adhesion/chemotaxis
32
What is the source of TGF-B?
Platelets, extracellular matrix of bone, cartilage matrix, activated TH1 cells and natural killer cells, macrophages/monocytes and neutrophils
33
What does TGF-B do?
``` Also strongly mitogenic Allows damaged (irradiated, corticosteroid-treated) tissues to revert to normalized collagen deposition ``` Mesenchymal cell proliferation Regulates endothelial, firboblastic and osteoblastic mitogenesis Regulates collagen syntehsis
34
What is the source of TGF-B?
Platelets, extracellular matrix of bone, cartilage matrix, activated TH1 cells and natural killer cells, macrophages/monocytes and neutrophils
35
What is the source of Basic Fibroblast Growth Factor?
Platelets, macrophages, mesenchymal cells, chondrocytes, osteoblasts
36
PRP
Components of whole blood remaining after the removal of most of the red cells; buffy coat
37
Buffy coat layer
white cells and platelets
38
PPP
plasma layer without the buffy coat; so you get lots of fibrinogen and coagulation factors but no cells
39
Platelet Concentrate
Essentially the buffy coat +/- a small (variable ) amount of plasma Buffy coat = leukocytes + plts Leukocytes = neutrophils, eosinophils, basophils, macrophages, B and T lymphocytes
40
Platelet Gel
Platelet concentrate with enough fibrinogen (2-4 mg/ml) to set up when combined with an activator
41
What is the activator in plt gel?
Thrombin (bovine or human) Clacium (usually ClC2) or collagen Platelets 2-6x over baseline
42
What are the two theories for how many plts you need?
1. Increase in multiples above baseline (2-6 x baseline) | 2. Absolute numeric concentration (Typically > 1,000,000/ul
43
What happens when platelets above 6x baseline?
Delays healing; possible up regulation of other tissues to factors in the presence of thrombocytopenia
44
Platelet gel is used in promoting healing in all tissues except what?
Nervous tissue
45
Platelet Gel Contraindications
``` Severe hypovolemia Unstable angine/LM disease Heparin therapy Post-incisional harvest THrombocytopenia ( ```
46
Where should you NEVER apply plt gel?
Coronary grafts
47
How many platelets in a "unit" of whole blood?
(Platelets/ul) x 1000 x (ml of whole blood)
48
How many platelets in a "unit" of PRP?
(Platelets/ul) x 1000 x (ml of PRP)
49
What is the percent yield of platelets in PRP?
(# platelets in PRP x 100) / (#platelets in whole blood)
50
What are the two fields of stem cell therapy?
``` Bone marrow (mesenchymal) derived Adipose derived ```
51
Mesenchymal Stem Cells
Generally found in the bone marrow but can be isolated from circulating blood, cord blood, fallopian tubes, and fetal tissue High capacity for pluropotentiality High capacity for self renewal
52
Adipose- Derived Stem Cells
Also a source of multipotential stem cells >500x more stem cells in 1 gram of fat as compared to 1 gram of bone marrow Have similar ability to differentiate as does BM derived Can be extracted without antesthesia/seditive Avoids fetal stem cell discussion
53
Stem cells are attracted and stimulated by what?
Activated platelets and the "factors" those platelets produce
54
Adipose-Derived Stem Cell Extraction Systems
1. Remove lipids 2. Remove supernatant (saline, phenylephrine, lidocaine) 3. Concentrate the adipose stem cells 4. Maintain stromal vascular fraction (SVF) which creates a wgood microenvirnment to help promote graft retension 5. allow stem cell extract to be mixed asome ratio with platelet concentrate in an aerobic environment
55
SVF
stromal vascular fraction (SVF)

CV Perf Tech III (16 decks)

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