PREFINAL LECTURE L1: PLATELET PRODUCTION, STRUCTURE AND FUCNTION Flashcards

1
Q

T or F:
Platelets are nucleated blood cells

A

F
They are non-nucleated

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2
Q

Average platelet count

A

150-400 x10^9/L

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3
Q

T or F:
Platelets count is slightly higher in women than in men

A

T

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4
Q

Platelet count is slightly lower in both sexes who are older than how many years of age

A

65 years

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5
Q

When does platelet trigger primary hemostasis

A

Upon exposure to sub-endothelial collagen or endothelial cell inflammatory proteins

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6
Q

Platelets arise from what bone marrow cells

A

Megakaryocytes

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7
Q

Largest bone marrow blood cells

A

Megakaryocytes

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8
Q

What do you call the characteristic of megakaryocytes wherein they posses multiple chromosome copies

A

Polyploid

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9
Q

Size of megakaryocytes

A

30-50 um in diameter

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10
Q

Observable morphology of megakaryocytes under Wright stain

A

Multilobulated nucleus, and abundant granular cytoplasm

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11
Q

Megakaryocytes account for how many percent of all bone marrow cells

A

Less than 0.5%

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12
Q

How many megakaryocytes on a normal Wright stained bone marrow aspirate smear may be identified

A

2-4 megakaryocytes per 10x LPF

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13
Q

A specialized microenvironment near blood vessels (especially venous sinusoids) where stem cells and other cells interact.

A

vascular niche

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14
Q

wide, thin-walled blood vessels in the bone marrow that help with blood cell movement into the bloodstream.

A

venous sinusoids

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15
Q

What causes megakaryocytes and HSCs to cluster in vascular niches?

A

cytokines from stromal cells

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16
Q

growth factor that recruits megakaryocyte progenitors

A

thrombopoietin (TPO)

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17
Q

megakaryocyte progenitors are recruited from

A

common myeloid progenitors

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18
Q

T or F:
Megakaryocytes can only be found in the bone marrow

A

F
can also be found in the lungs

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19
Q

megakaryocyte progenitors arise from the common myeloid progenitor under the influence of what transcription gene product

A

GATA-1

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20
Q

GATA-1 stands for

A

globin transcription factor-1

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21
Q

GATA-1 is a protein product of what gene

A

X chromosome gene GATA1

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22
Q

GATA-1 is regulated by what cofactor

A

FOG1

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23
Q

FOG1 stands for

A

friend of GATA

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24
Q

FOG1 is a product of what gene

A

zinc finger protein multitype 1 (ZFPM1) gene

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25
Q

megakaryocyte differentiation is suppressed by what transcription gene product

A

MYB

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26
Q

purpose of GATA-1 and MYB

A

balance megakaryocytopoiesis with erythropoiesis

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27
Q

how many megakaryocyte lineage-committed progenitor stages are there

A

3

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28
Q

enumerate the stages in order of differentiation

A

1) burst-forming unit (BFU-Meg)
2) colony-forming unit (CFU-Meg)
3) light density CFU (LD-CFU-Meg)

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29
Q

all three progenitor stages resemble what cell

A

lymphocytes

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30
Q

T or F:
the three progenitor stages can be distinguished by Wright-stained light microscopy

A

F

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31
Q

progenitor stage/s that are diploid and undergo normal mitosis

A

1) BFU-Meg
2) CFU-Meg

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32
Q

how many colonies can BFU-Meg form in culture

A

hundreds

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33
Q

how many colonies can CFU-Meg form in culture

A

dozens

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34
Q

progenitor stage/s that undergo endomitosis

A

LD-CFU-Meg

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35
Q

what makes endomitosis unique to megakaryocytes

A

DNA replication and cytoplasmic maturation are normal but cells lose their capacity to divide

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36
Q

3 factors that stimulate megakaryocyte formation from hematopoietic stem cells

A

1) TPO
2) Meg-CSF
3) IL-3

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37
Q

endomitosis is a form of mitosis that lacks what cell division processes

A

telophase and cytokinesis

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38
Q

what happens in cytokinesis

A

separation into daughter cells

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39
Q

As GATA-1 and FOG1-driven transcription slows, what transcription factor mediates the switch from mitosis to endomitosis

A

RUNX1

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40
Q

how does RUNX1 mediates the switch from mitosis to endomitosis

A

by suppressing the Rho/ROCK signaling pathway

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41
Q

what happens in reduced Rho/ROCK signal

A

actin and myosin levels will be inadequate

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42
Q

what happens if actin and myosin levels are inadequate

A

cytokinesis will fail

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43
Q

what transcription factor promotes DNA replication without cell division (endomitosis)

A

NF-E2

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44
Q

What does it mean for a cell to be polyploid (e.g., 8N, 16N, 32N)?

