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146 Cards in this Set
- Front
- Back
Plasma constitutes what percentage of the total volume of the blood?
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50-60%
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11 substances found in plasma?
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1. water
2. proteins 3. ions 4. glucose 5. lipids 6. amino acids 7. vitamins 8. globulins 9. albumin 10. hormones 11. dissolved gases |
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Plasma constitutes what percentage of the total volume of the blood?
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50-60%
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3 general cells/cellular components of blood?
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1. RBCs (erythrocytes)
2. WBCs (leukocytes) 3. Thrombocytes (platelets) |
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11 substances found in plasma?
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1. water
2. proteins 3. ions 4. glucose 5. lipids 6. amino acids 7. vitamins 8. globulins 9. albumin 10. hormones 11. dissolved gases |
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RBCs have what for O2 binding?
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hemoglobin
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Plasma constitutes what percentage of the total volume of the blood?
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50-60%
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3 general cells/cellular components of blood?
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1. RBCs (erythrocytes)
2. WBCs (leukocytes) 3. Thrombocytes (platelets) |
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What do WBCs do?
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fight infection
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RBCs have what for O2 binding?
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hemoglobin
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What do WBCs do?
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fight infection
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How many types of WBCs are there? Name them.
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5
1. T an B lymphocytes 2. Monocytes/macrophages 3. Neutrophils 4. Eosinophils 5. Basophils |
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11 substances found in plasma?
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1. water
2. proteins 3. ions 4. glucose 5. lipids 6. amino acids 7. vitamins 8. globulins 9. albumin 10. hormones 11. dissolved gases |
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How many types of WBCs are there? Name them.
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5
1. T an B lymphocytes 2. Monocytes/macrophages 3. Neutrophils 4. Eosinophils 5. Basophils |
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3 general cells/cellular components of blood?
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1. RBCs (erythrocytes)
2. WBCs (leukocytes) 3. Thrombocytes (platelets) |
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What are thrombocytes and what are they involved in?
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fragments of megakaryocytes...inv. in blood clotting
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What are thrombocytes and what are they involved in?
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fragments of megakaryocytes...inv. in blood clotting
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RBCs have what for O2 binding?
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hemoglobin
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What percentage of plasma is water?
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90%
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What percentage of plasma is water?
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90%
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What portion of blood is plasma?
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the liquid portion
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What portion of blood is plasma?
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the liquid portion
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The plasma is a ? medium.
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transport
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The plasma is a ? medium.
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transport
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What, in general, does the plasma transport?
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inorganic substances (ex, Na+ and Cl-) and organic substances (ex, plasma proteins)
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What, in general, does the plasma transport?
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inorganic substances (ex, Na+ and Cl-) and organic substances (ex, plasma proteins)
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Name the 5 plasma proteins?
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1. Albumins
2. Other proteins that buffer pH change 3. Globulins (alpha, beta, and gamma) 4. Gamma globulins 5. Fibrinogen |
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Name the 5 plasma proteins?
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1. Albumins
2. Other proteins that buffer pH change 3. Globulins (alpha, beta, and gamma) 4. Gamma globulins 5. Fibrinogen |
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Function of albumin?
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est. osmotic gradient b/n blood and interstitial fluid
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Function of albumin?
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est. osmotic gradient b/n blood and interstitial fluid
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Function of Globulins (alpha, beta, and gamma)?
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roles range from blood clotting to transport
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Function of Gobulins (alpha, beta, and gamma)?
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roles range from blood clotting to transport
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Function of gamma globulins?
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role in immunity as antibodies
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Function of gamma globulins?
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role in immunity as antibodies
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What do WBCs do?
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fight infection
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How many types of WBCs are there? Name them.
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5
1. T an B lymphocytes 2. Monocytes/macrophages 3. Neutrophils 4. Eosinophils 5. Basophils |
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What are thrombocytes and what are they involved in?
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fragments of megakaryocytes...inv. in blood clotting
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What percentage of plasma is water?
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90%
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What portion of blood is plasma?
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the liquid portion
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The plasma is a ? medium.
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transport
|
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What, in general, does the plasma transport?
