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FCA(SA) Primaries > Haematology > Flashcards

Haematology Flashcards

(94 cards)

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1
Q

Factor 1

A

Fibrinogen

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2
Q

Factor 2

A

Prothrombin

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3
Q

Factor 3

A

Tissue factor
Thromboplastin

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4
Q

Factor 4

A

Calcium

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5
Q

Factor 5

A

Pro-accelarin
Labile factor
Ac-globulin

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6
Q

Factor 6

A

No longer exists!

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7
Q

Factor 7

A

Pro-convertin
Stable factor
Serum prothrombin conversion factor

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8
Q

Factor 8

A

Factor A
Anti-haemophilic factor A

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9
Q

Factor 9

A

Factor B
Anti-haemophilic factor B
Christmas factor
Plasma thromboplastin component

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10
Q

Factor 10

A

Stuart-Power factor

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11
Q

Factor 11

A

Plasma prothrombin antecedent

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12
Q

Factor 12

A

Hageman factor

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13
Q

Factor 13

A

Fibrin stabilising factor

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14
Q

What events lead to haemostasis

A
  1. vascular constriction
  2. platelet plug formation
  3. blood clot formation
  4. fibrous organisation
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15
Q

In haemostasis, what causes smooth muscle contraction

A
  1. local myogenic spasm (largest contributor)
  2. local autocoid factors
  3. nervous reflexes from pain and other sensory impulses
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16
Q

What are autocoids,
and where are they released from

A

Biological factors that act like hormones,
are of brief duration,
act near the site of synthesis.

Released from
Traumatised tissues
vascular endothelium
platelets

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17
Q

Components of the platelet membrane surface

A

glycoproteins (vWF, Gp1b receptor)
phospholipids

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18
Q

Half-life of platelets

A

8-12 days

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19
Q

Contractile proteins found in platelets

A

actin
myosin
thrombosthenin

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20
Q

Components of platelets

A
  1. contractile elements
  2. residual endoplasmic reticulum and golgi bodies
  3. mitochondria
  4. enzyme systems
  5. fibrin stabilising factor (factor 13)
  6. growth factor
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21
Q

Elimination of platelets

A

macrophage system
macrophages of spleen

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22
Q

Steps of platelet plug formation

A
  1. SHAPE CHANGE after exposure to collagen - platelet develops pseudo-pods and become sticky
  2. SECRETION: platelets contract to release granules containing thromboxane A2
  3. AGGREGATION: platelets now stick together, pseudopods bind to vWF/factor
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23
Q

Common goal of both intrinsic and extrinsic clotting cascades

A

Conversion of prothrombin/2 to thrombin via prothrombin activator, after which fibrinogen/1 is converted to fibrin,
allowing for clot formation and stabilisation