A

A polyploid cell has multiple complete sets of chromosomes

For example, 8N means the cell has four times the normal 2N DNA content

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45
Q

what does 128N indicate

A

this level of ploidy is unusual, and may signal hematologic disease

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46
Q

T or F:
some megakaryocytes reach 128N

A

T

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47
Q

purpose of employing multiple DNA copies of megakaryocytes

A

to synthesize abundant cytoplasm

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48
Q

phase in which microscopists become able to recognize the unique Wright-stained morphology of megakaryocytes

A

terminal differentiation

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49
Q

least differentiated megakaryocyte precursor

A

MK-1 stage

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50
Q

MK-1 is aka

A

megakaryoblast

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51
Q

T or F:
megakaryoblast look like lymphocytes

A

F
they no longer do

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52
Q

megakaryoblasts are not reliably distinguishable with what cells

A

bone marrow myeloblasts

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53
Q

Vague clues that help distinguish megakaryoblasts

A

1) plasma membrane blebs
2) blunt projections from the margin

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54
Q

the megakaryoblast begins to develop most of what cytoplasmic ultrastructures

A

1) procoagulant-laden-α-granules
2) dense granules
3) demarcation system (DMS)

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55
Q

series of membrane-lined channels that invade from the plasma membrane and grown inward to subdivide the entire cytoplasm

A

DMS

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56
Q

DMS is biologically identical to what

A

megakaryocyte’s plasma membrane

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57
Q

what does DMS do during thrombocytopoiesis

A

delineates the individual platelets

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58
Q

developmental stage of megakaryocyte where the nucleus begins to indent and the cell has 4N DNA content

A

MK-II stage

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59
Q

MK-II is aka

A

promegakaryocyte

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60
Q

when does the promegakaryocyte reaches its full ploidy level

A

by the end of MK-II stage

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61
Q

most abundant megakaryocyte stage

A

MK-III

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62
Q

MK-III is aka

A

megakaryocyte

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63
Q

describe the morphology of megakaryocytes (nucleus, chromatin, cytoplasm)

A

1) nucleus is intensely dented/lobulated
2) variably condensed chromatin with light and dark patches
3) azurophilic and granular cytoplasm

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64
Q

platelet shedding is aka

A

thrombocytopoiesis

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65
Q

what makes megakaryocytes “platelet-like”

A

because of the spread of the DMS and α-granules

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66
Q

during thrombocytopoiesis, a single megakaryocyte may shed how many platelets

A

2000-4000 platelets

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67
Q

in an average size healthy human there are how many megakaryocytes, producing how many platelets per day

A

10 megakaryocytes producing 10 platelets per day

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68
Q

total platelet population turn over

A

8 to 9 days

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69
Q

at what instances where platelet production may rise by as much as tenfold

A

increased platelet consumption e.g. immune thrombocytopenic purpura

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70
Q

evidence of platelet budding or shedding in megakaryocyte cultures

A

1) DMS dilates
2) longitudinal bundles of tubules form
3) proplatelet process develop
4) transverse constrictions appear throughout the proplatelet process

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71
Q

how does proplatelet process shed platelets

A

they pierce through or between sinusoid-lining endothelial cells and extend to the venous blood

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72
Q

thrombocytopoiesis leaves behind naked megakaryocyte nuclei to be consumed by

A

marrow macrophages

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73
Q

what methods are used to identify visually indistinguishable megakaryocyte progenitors in hematologic disease

A

1) immunostaining of fixed tissue
2) flow cytometry with immunologic probes
3) FISH with genetic probes

