MOD Ch4

Question 1

Filariasis

Answer 1

Helminth infection (Wuchereria), can cause localized edema

Question 2

Pulmonary Edema

Answer 2

Chronic lung congestion can lead to “heart failure” cells (hemosiderin-laden macraphages)

Question 3

Hepatic congestion

Answer 3

Often from advanced heart failure. Leads to “nutmeg liver” due to hepatocyte necrosis from ischemia in a centrilobular pattern.

Question 4

Steps of hemostasis

Answer 4

1. Vasoconstriction
2. Primary hemostasis
3. Secondary hemostasis

Question 5

Primary hemostasis steps

Answer 5

1. Adhesion
2. Activation
3. Aggregation

Question 6

Primary hemostasis, adhesion

Answer 6

Weibel-Palade bodies release von Willebrand factor, which allows for adhesion.

Question 7

Von Willebrand disease

Answer 7

No VWF, normal platelet count

Question 8

Bernard Soulier syndrome

Answer 8

No Gplb receptor (visible under microscope: giant platelets)

Question 9

Primary hemostasis, activation

Answer 9

GpIIb-IIIa change to form fibrinogen links.

Secretion initiated by thrombin, release by ADP and thromboxane A2 (which is inhibited by aspirin)

Question 10

Primary hemostasis, aggregation

Answer 10

GpIIb–IIIa complex allows cross-linking

Question 11

Glanzmann thromasthenia

Answer 11

GpIIb-IIIa deficiency

Question 12

Thrombocytopenia

Answer 12

Loss or less production of platelets (platelet count may be low, but platelets are functional)

Question 13

Vitamin K dependent clotting factors

Answer 13

II, VII, IX, X

Question 14

Coumadin

Answer 14

aka Warfarin, blocks Vitamin K dependent clotting factors

Question 15

Factor V Leiden mutation

Answer 15

Factor V mutation that makes factor V resistant to cleavage by Protein C
–> inability to inhibit coagulation

Question 16

Heparin induced thrombocytopenia

Answer 16

Antibodies to PF4-heparin complexes leads to a prothrombotic state.

1. exposure to unfractionated heparin
2. PF4-heparin complexes form
3. IgG crosslinks platelet Fc receptors and PF4-heparin complexes
4. platelet activation and aggregation

Question 17

Antiphospholipid antibody syndrome

Answer 17

Antibodies against plasma proteins that bind to phospholipids
Sx: vascular, obstetric (unexplained miscarriages)
Primary: has an immune disorder
Secondary: does not have an immune disorder

Question 18

Septic emboli

Answer 18

Endocarditis–> valve vegetations break loose

Sx: Janeway lesions, Roth spots, Splinter hemorrhage