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inorganic substances (ex, Na+ and Cl-) and organic substances (ex, plasma proteins)
|
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Name the 5 plasma proteins?
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1. Albumins
2. Other proteins that buffer pH change 3. Globulins (alpha, beta, and gamma) 4. Gamma globulins 5. Fibrinogen |
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Function of albumin?
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est. osmotic gradient b/n blood and interstitial fluid
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Function of Gobulins (alpha, beta, and gamma)?
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roles range from blood clotting to transport
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Function of gamma globulins?
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role in immunity as antibodies
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Function of fibrinogen?
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key factor in blood clotting
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Besides the plasma proteins name 4 other substances you may see in the plasma?
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1. nutrients
2. wastes 3. gases 4. hormones |
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What are erythrocytes?
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RBCs...they transport O2
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What are leukocytes?
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WBCs...they are mobile units of the body's immune defense system
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3 functions of leukocytes?
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1. defend against invasion by pathogens
2. identify and destroy cancer cells 3. function as "clean up crew", by phagocytizing debris of dead or injured cells |
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What are thrombocytes?
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platelets....circulating cell frags of megakaryocytes...involved in hemostasis
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There are ? kinds of leukocytes split into ? categories.
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5 kinds split into 2 categories
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What are the 2 categories of leukocytes?
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1. polymorphonuclear granulocytes
2. mononuclear agranulocytes |
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What characterizes polymorphonuclear granulocytes?
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nuclei segmented into lobes, with abundant membrane-enclosed granules in cytoplasm
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Which leukocytes fall under the category of polymorphonuclear granulocytes?
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1. Neutrophils
2. Eosinophils 3. basophils |
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Which of the polymorphonuclear granulocytes is phagocytic, seen in acute infl., and attacks bacteria, fungi and cell debris?
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neutrophils
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Which polymorph. gran. is associated with allergic rxns and parasitic infections?
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eosinophils
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Which polymorph. gran. is assoc. with allergica and stress responses (although not much else is known about their function)?
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basophils
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What characterizes mononuclear agranulocytes?
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They have a single, large, nonsegmented nucleus and few granules
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Which of the leukocytes fall under the category of mononuclear agranulocytes?
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1. monocytes/macrophages
2. lymphocytes ( |
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Which of the mononuc. agran.s are phagocytic, important in inflammation, wound healing, T cell activation, and are seen in chronic inflammation?
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monocytes/macrophages
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Which of the mononuclear agranulocytes is associated with T and B cells and the immune response?
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lymphocytes
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What is hemostasis?
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arrest of bleeding from damaged blood vessels
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5 stages of hemostasis?
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1. vascular spasm
2. platelet plugging 3. blood coagulation 4. clot retraction 5. clot dissolution |
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Describe the 1st stage of hemostasis?
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Vascular spasm: Vascular constriction, reduces blood flow thru damaged vessel (last less than 1 min., short lived)
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Describe the 2nd step of hemostasis?
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Platelet plugging: platelet aggregation forms plug, sealing vessel
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Describe the 3rd step of hemostasis?
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blood coagulation: clotting
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Describe the 4th stage of hemostasis?
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clot retraction: shrinkage, w/ squeezing out of serum and cells, 20-60 minutes after clot formation
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Describe th 5th stage of hemostasis?
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clot dissolution: clot slowly dissolved by plasmin, but dissolution begins shortly after clotting
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What is Von Willebrand Factor (vWF)?
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produced by epithelial cells...circulates in blood...a carrier of factor VIII...binds to collagen at injury and then platelets bind to factor VIII
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What does the aggregating platelet plugging release?
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ADP and thrombaxone
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The ADP and thrombaxone produced by the aggregating platelet plug do what?
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Gives positive feedback to platelet plug so it produces more ADP and thrombaxone...also stimulates normal (uninjured endothelium) to produce prostacyclin and Nitrous Oxide to prevent clotting
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Coagulation does what to the platelet plug?
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reinforces it
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What does coagulation do to blood?
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converts it to a gel in area of vessel damage
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In coagulation what stabilizes the clot?
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formation of fibrin mesh
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What forms the fibrin mesh in coagulation?