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74
Q

what are the megakaryocyte membrane markers

A

1) MPL
2) CD34
3) CD41
4) CD61
5) CD36
6) CD42
7) CD62

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75
Q

MPL stands for

A

myeloproliferative leukemia protein

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76
Q

what is MPL

A

TPO receptor site

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77
Q

T or F:
MPL is present at all maturation stages

A

T

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78
Q

CD34 is aka

A

stem cell and myeloid progenitor marker

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79
Q

T or F:
CD34 disappears as differentiation proceeds

A

T

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80
Q

marker that first appears in megakaryocyte progenitors

A

CD41/CD61

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81
Q

CD41/CD61 is aka

A

glycoprotein (GP) IIb/IIIa

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82
Q

T or F:
CD41/CD61 remains present throughout maturation

A

T

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83
Q

proteins that may be detected in the fully developed megakaryocyte

A

1) cytoplasmic coagulation factor VIII
2) VWF
3) fibrinogen

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84
Q

weight of TPO

A

70,000 Dalton

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85
Q

TPO possesses how many percent homology with erythropoietin

A

23%

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86
Q

mRNA for TPO has been found in what organs

A

kidney, liver, stromal cells, and smooth muscle cells

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87
Q

primary source of TPO

A

liver

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88
Q

T or F:
TPO is a hormone

A

T
circulates as a hormone in the plasma

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89
Q

aside from being a hormone, TPO is also a

A

ligand

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90
Q

how does TPO function as a ligand

A

binds the megakaryocyte and MPL

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91
Q

define v-mpl

A

viral oncogene associated with murine myeloproliferative leukemia

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92
Q

T or F:
The plasma concentration of TPO is directly proportional to platelet and megakaryocyte mass

A

F
inversely proportional

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93
Q

induces thrombocytopoiesis

A

TPO

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94
Q

elevate the platelet count in patients being treated for a variety of cancers, including acute leukemia

A

Synthetic TPO mimetics (analogs)

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95
Q

a non immunogenic oligopeptide that raises the platelet count in patients with chronic immune thrombocytopenic purpura (ITP)

A

romiplostim (Nplate, Amgen)

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96
Q

nonpeptide TPO mimetic that binds an MPL site separate from romiplostim and is used in the treatment of chronic ITP and patients with thrombocytopenia resulting from chronic hepatitis C or severe aplastic anemia

A

eltrombopag (Promacta, Novartis)

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97
Q

cytokines that function with TPO to stimulate megakaryocytopoiesis

A

IL-3
IL-6
IL-11

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98
Q

interleukin that acts in synergy with TPO to induce early differentiation of stem cells

A

IL-3

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99
Q

interleukins that act in presence of TPO to enhance endomitosis, megakaryocyte maturation, and thrombocytopoiesis

A

IL-6
IL-11

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100
Q

IL-11 mimetic that stimulates platelet production in patients with chemotherapy-induced thrombocytopenia

A

oprelvekin (Neumega, Pfizer)

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101
Q

cytokines and hormones that participate with TPO and interleukins

A

1) stem cell factor
2) GM-CSF
3) G-CSF
4) acetylcholinesterase-derived megakaryocyte growth stimulating peptide

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102
Q

stem cell factor is aka

A

kit ligand, mast cell factor

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103
Q

factors that inhibit in vitro megakaryocyte growth

A

1) Platelet factor 4 (PF4)
2) B-thromboglobulin
3) neutrophil-activating peptide 2
4) IL-8

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104
Q

reduction of these transcription factors diminish megakaryocytpoiesis at the progenitor, endomitotic, and terminal maturation phases

A

1) FOG1
2) GATA-1
3) NF-E2

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105
Q

platelets are distributed throughout the RBC monolayer at (value)

A

7-21 cells per 100 x field

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105
Q

size of platelets

A

2.5 um in diameter

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106
Q

the mean platelet volume is measured in

A

buffered isotonic suspension

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107
Q

normal MPV

A

8-10 fL

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108
Q

shape of circulating resting platelet

A

biconvex

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109
Q

shape of platelets in EDTA blood

A

round-up

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110
Q

average platelet count of men over 65

A

122-350 x 10^9/L

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111
Q

average platelet count of women over 65

A

140-379 x 10^9/L

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112
Q

proportion of platelets sequestered within the spleen

A

one third

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113
Q

appear in compensation for thrombocytopenia

A

reticulated platelets

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114
Q

reticulated platelets are aka

A

stress platelets

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115
Q

size of reticulated platelets

A

> 6 um

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116
Q

MPV of reticulated platelets

A

12-14 fL

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117
Q

shape of reticulated platelets in citrated tubes

A

cylindrical and beaded

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118
Q

how can platelet dense granule nucleotides interfere with the quantitative evaluation of reticulated platelet production

