PRIMARY HEMOSTASIS Flashcards
(137 cards)
1
Q
3 coats of blood vessel wall
A
Tunica intima
Tunica media
Tunica adventitia
2
Q
Also known as tunica interna
A
Tunica intima
3
Q
Simple squamous epithelium lining the blood vessel wall
A
Endothelium
4
Q
Composed of smooth muscle and elastic fiber ; thickest coat
A
Tunica media
5
Q
Also known as tunica externa
A
Tunica adventitia
6
Q
Distributing blood vessels that leave the heart measuring 4 mm ; thickest walls of the vascular systems
A
Arteries
7
Q
Microscopic continuation of arteries that give off branches called metarterioles, which in turn join the capillaries ; measuring 30 um
A
Arterioles
8
Q
Collecting blood vessels that return to the heart ; larger , have a more irregular lumen than arteries ; measuring 5 mm
A
Veins
9
Q
Microscopically sized veins; connect the capillaries to the veins ; measuring 20 um
A
Venules
10
Q
Blood passes from the arterial to the venous via the ___ ; measuring 8 um
A
Capillaries
11
Q
Specialized types of capillaries found in locations such as the bone marrow, spleen and liver
A
Sinusoids
12
Q
Aka prostaglandin I2
A
Prostacyclin
13
Q
Inhibits platelet activation ; penetrates the platelet and bind at its IP receptor
A
Prostacyclin
14
Q
produced by the eicosanoid pathway in endothelial cells
A
Prostacyclin
15
Q
Stimulates vasodilation
A
Adenosine
16
Q
A thrombin factor that binds thrombin and reduces its ability participate in clotting process
A
Thrombomodulin
17
Q
Thrombomoduling + thrombin, activate what (2)
A
Protein C
TAFI (thrombin activatable fibrinolysis inhibitor)
18
Q
It inactivates factors Va and VIIIa
A
Activated protein C
19
Q
An antifibrinolytic enzyme produced by thrombomodulin and thrombin
A
TAFI (thrombin activatable fibrinolysis inhbitor)
20
Q
Weakly enhances antithrombin (previously called Antithrombin III)
A
Heparan sulfate
21
Q
Major plasminogen activator
A
TPA (tissue plasminogen activator)
22
Q
Aka fibrinolysin ; enzyme that dissolves clot
A
Plasmin
23
Q
Aka fibrinolysin ; enzyme that dissolves clot
A
Plasmin
24
Q
Aids in platelet adhesion ; act as a carrier protein for factor VIII
A
VWF
25
Site of synthesis of VWF
Endothelial cell
Megakaryocyte
26
Sites of storage of VWF
Weibel-Palade bodies
Alpha granules
27
A disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 133
ADAMTS 13
28
VWF cleaving protease ; secreted by the liver
ADAMTS 13
29
Regulates the size of circulating VWF by cleaving ultra long VWF multimers into shorter segments (have hemostasis potential)
ADAMTS 13
30
Caused by ADAMTS 13 deficiency
Thrombotic Thrombocytopenic purpura
31
How many days do platelets stay in the spleen n
2 days
32
Approx ____ of the total number of plts are in the systemic
2/3
33
__ of the total number of plts are in the spleen
1/3
34
Platelets life span
9 days plus or minus 1 day
35
On a wright-stained PBS, platelets are spread throughout the RBC monolayer (_ to _ cells per ___x field)
7 to 21 cells per 100x field
36
Platelets have an average diameter of
2.5 um (2 to 4 um)
37
Also known as stress platelet ; appear in compensation for thrombocytopenia
Reticulated platelets
38
Newly released from megakaryocytes and still contain RNA ; markedly larger than usual
Reticulated plt
39
Can help differentiate bone marrow failure from peripheral destruction in thrombocytopenia ; early predictor of bone marrow recovery after chemo and transplantation
Reticulated platelets
40
Potentially prothrombotic (may be associated with increased risk of cardiovascular disease)
Reticulated platelet
41
Normal average size of platelets
2.5 um
42
Mean platelet volume reference range
6.8 - 10.2 fL
43
This anticoagulant causes swelling of platelets (causes approx 20% increase in MPV during the first hour)
EDTA
44
MPV should be based on EDTA specimens that are between _ to _ hours old
1-4 hours
45
Small platelets ; x-linked recessive
Wiskott-Aldrich syndrome
46
Infections with small platelets (TORCH)
Toxoplasma
Other agents
Rubella virus
Cytomegalovirus
Herpes virus
47
Disorders characterized by Large platelets