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24
Q

Which factors are involved in the extrinsic cascade

A
  1. fibrinogen
  2. prothrombin
  3. tissue factor
  4. calcium
  5. pro-accelarin globulin
  6. proconvertin
  7. Stuart Prower factor
  8. fibrin-stabilising factor
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25
Which factor is only in the extrinsic pathway, not the intrinsic
factor 7/proconvertin
26
Which factors are involved in the intrinsic cascade
1. fibrinogen 2. prothrombin 4. calcium 5. pro-accelarin globulin 8. anti-haemophilic A 9. anti-haemophilic B 10. Stuart-Prower 11. plasma prothrombin antecedent 12. Hageman factor 13. fibrin-stabilising factor
27
Which factors are ONLY involved in the intrinsic pathway
8. anti-haemophilia A 9. anti-haemophilia B 11. plasma-prothrombin antecedent 12. Hageman factor
28
Which factors are NOT involved in the intrinsic cascade
3. tissue factor 7. pro-convertin
29
Which factors are NOT involved in the extrinsic cascade
8. anti-haemophilic A 9. anti-haemophilic B 11. plasma-prothrombin antecedent 12. Hageman factor
30
Which factors are present in both extrinsic and intrinsic pathways
1. fibrinogen 2. prothrombin 4. calcium 5. pro-accelarin globulin 10. Stuart-Prower 13. fibrin-stabilising factor
31
Which factors are vitamin K dependent
2. prothrombin 7. proconvertin 9. anti-haemophilia B 10. Stuart-Prower
32
Platelet diameter
1-4mcg (some say 2-3mcg)
33
Platelet volume
7 x 10^-15 liter
34
Platelet concentration
150,000 - 450,000 / mcL
35
Platelet half-life
8-12 days
36
Platelet lifespan
7-10 days
37
Progenitor of platelets
Pluripotent stem cells
38
Pluripotent stem cells found in
bone marrow
39
True/False: Platelets have a nucleus
False
40
Platelet production from bone marrow takes how long?
10 days
41
This regulates production of platelets
thrombopoietin
42
Platelets are recycled by what, and where
reticuloendothelial systems liver spleen
43
Platelet membrane consists of
double layer phospholipids glycoproteins
44
What is the glycocalyx of platelets, what is its function
Outer layer of glycoproteins of the membrane; important for platelet adhesion and aggregation
45
Platelets: purpose of invaginations/open canalicular systems
absorption by platelets of coagulation proteins
46
What maintains platelet discoid shape
microtubules
47
Platelets: purpose of membranous surface microtubules
contractile protein system
48
Platelets: Dense tubular system, 1. what is it 2. what does it contain 3. what does it (possibly) synthesise
1. residual endoplasmic reticulum 2. calcium, ATPase, adenyl cyclase, acetylcholinesteras, peroxidase, G6P-ase 3. thromboxane A2, prostaglandins
49
Platelets: other/smaller structures
dense bodies alpha-granules lysosymes, peroxisomes
50
Name the platelet glycocalyx glycoproteins and their functions
GP 1a: adhesion to collagen GP 1b: attachment to vWF and subendothelium GP 2b: attachment to vWF and subendothelium; platelet-platelet aggregation (fibrinogen receptor) GP 3a: attachment to vWF and subendothelium; platelet-platelet aggregation (fibrinogen receptor)
51
Platelets: membrane phospholipids important in providing
platelet activating factor platelet factor 3 arachidonic acid
52
Platelets: contents of alpha granules
B-thromboglobulin fibronectin fibrinogen platelet factor 4 PDGF thrombospondin vWF
53
Platelets: contents of DG granules
serotonin ATP ADP pyrophosphate adrenaline
54
What are the consecutive stages of platelet haemostasis
1. adhesion 2. secretion 3. aggregation 4. procoagulant activity
55
True/False: no metabolic activity is required for adhesion of platelets
True (platelets adhere to subendothelial collagen by GP 1a
56
What activates platelets
1. adhesion to proteins 2. cell-contact during aggregation 3. these substances: adrenaline, serotonin, ADP. thrombin
57
What is promoted when platelets are activated
1. secretion/release of substances 2. shape change 3. aggregation
58
What, and in what sequence, is secreted from platelets once adhesion has occurred
first 30 seconds: DG release: serotonin, adrenaline, ADP after 30 seconds: A-granule release: firinogen, B-thromboglobulin, PAF-4, labile factor, vWF, PDGF, throbospondin
59
Role of thromboxane A2 in platelet aggregation
aggregation at the site of vascular injury
60
Role of ADP in platelet aggregation
platelet-platelet adhesion liberates more ADP and thromboxane A2 activates fibrinogen receptors
61
Desmopressin: what class and kind of drug is it
platelet aggregate, synthetic vasopressin analogue
62
True/False: Desmopressin has no vasoconstrictor potential
True
63
How does Desmopressin enhance platelet aggregation
1. increased factor 7 and vWF (by 4-6 tines) 2. increased factors 8 and 12 3. mobilises tPA from endothelial cells
64
True/False: when Desmopressin mobilises tPA, it causes significant thrombolysis
False
65
Desmopressin indications
Platelet dysfunction secondary to uraemia, cirrhosis Aspirin-induced coagulopathy Mild haemophilia or Von Willebrand Disease
66
Vasopressin is also known as:
Antidiuretic hormone/ ADH
67
Where is ADH SYNTHESISED
hypothalamus
68
WHERE IS ADH SECRETED
posterior pituitary
69
Physiological effects of ADH
water reabsorption in the medullary collecting duct; Sodium reabsorption in the cortical collecting duct; Potassium secretion in the cortical collecting duct; reduction in renal blood flow and GFR
70
Desmopressin: dose
3mcg/kg IV over 15 minutes
71
Desmopressin onset
30 minutes
72
Desmopressin peak
90-120 minutes
73
Desmopressin duration
8-10 hours
74
True/False: a repeat dose of desmopressin significantly improves platelet aggregation
False
75
Desmopressin side-effects
hyonatraemia due to prostacyclin release; hypotension due to prostacyclin release; thrombosis
76
What clears or cleaves fibrin and fibrinogen
Plasmin
77
Precursor of plasmin
Plasminogen
78
What kind of molecule is plasminogen
B-globulin
79
Name fibrin degradation products
D-dimers fragments X, Y, D, E
80
What are D-dimers
products of cross-linked fibrin after fibrin degradation
81
Name two anti-fibrinolytics
Epsilon Amino Capnoic Acid (EACA) Tranaxaemic Acid (cyclokapron)
82
How do anti-fibrinolytics prevent clot degradation
impairs conversion of plasminogen to plasmin; impairs binding of plasmin to fibrin and fibrinogen
83
Uses/indications of EACA
1. prostate surgery 2. post-tonsillectomy bleeding 3. cardiopulonary bypass 4. after thrombolytic therapy 5. dental surgery for haemophilia or Von Willebrand Disease 6: hereditary angioneurotic oedema - this has now fallen out of favour
84
Uses/indications of cyclokapron
1. cardiopulmonary bypass 2. orthotopic liver transplant 3. polytrauma 4. PPH 5. hyperfibrinolysis
85
Name four plasminogen activators and plasminogen proteolytic enzymes
trypsin chymotrypsin plasmin kallikrein
86
Side effects of EACA
nausea/vomiting/diarrhoea fatal thrombosis urinary clot formation
87
Side effects of TXA
nausea/vomiting/diarrhoea colour blindness seizures
88
EACA dose
5-6 grams 6 hourly, slowly
89
EACA half-life
90-120 minutes
90
EACE: what eliminates it
kidneys
91
True/False: TXA is twice as potent as EACE
False: ten times as potent
92
TXA dose in cardiopulmonary bypass
loading dose: 10-20 mg/kg infusion: 1-2 mg/kg/hr
93
Causes of post-cardiopulmonary bypass bleeding
1. platelet dysfunction or inactivation 2. coagulopathy secondary to haemodilution and consumption of clotting factors
94

FCA(SA) Primaries (1 decks)

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