A

falsely raising by binding nucleic acid dyes

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119
Q

T or F:
reticulated platelets are potentially prothrombic

A

T

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120
Q

neutral phospholipids of plt plasma membrane that predominate the outer blood plasma layer

A

phosphatidylcholine
sphyngomyelin

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121
Q

anionic or polar phospholipids that predominate in the inner, cytoplasmic layer

A

phosphatidylinositol
phosphatidylethanolamine
phosphatidylserine

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122
Q

how can phosphatidylinositol support platelet activation

A

by supplying arachidonic acid

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123
Q

arachidonic acid becomes converted to

A

thromboxane A2

124
Q

cellular and humoral stimuli that activates receptors

A

ligands or agonists

125
Q

platelet membrane surface

A

glycocalyx

126
Q

glycocalyx absorbs what substances

A

albumin, fibrinogen and other plasma proteins

127
Q

glycocalyx absorbs plasma proteins and transports them to internal storage organelles with the use of what process

A

endocytosis

128
Q

formed when the plasma membrane invades the platelet interior

A

surface-connected canalicular system (SCCS)

129
Q

upon platelet activation, the SCCS is the route for

A

endocytosis and secretion of a-granule contents

130
Q

condensed remnant of the rough endoplasmic reticulum

A

dense tubular system (DTS)

131
Q

the DTS sequesters what molecules and enzymes that support platelet activation

A

1) calcium
2) phospholipase A2
3) cyclooxygenase
4) thromboxane A2
5) phospholipase C
6) inositol triphosphate (IP3)
7) diacylglycerol (DAG)

132
Q

which enzyme/s support the production of thromboxane A2

A

1) PLA2
2) COX-1/2
3) thromboxane synthetase

133
Q

which enzyme/s support the production of IP3 and DAG

A

phospholipase C

134
Q

what maintains the platelet’s discoid shape

A

circumferential microtubules

135
Q

tubules disassemble at refrigerator temp or when platelets are treated with

A

colchicine

136
Q

shape of platelets when the tubules disassemble

137
Q

platelets shape at 37C

A

disc shape

138
Q

meshwork composed of actin

A

microfilaments

139
Q

function of actin

A

contractile in platelets and anchors the plasma membrane glycoproteins and proteoglycans

140
Q

actin appearance in the resting platelet

A

globular and amorphous

141
Q

actin appearance when the cytoplasmic calcium concentration rises

A

filamentous and contractile

142
Q

the cytoplasm contains intermediate filaments of

A

desmin and vimentin

143
Q

how does the intermediate filaments contribute in maintaining the platelet shape

A

connect actin and the tubules

144
Q

what control the plt shape change, extension of pseudopods, and secretion of granule contents

A

1) microtubules
2) actin microfilaments
3) intermediate microfilaments

145
Q

dense granules and α-granules share some of the same key membrane proteins, such as:

A

P-selectin
αIIbβ3 (aka GPIIb/IIIa)
GPIb/IX/V complex

146
Q

there are how many a-granules in each platelet

147
Q

color of a-granules in osmium-dye transmission electron microscopy preparations

A

medium gray

148
Q

a-granules contain what substances

149
Q

as the platelet becomes activated, a-granule membranes fuse with

150
Q

what happens to a-granules during platelet activation

A

flow to the microenvironment and participate in plt adhesion and aggregation and support plasma coagulation

151
Q

how many dense granules per platelet

152
Q

T or F:
dense granules appear later than a-granules in megakaryocyte differentiation

153
Q

color of dense granules under osmium

A

black (opaque)

154
Q

what happens to dense-granules during platelet activation

A

migrate to the plasma membrane and release their contents directly into the plasma on platelet activation

155
Q

aside from proteins, platelets also contain what substance similar to neutrophils

156
Q

what are the platelet dense granules

A

1) calcium and magnesium
2) ATP
3) ADP
4) serotonin

157
Q

property of ADP

A

supports neighboring platelet aggregation by binding to P2Y1 and P2Y12 ADP receptors

