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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
Q

TGF-B

A

Transforming Growth Factor Beta

26
Q

What does TGF-B do?

A 
Also strongly mitogenic
Allows damaged (irradiated, corticosteroid-treated) tissues to revert to normalized collagen deposition
27
Q

What do attracted neutrophils and macrophages release?

A

A host of other healing factors

28
Q

Are granulocytes (neutrophils) good?

A

Good/bad/indifferent

29
Q

Where are cells expressing CD34 protein concentrated?

A

IN the mononuclear layer of platelet concentrate

30
Q

What are CD34 proteins?

A

Cells are stem cell “markers” and are important for other cells’ adhesion/chemotaxis

31
Q

What are CD34 proteins?

A

Cells are stem cell “markers” and are important for other cells’ adhesion/chemotaxis

32
Q

What is the source of TGF-B?

A

Platelets, extracellular matrix of bone, cartilage matrix, activated TH1 cells and natural killer cells, macrophages/monocytes and neutrophils

33
Q

What does TGF-B do?

A 
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
Q

What is the source of TGF-B?

A

Platelets, extracellular matrix of bone, cartilage matrix, activated TH1 cells and natural killer cells, macrophages/monocytes and neutrophils

35
Q

What is the source of Basic Fibroblast Growth Factor?

A

Platelets, macrophages, mesenchymal cells, chondrocytes, osteoblasts

36
Q

PRP

A

Components of whole blood remaining after the removal of most of the red cells; buffy coat

37
Q

Buffy coat layer

A

white cells and platelets

38
Q

PPP

A

plasma layer without the buffy coat; so you get lots of fibrinogen and coagulation factors but no cells

39
Q

Platelet Concentrate

A

Essentially the buffy coat +/- a small (variable ) amount of plasma
Buffy coat = leukocytes + plts
Leukocytes = neutrophils, eosinophils, basophils, macrophages, B and T lymphocytes

40
Q

Platelet Gel

A

Platelet concentrate with enough fibrinogen (2-4 mg/ml) to set up when combined with an activator

41
Q

What is the activator in plt gel?

A

Thrombin (bovine or human)
Clacium (usually ClC2) or collagen
Platelets 2-6x over baseline

42
Q

What are the two theories for how many plts you need?

A
  1. Increase in multiples above baseline (2-6 x baseline)

2. Absolute numeric concentration (Typically > 1,000,000/ul

43
Q

What happens when platelets above 6x baseline?

A

Delays healing; possible up regulation of other tissues to factors in the presence of thrombocytopenia

44
Q

Platelet gel is used in promoting healing in all tissues except what?

A

Nervous tissue

45
Q

Platelet Gel Contraindications

A 
Severe hypovolemia
Unstable angine/LM disease
Heparin therapy
Post-incisional harvest
THrombocytopenia (
46
Q

Where should you NEVER apply plt gel?

A

Coronary grafts

47
Q

How many platelets in a “unit” of whole blood?

A

(Platelets/ul) x 1000 x (ml of whole blood)

48
Q

How many platelets in a “unit” of PRP?

A

(Platelets/ul) x 1000 x (ml of PRP)

49
Q

What is the percent yield of platelets in PRP?

A

(# platelets in PRP x 100) / (#platelets in whole blood)

50
Q

What are the two fields of stem cell therapy?

A 
Bone marrow (mesenchymal) derived
Adipose derived
51
Q

Mesenchymal Stem Cells

A

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
Q

Adipose- Derived Stem Cells

A

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
Q

Stem cells are attracted and stimulated by what?

A

Activated platelets and the “factors” those platelets produce

54
Q

Adipose-Derived Stem Cell Extraction Systems

A
  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
Q

SVF

A

stromal vascular fraction (SVF)

CV Perf Tech III (16 decks)

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