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conversion of fibrinogen to fibrin (catalyzed by thrombin)
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During coagulation what do fibrin threads trap?
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RBCs, platelets, and other components (forming a clot)
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The 2 possible pathways of coagulation?
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1. extrinsic
2. intrinsic |
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Speed of intrinsic pathway? What initiates it?
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- slower clot formation
-initiated by VESSEL injury (collagen exposure) |
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Speed of extrinsic pathway? What initiates it?
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- more rapid
- initiated by exposure of blood to TISSUE proteins |
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Where do the extrinsic and intrinsic pathways meet?
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at Factor X...at which point the remaining cascade is the same
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What converts prothrombin to thrombin
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Factor Xa
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What converts fibrinogen to fibrin?
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Thrombin (IIa)
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What is a cofactor required by many steps in the clotting cascade?
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Calcium
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What do protein c, protein s, and anti-thrombin do?
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all prevent clotting (endogenous to body)
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What enzyme slowly dissolve the clot during clot dissolution?
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plasmin
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Where is plasmin made?
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in the liver, as the inactive precursor plasminogen
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In what fashion is plasminogen activated in?
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cascade fashion
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Name a factor that is involved in clot formation that is also involved in the cascade that activates plasminogen for clot dissolution?
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Factor XII (hageman factor)
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When a clot is formed, and activated plasmin is trapped in the clot what does it slowly break down?
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the fibrin mesh
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What is fibrinolysis?
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the process of clot dissolution
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What removes the products of a dissolving clot?
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Phagocytic WBCs
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What does hypercoaguable literally mean?
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"too much clotting"
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2 general forms of hypercoagulable states?
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1. conditions creating increased platelet function
2. cond.s causing increased clotting activity |
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Hypercoaguable states predispose to thrombosis, thrombi in what two structures? Due to what?
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1. arteries : due to turbulence (platelets)
2. Veins : due to stasis (platelets and fibrin) |
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In hypercoaguable states which has the higher pressure, Arteries or Veins?
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arteries
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What does stasis mean?
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blood not flowing
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Name 3 scenarios of increased platelet activation?
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1. endothelial damage
2. increased platelet sensitivity to adhesion, aggregation factors 3. disturbances in flow |
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Name 5 things that may lead to disturbances of flow and result in increased platelet activation?
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(damage in chronic disease states)
1. artherosclerosis 2. smoking 3. HTN 4. diabetes mellitus 5. elevated blood lipids/cholesterol |
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2 general disorders that may affect coagulation components and result in increased clotting activity?
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1. Primary : genetic mutations
2. Secondary : acquired |
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In primary disorders affecting coagulation components what may there be genetic mutations in?
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1. Factor V and prothrombin are the most common (so clotting cascade can go on indiscriminately)
2. Deficiencies in antithrombin III, protein C, and protein S are less common (anticoagulant factors) |
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Name 4 different things that you may acquire that could cause 2ndary increased clotting activity?
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1. Stasis (immobilized or postsurgical patient)
2. MI 3. Cancer 4. Hyperestogenic states, oral contraceptives |
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Can tumor cells produce thrombin?
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yes
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An increase in estrogen can lead to what?
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increased synthesis of clotting factors in liver and decreased synthesis of anticlotting factors (such as antithrombin III)
-leads to secondary disorder of coagulation component |
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Name 4 types of bleeding disorders?
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1. Platelet defects
2. coagulation defects 3. disseminated intravascular coagulation 4. vascular disorders |
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What are platelets integral to the formation of?
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clots
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What does the suffix -penia indicate?
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a decreased number of
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Name two types of platelet defects?
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1. thrombocytopenia
2. thrombocytopathia |
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What is thrombocytopenia?
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a platelet defect where there is a decreased number of circulating platelets
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What is thrombocytopathia?
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a platelet defect where there is impaired platelet function
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Normally there are how many platelets per mL of blood? How many are there in thrombocytopenia?
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normally 150-400 million/mL....in thrombocytopenia there is less than 100,000 platelets/mL (so more than 1000X decrease)
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In thrombocytopenia there is an increased ? risk.