158
Q

property of serotonin

A

vasoconstrictor that binds endothelial cells and platelet membrane

159
Q

property of calcium and magnesium

A

support platelet activation and coagulation

160
Q

platelet membrane contains what receptors

A

1) Cell adhesion molecule (CAM) integrin family
2) seven-transmembrane receptor family
3) miscellaneous receptors

161
Q

purpose of integrins

A

allows platelet to adhere to the injured blood vessel lining by binding collagen

162
Q

what does integrin being heterodimeric mean

A

it composed of two dissimilar proteins

163
Q

an integrin that binds the subendothelial collagen that becomes exposed in the damaged blood vessel wall

164
Q

Which integrin binds to laminin?

165
Q

which integrin binds to fibronectin

166
Q

What platelet receptors promote adhesion by binding to endothelial proteins?

A

α5β1 and α6β1

167
Q

It binds to collagen and the adhesive protein thrombospondin.

168
Q

What is GP Ib/IX/V composed of?

A

-Two GP Ibα
-two GP Ibβ
-two GP IX
-one GP V subunit

169
Q

What is the function of GP Ib/IX/V under high shear conditions?

A

binds to von Willebrand factor (vWF), and support platelet tethering for capillaries and arterioles

170
Q

What is the role of GP Ibβ in platelet signaling?

A

interacts with actin-binding protein, enabling “outside-in” signaling

171
Q

What do GP IX and GP V contribute to the GP Ib/IX/V complex?

A

help assemble the four GP Ib molecules

172
Q

Where are the integrin αIIbβ3 (GP IIb/IIIa) found in resting platelets?

A

1) plasma membrane
2) SCCS
3) a-granule membranes

173
Q

What activates the integrin αIIbβ3 to bind fibrinogen?

A

Inside-out signaling triggered by agonist

174
Q

Why is αIIbβ3 essential in platelet aggregation?

A

It binds fibrinogen, forming bridges between platelets, leading to aggregation.

175
Q

Besides fibrinogen, which proteins bind to αIIbβ3

A

vWF, vitronectin, and fibronectin

176
Q

amino acid sequence of the adhesive proteins as well as fibrinogen

A

arginine-glycine-aspartate (RGD)

177
Q

what are the agonists for seven-transmembrane repeat receptors (STRs)

A

1) Thrombin
2) Thrombin receptor activation peptide (TRAP)
3) adenosine diphosphate (ADP)
4) epinephrine
5) serotonin
6) thromboxane A2

178
Q

STR of thrombin

A

PAR1 and PAR4

179
Q

STR of ADP

A

P2Y1 and P2Y12

180
Q

STR of TXA2

A

TPa and TPb

181
Q

STR of epinephrine

A

a2-adrenergic

182
Q

STR of prostacyclin

183
Q

effect of P2Y1 signaling

A

-increase in intracellular Ca levels
-contributes to initial platelet activation
-shape change
-formation of small REVERSIBLE aggregates

184
Q

effect of P2Y12 signaling

A

-decrease in cyclic adenosine monophosphate (cAMP) levels
-formation of IRREVERSIBLE platelet aggregates

185
Q

what happens during binding of TPa and TPb to TXA2

A

produce more TXA2 from the platelet that activates neighboring platelets (recruiting)

186
Q

what happens during binding of epinephrine and a2-adrenergic receptor

A

-inhibits adenylate cyclase
-reduction in cAMP

187
Q

prostacyclin is a prostaglandin produced by what cells

A

endothelial cells

188
Q

what happens during binding of prostacyclin with IP receptor

A

-increase cAMP
-inhibition of platelet activation

189
Q

IP means

A

inositol phosphate

190
Q

what are the intercellular adhesion molecules (ICAMs)

A

CD50
CD54
CD102

191
Q

ICAMs function

A

play a role in inflammation and immune reaction

192
Q

what mediates platelet-to-white- blood cell and platelet-to-endothelial cell adhesion

A

platelet-endothelial cell adhesion molecule (PECAM)

193
Q

marker of PECAM

194
Q

a low affinity receptor for the immunoglobulin Fc portion that plays a role in heparin-induced thrombocytopenia

