Platelets, coagulation and bleeding/thrombotic disorders

Question 1

What happens when primary hemostasis aggregates with other platelets?

Answer 1

Form a surface for coagulation cascade

Question 2

In secondary hemostasis, what organ makes most coagulation factors?

Answer 2

The liver

Question 3

3 features of a platelet?

Answer 3

1. Anucleated
2. Lifespan ~10 days
3. Circulating platelets do not adhere-during stasis, adhesion occurs

Question 4

What is primary hemostasis generally initiated by?

Answer 4

Injury

Question 5

Primary hemostasis adheres to subendothelium by interacting with what?

Answer 5

von Willebrand factor

Question 6

In secondary hemostasis, what two things combine to form a stable clot?

Answer 6

Fibrin and platelet aggregates

Question 7

Secondary hemostasis involves a series of what?

Answer 7

activating enzymatic conversions

Question 8

In secondary hemostasis, which factors are vitamin k dependant?

Answer 8

Factors II, VII, IX and X

Question 9

What is an example of a natural anticoagulants and how does it work?

Answer 9

protein C

Prevent growth of clot

Question 10

What is the purpose of fibrinolysis?

Answer 10

It breaks down clot

Question 11

What are 3 ways to asses hemostasis?

Answer 11

• Platelet count (part of CBC)
• Coagulation cascade (Prothrombin time-PT and partial thromboplastin time-PTT)
• Fibrinolysis

Question 12

What might be a reason for prolonged coagulation tests?

Answer 12

deficiency or inhibitor of a coagulation factor

Question 13

What is a pathological counterpart of hemostasis?

Answer 13

Thrombotic disorders

Question 14

What 3 things make up “Virchow’s triad”?

Answer 14

Endothelial injury
Abnormal blood flow
Hypercoagulability

Question 15

6 acquired hypercoagulable states

Answer 15

Surgery/trauma
Limb immobilization
Bedridden
Long-distance air travel
Pregnancy
Oral contraceptives

Question 16

3 causes of blood disorders

Answer 16

Abnormal vessels
Decreased platelets/dysfunction
Abnormal factors

Question 17

What are two causes of platelet-type bleeding?

Answer 17

thrombocytopenia, von Willebrand disease

Question 18

3 causes of Thrombocytopenia

Answer 18

Decreased bone marrow production
Hemodilution due to multiple transfusions
Immune reaction due to platelet autoantibodies directed at platelet surface proteins

Question 19

What platelet count might result in spontaneous bleeding?

Answer 19

<10-20,000

Question 20

What platelet count might result in spontaneous bleeding?

Answer 20

<10-20,000

Question 21

What kind of drugs can increase bleeding tendency?

Answer 21

Antiplatelet drugs, such as aspirin

Question 22

What are two inherited abnormalities in coagulation factors?

Answer 22

von Willebrand disease, Hemophilia A and B

Question 23

What factor is von Willebrand disease associated with?

Answer 23

factor VIII

Question 24

What are two acquired abnormalities in coagulation factors?

Answer 24

liver disease, vitamin K deficiency

Question 25

What factors can alter CBC (complete blood count)?

Answer 25

``` Iron deficiency Medications Alcohol Infections Gender Pregnancy ```

Question 26

What is included in your CBC?

Answer 26

red and white blood cells and platelets

Question 27

What does the leukocyte count include?

Answer 27

all nucleated hematopoietic cells-except red blood cells

Question 28

White blood count is important in evaluating:

Answer 28

infections, some drug effects, radiation therapy

Question 29

What is a normal WBC

Answer 29

3500-10,000 cells/microliter

Question 30

What percent (and total number) of the WBC are neutrophils?

Answer 30

1800-6700 (55%)

Question 31

What percent (and total number) of the WBC are eosinophils?

Answer 31

0-570 (3%)

Question 32

What percent (and total number) of the WBC are lymphocytes?

Answer 32

1400-3900 (35%)

Question 33

Where would your WBC fall if you had leukocytosis?

Answer 33

> 10,000

Question 34

What are 3 causes of leukocytosis?

Answer 34

Chronic infection or inflammation Exercise Some leukemias

Question 35

(T/F) Microcytic anemia is when you have too many cells

Answer 35

False

Question 36

Microcytic patients with an iron deficiency often also have what?

Answer 36

Glossitis

Question 37

What are two causes of microcytic anemia?

Answer 37

Iron deficiency and lead poisoning

Question 38

(T/F) Macrocytic anemia is when you have too many cells

Answer 38

True

Question 39

3 causes of macrocytic anemia

Answer 39

Liver disease Drugs Vitamin B12 or folate deficiency

Question 40

Macrocytic patients beacuse of vitamin B12 or folate deficiency often include what other types of symptoms?

Answer 40

neurological (paresthesia, weakness, dementia)

Question 41

What is leukemia?

Answer 41

systemically distributed neoplasms of white cells

Question 42

Acute myeloid or lymphatic leukemia shows no evidence of what?

Answer 42

maturation in blood or marrow

Question 43

In acute myeloid or lymphatic leukemia, what percentage of cells are blast (immature)?

Answer 43

>20%

Question 44

What type of leukemia can have skin and gum infiltration?

Answer 44

Acute myeloid or lymphatic

Question 45

What are lymphomas, and what are the two specific types?

Answer 45

solid tumors of hematopoietic system/neoplasms of lymphoid tissue Non-hodgkin, and Hodgkin

Question 46

Which type of lymphoma is curable in most patients?

Answer 46

Hodgkin

Question 47

What are the characteristics of non-hodgkin lymphoma?

Answer 47

indolent to very aggressive: survival is years to weeks depending on type

Question 48

Lymphomas usually have (enlarged/reduced), (painless/painful) lymphadenopathy

Answer 48

Enlarged, painless

Question 49

Both hodgkins and non-hodgkins are __________ ____________ at various developmental stages.

Answer 49

Clonal expansions

Question 50

Both hodgkins and non-hodgkins are __________ ____________ at various developmental stages.

Answer 50

Clonal expansions