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bleeding
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Two types of increased bleeding risks seen in thrombocytopenia?
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1. Petechiae
2. Purpura |
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What is petechiae?
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small, purple spots seen on skin surface in thrombocytopenia
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What is purpura?
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larger than petechiae...bruising...associated with thrombocytopenia
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Where is there decreased platelet production in people with thrombocytopenia?
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in the bone marrow
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Name 4 things that may cause decreased platelet production in the bone marrow associated with thrombocytopenia?
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1. aplastic anemia
2. leukemia 3. radiation 4. HIV |
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In thrombocytopenia where may you see increased platelet pooling?
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in the spleen
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What is splenomegaly? What is it associated with? What is it caused by?
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an increase in spleen size...associated with thrombocytopenia...may be caused by,
1. cirrhosis 2. portal HTN 3. lymphomas |
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In thrombocytopenia you may see decreased ? survival due to immune or nonimmune mechanisms.
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platelet
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What makes the platelets appear as if they are foreign to the body, causing the body to make antiplatelet Abs to remove them?
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haptins
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3 general things associated with thrombocytopenia?
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1. decreased platelet production in bone marrow
2. increased platelet pooling in spleen 3. decreased platelet survival due to immune or nonimmune mechanisms |
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What is thrombocytopathia?
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decreased platelet FUNCTION
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2 ways that you may become inflicted with thrombocytopathia?
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1. inherited disorders
2. drug induced |
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An inherited disorder causing thrombocytopathia?
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von willebrand disease
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3 drugs associated with drug induced thrombocytopathia?
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1. aspirin and other nsaids (ex. ibuprofen) : inhibit thromboxane production
2. Clopidogrel/ticlopidine : inhibit ADP 3. GPIIb/GPIIIa inhibitors : block receptor |
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What are GPIIb/GPIIIa inhibitors? What do they do?
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glycoprotein inhibitors (may cause thrombocytopathia)...glycoprotein causes von willebrand factor to stick, so when using these if they block the receptor platelets won't stick
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What are coagulation defects?
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defects in the coagulation cascade
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2 general types of coagaltion defects?
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1. impaired synthesis
2. hereditary disorders |
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2 types of impaired synthesis associated with coagulation defects?
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1. liver disease : because liver produces the most coagulationn factors
2. Vitamin K deficiency : factors VII, IX, X, prothrombin are vitamin K dependent |
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2 types of hereditary disorders associated with coagulation defects?
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1. hemophilia A : factor VIII (common, 1:5000 males)
2. von Willebrand disease : factor VIII-vWF (common, effects boys and girls)(often not diagnosed until adulthood because bleeding is so mild) |
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What is DIC aka?
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Disseminated Intravascular Coagulation (a coag. defect)
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Is DIC a primary disease?
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no it is a complication of other disorders
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Is DIC localized?
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no, it is throughout the body
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DIC is a paradoxical rxn of what?
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coagulation and hemorrhage
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DIC is the activation of what?
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the clotting cascade via thrombin generation resulting in systemic fibrin formation
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In DIC what system is overwhelmed?
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anticoagulant
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What is microvascular thrombosis?
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(associated with coagulation defects, DIC)...a vessel occlusion (closing off) and tissue ischemia
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In DIC what does massive clot formation use?
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all coagulation proteins and platelets
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In DIC what is activated and leads to more bleeding?
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fibrinolytic system
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Besides thrombocytopenia where else do you see petechiae and purpura?
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vascular disorders
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Name 4 vascular disorders?
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1. hemorrhagic telangiectasia
2. scurvy : vitamin C deficiency 3. cushing's syndrome 4. senile purpura |
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What is hemorrhagic telangiectasia?
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a vascular disorder
-uncommon autosomal dominant disorder -thin-walled, dilated capillaries and arterioles |
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What is scurvy?
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a vascular disorder
-vitamin C deficiency -poor collagen synthesis in endothelial wall, results in fragile vessel walls |
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What is Cushing's disease?
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a vascular disorder
-protein wasting and loss of tissue support due to excess cortisol |
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What is senile purpura?
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a vascular disorder
-bruising in the elderly caused by aging |