195
Q

marker for FcyIIA

196
Q

integrin that facilitates platelet binding to endothelial cells, leukocytes

A

P-selectin

197
Q

marker for P-selectin

198
Q

where is CD62 found

A

a-granule membranes of the resting platelet

199
Q

where does CD62 migrate

A

via SCCS to the surface of activated platelets

200
Q

common means for measuring in vivo platelet activation

A

P-selectin quantification thru flow cytometry

201
Q

T or F:
platelet adhesion, aggregation and secretion often occur simultaneously

202
Q

what is shear force

A

stress created in vessel walls as blood flows

203
Q

shear force in venules and veins

204
Q

shear force in arterioles and capillaries

205
Q

shear force in stenosed arteries

A

up to 40,000 s-1

206
Q

in shear force that exceed 1000 s-1, platelet adhesion and aggregation require as define sequence of events which involves what key players

A

1) collagen
2) tissue factor
3) phospholipid
4) VWF
5) CAMS, ligands, activators

207
Q

what happens when blood vessel wall is injured

A
  1. disrupts the collagen of the ECM
  2. damaged endothelial cells release vwf and adhere to sites of injury
208
Q

molecular weight of vwf

A

500,000 to 20,000,000 Daltons

209
Q

what happens to WVF under shear stress

A

It becomes thread-like and unrolls, exposing sites for weak binding to GP Ibα.

210
Q

Which platelet receptor component binds to VWF during shear stress?

A

GP Ibα, a part of the GP Ib/IX/V complex.

211
Q

What is the function of the reversible binding between VWF and GP Ibα?

A

It tethers and decelerates the platelet’s forward motion.

212
Q

Which enzyme regulates the interaction between VWF and platelets?

213
Q

ADAMTS13 is aka

A

VWF-cleaving protease

214
Q

What does ADAMTS13 do to VWF?

A

cleaves large VWF multimers into smaller, less active forms

215
Q

secretes ADAMTS13

216
Q

what disrupts the temporary VWF-GPIba tethering reaction

A

GPVI comes in contact with the exposed ECM collagen

217
Q

What happens when type I fibrillar collagen binds to GP VI on the platelet?

A

triggers internal platelet activation pathways, releasing TXA2 and ADP in an “outside-in” reaction

218
Q

receptors involved in the “outside-in” reaction

A

TPa and TPb for TXA2
P2Y1 and P2Y12 for ADP

219
Q

What does the “inside-out” reaction triggered by TXA2 and ADP lead to?

A

raises the affinity of integrin α2β1 for collagen

220
Q

What is the combined effect of GP Ib/IX/V, GP VI, and α2β1 integrin on the platelet?

A

platelet become firmly affixed to the damaged surface

221
Q

What happens to the platelet after it is firmly affixed to the damaged surface?

A

It loses its discoid shape and spreads.

222
Q

What is exposed on the blood vessel wall after injury, in addition to collagen and VWF?

A

Tissue factor

223
Q

tissue factor is from

A

subendothelial smooth muscle cells and fibroblasts

224
Q

tissue factor triggers the production of

225
Q

How does thrombin activate platelets?

A

it cleaves PAR1 and PAR4

226
Q

the further activation caused by thrombin generates what

A

collagen and thrombin activated (COAT) platelet

227
Q

role of TXA2 and ADP in platelet activation

A

activate neighboring platelets, triggering inside-out activation of integrin αIIbβ3

228
Q

What does the inside-out activation of integrin αIIbβ3 enable?

A

enables integrin αIIbβ3 to bind RGD sequences of fibrinogen and VWF

229
Q

What does P-selectin from the α-granule membranes promote?

A

promotes the binding of platelets with leukocytes

230
Q

What happens to platelets upon further activation and aggregation in terms of its shape

A

discoid to round, form pseudopods

231
Q

Why do platelets form a syncytium during aggregation?