Bernard-Soulier syndrome
Gray platelet syndrome
MYH9 gene mutations
48
Disorders with Large platelets that are autosomal recessive
Bernard-soulier syndrome
Gray platelet syndrome
49
Disorders with Large platelets that is autosomal dominant
MYH9 gene mutation n
50
Examples of MYH9 gene mutations
Fechtner syndrome
Sebastian syndrome
Epstein syndrome
MHA
51
Shape of resting and circulating platelets
Biconcave or disk shaped
52
Shape of activated platelets
Spherical with pseudopods
53
On a wright’s stained smear, platelets appear
Lavender and granular
54
A general part of platelet cytoplasm that Is centrally located ; granular
Chromomere
55
A general part of platelet cytoplasm that peripherally located ; non granular
Hyalomere
56
Process by which megakaryocytes develop from hematopoietic stem cell
Megakaryocytopoiesis
57
Aka Megakaryocyte growth and development factor (MGDF)
THROMBOPOIETIN
58
Major regulator of platelet production ; produced primarily by the liver ; 70,000 dalton molecule; possesses 23% homologous with erythropoietin
THROMBOPOIETIN
59
Thrombopoietin receptor site present at all maturation stages (from BFU-meg to platelets)
MPL
60
Stimulates megakaryocytopoiesis ; induces the proliferation and maturation of megakaryocytes ; induces thrombocytopoiesis
THROMBOPOIETIN
61
Largest cells in the bone marrow ; measuring 3-160 um
Megakaryocyte
62
Megakaryocyte size
30-160 um
63
Has a multilobulated nucleus and abundant granular cytoplasm
Megakaryocyte
64
_____ of all bone marrow cells
<0.5%
65
______ megakaryocytes per 10x low power field
2-4
66
Least mature progenitor ; participates in normal mitosis
Burst-forming unit (BFU-meg)
67
2nd Megakaryocyte progenitor ; participates in normal mitosis
Colony-forming unit (CFU-meg)
68
Most mature Megakaryocyte progenitor
Light density CFU (LD-CFU-MEG)
69
Loses its capacity to divide ; performs endometriosis
LD-CFU-MEG
70
BFU-MEG. CFU-MEG, LD-CFU-MEG resemble the
LYMPHOCYTES
71
Stages wherein the observers are able to recognize the unique wright-stained morphology of the cells in the BM smears or H&E stained BM biopsy sections
Megakaryocyte precursors
72
Least differentiated ; cannot be reliably distinguish from Myeloblasts or pronormoblasts in light microscopy
MK-1-Stage (Megakaryoblast)
73
Begins to develop of its cytoplasmic ultrastructure (including alpha granules, dense granules, and the demarcation system)
MK-I-STAGE (megakaryoblast)
74
Identified by the appearance of nuclear lobularity
MK-II stage (promegakaryocyte)
75
Most abundant ; easily recognized at 10x magnification ; platelet shedding
MK-III stage (Megakaryocyte)
76
One Megakaryocyte may shed _____ to ____ platelets
2000 - 4000
77
Aka thrombopoiesis , thrombocytopoiesis
Platelet shedding
78
Ultimately delineates individual platelets during thrombocytopoiesis
Demarcation system
79
Studied using scanning and transmission electron microscopy, flow cytometry and molecular sequencing
Ultrastructure of the platelets
80
Selectively permeable ; provides phospholipids that support platelet activation internally and plasma coagulation externally ; anchored within the membrane are glycoproteins and proteoglycans
Platelet plasma membrane
81
Neutral phospholipid that are found in the outer, plasma layer
Phosphatidylcholine and sphingomyelin
82
A ionic or polar phospholipids
Phosphatidylinositol
Phosphatidylethanolamine
Phosphatidylserine
83
An ionic or polar phospholipid that supports platelet activation by supplying arachindonic acid
Phosphatidylinositol
84
An ionic or polar phospholipid that flips to the outer surface upon activation and is the charged phospholipid surface on which 2 coag pathway complexes assemble
Phosphatidylserine
85
2 coagulation pathway complexes
Tenase complex
Prothrombinase complex
86
Phospholipids found in the inner, cytoplasmic layer
Phosphatidylinositol
Phosphatidylethanolamine
Phosphatidylserine
87
The platelet membrane surface ; unique to the platelet
Glycocalyx
88
Absorbs albumin, fibrinogen, and other plasma proteins through endocytosis
Glycocalyx
89