A

Because platelets exhaust their internal energy sources and membrane integrity is lost

232
Q

what occurs during lost of membrane integrity of platelets during aggregation

A

phosphatidylserine flip to the outer layer

233
Q

what is synyctium

A

massive clump of platelets

234
Q

in primary hemostasis, arteries may end with the formation of what

A

white clot

235
Q

white clot is primarily composed of

A

plt and vwf

236
Q

what does white clot indicate (pathologic)

A

inappropriate plt activation ; pathologic basis for arterial thrombotic events

237
Q

examples of arterial thrombotic events

A

1) AMI
2) peripheral artery dse
3) ischemic stroke

238
Q

why does avidity of a2b1 and GPVI receptors increase risk of cardiovascular events

A

high avidity-> more binding sites for collagen and vwf-> inc plt adhesion/aggregation-> inc risk of abnormal clotting

239
Q

secondary hemostasis is

A

coagulation

240
Q

What combination of factors triggers secondary hemostasis

A

1) polar phospholipid exposure on activated plt
2) plt fragmentation with cellular microparticle release
3) secretion of a-granules and dense granules

241
Q

primary hemostasis: white clot; secondary hemostasis: ?

242
Q

red clot is composed of

A

fibrin and rbcs

243
Q

role of red clot

A

essential in wound repair

244
Q

white clot: inappropriate coagulation in arteries; red clot: ?

A

inappropriate coagulation in veins and venules

245
Q

pathologic indications of red clot

A

deep vein thrombosis and pulmonary embolism

246
Q

triggers the actin microfilament contraction in platelets

A

-outside in activation of plt through STR (ADP+P2Y12)
-GPVI

247
Q

what happens when intermediate filaments contract

A

moves the circumferential microtubules inward-> compressing the granules

248
Q

Where do the contents of the a-granules and lysosomes flow after platelet activation?

249
Q

Where does dense granules migrate and secrete their contents

A

plasma membrane

250
Q

dense granules secrete

A

vasoconstrictors and platelet agonists

251
Q

what does vasoconstrictors and platelet agonists do

A

amplify primary hemostasis

252
Q

role of a-granule contents in platelet activation

A

large molecule coagulation proteins that participate in secondary hemostasis

253
Q

How do platelets support coagulation at the cellular level?

A

by presenting phosphatidylserine, where complexes assemble

254
Q

what complexes assemble at the phosphatidylserine

A

factor IX/VIII (tenase) and factor X/V (prothrombinase) complexes

255
Q

role of calcium in platelet-mediated coagulation

A

secreted by dense granules, helps form tenase and prothrombinase complexes.

256
Q

contents of a-granules

A

1) fibrinogen
2) factor V
3) factor VIII
4) VWF

257
Q

role of a-granules

A

supports the action of tenase and prothrombinase

258
Q

all a-granule proteins

A

1) platelet-derived growth factor
2) endothelial growth factor
3) transforming growth factor B
4) fibronectin
5) thrombospondin
6) platelet factor 4
7) B-thromboglobulin
8) plasminogen
9) plasminogen activator inhibitor-1
10) a2-Antiplasmin
11) protein C inhibitor

259
Q

a-granule protein:
supports mitosis of fibroblasts and smooth muscle cells

A

1) platelet-derived growth factor
2) endothelial growth factor
3) transforming growth factor-B

260
Q

a-granule protein:
adhesion molecule

A

1) fibronectin
2) thrombospondin

261
Q

a-granule protein:
heparin neutralization, suppresses megakaryocytopoiesis

A

platelet factor 4

262
Q

a-granule protein:
only found in platelet a-granules

A

B-thromboglobulin

263
Q

a-granule protein:
fibrinolysis promotion

A

plasminogen

264
Q

a-granule protein:
fibrinolysis control

A

1) plasminogen activator inhibitor-1
2) a2-Antiplasmin

265
Q

a-granule protein:
coagulation control

A

protein C inhibitor

266
Q

What triggers the formation of platelet microparticles?

A

triggered by an activating stimulus that increases the intracellular calcium concentration in platelets

267
Q

How do elevated calcium levels inside platelets contribute to microparticle formation?

A
  1. inhibits asymmetric distribution of phospholipids
  2. activates enzyme calpain
268
Q

what does caplain do

A

cleaves platelet cytoskeleton

269
Q

inhibition of asymmetric distribution of phospholipids and caplain leads to

A

outward blebbing of the plasma membrane and formation of plt microparticles

270
Q

most abundant microparticles in the circulation

A

plt microparticles

271
Q

plt microparticles are formed after

A

exposure of plt to strong agonists or shear stress

272
Q

How do platelet microparticles influence coagulation?