Glycoprotein with collagen, vitronectin, laminin, fibronectin as ligands
GP Ia/IIa
90
Cell adhesion molecule (CAM) of the immunoglobulin gene family ; collagen as ligand
GP VI
91
Glycoprotein that is key collagen receptor
GP VI
92
Cell adhesion molecule of the leucine-rich repeat family
GP Ib/IX/V
93
VWF specific site
GPIb alpha
94
Deficiency of GPIb/IX/V complex
Bernard Soulier syndrome
95
Key fibrinogen receptor
GP IIb/IIIa
96
Deficiency of GPIIb/IIIa
Glanzmann’s thrombasthenia
97
Platelet STR (Seven Transmembrane Repeat) receptors
PAR 1
PAR 4
P2Y1
P2Y12
TPa abd TPb
Alpha2-andrenergic
IP
98
PLATELET STR : thrombin as ligand
PAR 1 & PAR 4
99
PLATELET STR : ADP as ligand
P2Y1 & P2Y12
100
PLATELET STR : TXA2 as ligand
TPA & TPB
101
PLATELET STR : Epinephrine (Adrenaline) as ligand
Alpha 2-adrenergic
102
PLATELET STR : prostaglandin I2 (Prostacyclin) as ligand
IP
103
A low affinity receptor for the immunoglobulin Fc portion ( has a role in a perilous condition known as heparin induced thrombocytopenia)
FcyIIA (CD32)
104
An integrin tht helps platelet binding to endothelial cells, WBCS and one another
P-selection (CD62)
105
Found on the alpha granules membranes of the resting platelet but travels via the SCCS to the surface of activated platelets
P-selectin (CD62)
106
Formed by tubulins
Microtubules
107
Formed by actins
Microfilaments
108
Connect with the actin and tubules maintaining platelet shape
Destin and vimentin
109
Platelet granules tat flow through the surface-connected canalicular system
Alpha granules and lysosomes’ contents
110
Platelet granules that travel to the plasma membrane
Dense granules
111
Number of alpha granules in each platelet
50 to 80
112
Stain medium gray (osmium-dye transmission electron microscopy preps)
Alpha granules
113
As the platelets become activated, alpha granule membrane fuse with the _____
Surface-connected canalicular system (SCCS)
114
Alpha granules proteins (not in the cytoplasm) that inhibit heparin
B-thromboglobulin
Platelet factor 4
115
Alpha granules proteins (not in the cytoplasm) that support mitosis of vascular fibroblasts and smooth muscle cells
EGF
PDGF
Transforming growth factor B
116
OTHERS : Alpha granules (not in the cytoplasm)
HMWK
117
Proteins in alpha granules and platelet cytoplasm
Fibrinogen
VWF
Factor V
118
Protein present alpha granules membrane
P-selectin
119
Number of dense granules per platelet
2 to 7
120
Stain black opaque when treated with osmium in transmission electron microscopy
Dense granules
121
They migrate to the plasma membrane and release their contents directly into the plasma
Dense granules
122
These granules are vasoconstrictors and platelets agonists that intensify primary hemostasis
Dense granules
123
A substance which initiates a response when combined with a receptor
Agonist
124
Supports neighboring platelet aggregation by binding to P2Y1 and PY12
ADP
125
Function unknown, but it is detectable upon platelet activation
ATP
126
Vasoconstrictor that binds endothelial cells and platelet membranes
Serotonin (5-hydoxytryptamine/5-HT)
127
Divalent cations support platelet activation and coagulation
Calcium and magnesium
128
Glycocalyx is _____ developed in the SCCS and ___ some of the glycoprotein receptors present in the platelet surface
Less ; lacks
129
SCCS is the route for
Endocytosis
Secretion of alpha granule contents
Secretion of lysosome contents
130
A tubular system that acts as a control center
Dense tubular system
131
Sequester calcium and bears a series of enzymes that support platelet activation
Dense tubular system
132
These series of enzymes produced by the dense tubular system that support the eicosanoid synthesis pathway
Phospholipase A2
Cyclooxygenase
Thromboxane A2
133
Thromboxane A2 is produced by what pathway
Eicosanoid pathway
134
Supports production of inositol triphosphate (IP3) and diary glycerol (DAG)
PHOSPHOLIPASE C
135
AKA acetyl salicylic acid
Aspirin
136
Most frequently used anti platelet therapy ; Cyclooxygenase inhibitor
Aspirin
137
Aspirin ingestion blocks the synthesis of
TXA2