A

exposing phosphatidylserine on their surface, crucial for the assembly of tenase and prothrombinase

273
Q

other functions of plt microparticles aside coagulation

A

1) modulate inflammation
2) oxidative stress
3) angiogenesis
4) thrombosis

274
Q

elevated plt particles is significant in what conditions

A

hypercoagulable conditions

275
Q

G-proteins are made up of what subunits

A

a, B, y (heterotrimers)

276
Q

What happens to G-proteins when an agonist binds to a receptor?

A

The G-protein releases GDP and binds GTP, activating the G-protein.

277
Q

What does the activated Gα subunit do?

A

briefly separates from the complex (G-protein), acts like an enzyme to hydrolyze GTP to GDP, and triggers signaling pathways

278
Q

What are two major signaling pathways triggered by G-protein activation?

A

Eicosanoid synthesis and the IP3-DAG pathway.

279
Q

how does hydrolysis done by G-protein leads to activation of pathways

A

hydrolysis resulted to phosphorylation

280
Q

eicosanoid synthesis is aka

A

prostaglandin, cyclooxygenase, or thromboxane pathway

281
Q

What enzyme releases arachidonic acid from the membrane?

A

Phospholipase A2

282
Q

5,8,11,14-eicosatetraenoic acid is aka

A

arachidonic acid

283
Q

arachidonic acid is the substrate for

A

cyclooxygenase

284
Q

what does cyclooxygenase do

A

converts arachidonic acid to prostaglandin G2 and prostaglandin H2

285
Q

enzyme that acts on prostaglandin H2 to produce TXA2

A

thromboxane synthetase

286
Q

what happens when TXA2 binds membrane receptors TPa or TPb

A
  1. inhibits adenylate cyclase activity
  2. reducing cAMP concentrations, which mobilizes ionic
    calcium from the DTS
287
Q

what does the rising cytoplasmic calcium level cause

A

contraction of actin microfilaments producing platelet shape change and further platelet activation

288
Q

What enzyme do endothelial cells use in place of thromboxane synthetase in the cyclooxygenase pathway?

A

prostacyclin synthetase

289
Q

end product of the cyclooxygenase pathway in endothelial cells

A

prostaglandin I2 (PGI2)

290
Q

prostaglandin I2 (PGI2) is aka

A

prostacyclin

291
Q

what pathway does prostacyclin+IP receptor binding activate

A

IP3-DAG pathway

292
Q

effect of prostacyclin on adenylate cyclase and cAMP

A

accelerates adenylate cyclase-> increased cAMP

293
Q

prostacyclin effect on intracellular Ca levels

A

causes sequestration of ionic calcium to the dense tubular system (DTS), making calcium unavailable in the cytoplasm

294
Q

what does the unavailability of Ca in the cytoplasm do to platelet function

A

shuts down plt function

295
Q

endothelial cell eicosanoid pathway: suppress platelet activation; platelet eicosanoid pathway:

A

promotes plt activation

296
Q

half-life of TXA2

A

30 seconds

297
Q

TXA2 diffuses from the platelet and reduced to

A

thromboxane B2

298
Q

What stable metabolite of thromboxane B2 is measurable in urine?

A

11-dehydrothromboxane B2

299
Q

enzyme that initiates the IP3-DAG pathway in platelets

A

phospholipase C

300
Q

What does phospholipase C do in the IP3-DAG pathway?

A

cleaves PIP2 to IP3 and DAG

301
Q

function of IP3 in plt activation

A

releases calcium from the dense tubular system (DTS)

302
Q

the release of Ca by IP3 causes what

A

actin microfilament contraction; activation of phospholipase A2

303
Q

function of DAG in the IP3-DAG pathway

A

activates phosphokinase C

304
Q

activation of phosphokinase C by DAG triggers the phosphorylation of what protein

A

pleckstrin

305
Q

what does pleckstrin do

A

regulates actin microfilament contraction

306
Q

Despite lacking nuclei, what allows platelets to synthesize proteins?

A

1) ribosomes
2) polyribosome complexes
3) regulatory factors
4) microRNAs (miRNAs)
5) template mRNAs

307
Q

What triggers protein synthesis in platelets?

A
  1. platelet activation
  2. ligand binding to the GPIIb/IIIa receptor
308
Q

What is the significance of platelet protein synthesis?

A

to alter their phenotype depending on level of activation