Lec 1 And Lec 2 - Heme Exam 1

Front 1

function of Hemostasis

Back 1

To keep blood confines in the vessel, to repair physiological danage to vessels, to strp bleeding in injury, to dissolve clot and repair tissue.

Front 2

Funtion of check and balance in homostasis

Back 2

very complex system to prevent execess bleeding, and to prevent execess cloting.

Front 3

Define hemostasis.

Back 3

it is the property of the circulation that maintains blood as a flud within the blood vessels and system's ability to prevent excessive blood loss upon injury.

Front 4

Four major components of hemostasis

Back 4

vessels, platelets, group of solubile plasma coagualation proteins that lead to coagulation cascade, the coagnulation factors such as fribinolysis. Chceks and balance inhibits each steps.

Front 5

how four major components of hemostasis are related to each other

Back 5

by connected to other systems such as kiniss, and complement system. Kinins for inflammation ,and complementory system for coagulation and inflammation.

Front 6

Process of primary hemostasis

Back 6

initial response to injury that include vessels and platelets. Platelets intract with injured vesesl and each cause formation of platelet plug. This is a temporary fix.

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goal of secoundary hemostasis

Back 7

to reinforce platelet plug with fibrin

Front 8

what is secoundary hemostasis

Back 8

complex system of plasma proteins in a cascade.

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Funtion of fibrinolysis

Back 9

to dissolve fibrin clot into fragments.

Front 10

function of inhibitors

Back 10

to limit each process to prevent excess clotting and bleeding. By checks and balances.

Front 11

stages of hemostasis

Back 11

primary, secoundary, and fribinolysis

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3 structures of vascular structure

Back 12

they are Tunica intima, tinuca media, Tunica adventia.

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Charectorestics of Tunica intima

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it’s the most inside layer. It contain layer of endothelial cells, basemsent membrane, and elastic membrane. Elastic membrane is the connective tissue, and basement membrane is the collagen. They are are smooth and side by sise.

Front 14

how vessels promote blood flow

Back 14

its by smooth lining and negative charge of endothilial vessesls.

Front 15

vascular structures that exposed promotes primary hemostasis

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subendothelium, and basement membrane are esposed,

Front 16

In primary hemostasis, time for vasoconstriction

Back 16

respond less that 1 minute.

Front 17

Actions in vasoconstriction in primary hemostasis

Back 17

constriction, detour blood around injury, activate plateles, and activate coagulation cascasde.

Front 18

vital functions of normal vessel walls in hemostasis

Back 18

normal, smooth lining and negative charge of vessels promotes flow.

Front 19

component(s) of primary hemostasis repair the injury.

Back 19

vonwillebrand's factor, and relasing platelet activating factor ( PAF)

Front 20

component(s) of secoundary hemostasis repair the injury.

Back 20

thromboplastin, and contact factors.

Front 21

Subendothelium initiates clotting process by

Back 21

secreing vonwillebrnd's factors, releasing PAF by exposing collagen, releasing tissue thromboplastin, reacting with contact factors.

Front 22

Part of coagulation cascade that is extrinsic in secondary hemostasis

Back 22

realising tissue thromboplastin

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Part of coagulation cascade that is intrinsic in secondary hemostasis

Back 23

reacting with contact factors

Front 24

Physiological hemostasis

Back 24

occus routinely to repair damages vessels oven when there is no external cut.

Front 25

function of vWf

Back 25

to initiate platelet adherance

Front 26

functiom of PAF - platlet activation factor

Back 26

helps platelets to activate themselves.

Front 27

When do inhibitors start

Back 27

they start same time as coagulation starts

Front 28

where do inhibitors secreted from

Back 28

they are secreted from inside of endothelial cells

Front 29

Inhibition of fibrinolytic system

Back 29

by PAI1 that released from endothelial cells.

Front 30

Structure of platelets

Back 30

2 - 3 um, disk shaped, Cytoplasmic fragments. Have peripharal zone, structural zone, organelle zone, and membrane system

Front 31

Production of platlets

Back 31

by megacaryocytes in bone marrow by the response to thrombopoietin .

Front 32

Ref range for platlets

Back 32

150000 - 450,000 * 10^9 / L

Front 33

Functions of platelets in hemostasis

Back 33

Plug up the initial injury, bag of regulating substanced for further clotting, serious of channeles like sponge holes for coagulation reactions.

Front 34

Structure of peripharal zone of platelet

Back 34

glycocalyx, glycoprotein, and phospholipid bilayer. Glycocalyz is the glycogen tich coat, and phospolipid bilayer is the membrane.

Front 35

glycocalyx funtion in peripharal zone of platlets

Back 35

to produce coagulation factors such as facror 5, vWF, and fribinogen. They are surface protein receptors for platlet function.

Front 36

Structural zone fucntion in platlet

Back 36

to maintain shape and allow for constriction when activated.

Front 37

Componenets in structural zone of platlets

Back 37

Microtubules and protein network, submembrane cytockeleton, actin and myosin. There are more actin than miosin.

Front 38

organelle zone of platlet components

Back 38

Mitochondria, glycogen particles, and 4 granuals that are dense bodies, Alpha granules, Lysosomal granuals, and peroxisone

Front 39

4 types of granuals in organelle zone of platelet

Back 39

alpha granuales, dense bodies, lysosomal granuals, peroxisomes.

Front 40

Membrane system of plaelet incude

Back 40

open canalucular system, dense tubular system .

Front 41

Open canalicular system in platlet function

Back 41

road into and out of platelet

Front 42

Dense tubular system fucntion

Back 42

interiar road for calcium storage.

Front 43

Function and charectorestics of Dense bodies

Back 43

It contain non protein mediators such as ADP, ATP etc that can be agonist for platlet action.

Front 44

Charectorestics of alpha granuals

Back 44

it has the protein mediators and it is the most numerous in the 4 types of granules in organelle zone.

Front 45

proteins that consists in alpha granuals

Back 45

Fribinogen, Factro V, vonwillebrand factor, plasminogen, plaminogen activator inhibitors, alpha 2 antiplasminogen, other proteins such as PDGF.

Front 46

Fibrinogen during thrombopoiesis

Back 46

it is absorbed by plasma.

Front 47

Fucntion of fibrinogen

Back 47

to form bridge for platelet aggregation.

Front 48

Function of plasminogen

Back 48

is fribrinolysis to break upclot.

Front 49

Fucntion of plasminogen activator inhibitor

Back 49

to inhibit fibrinolysis

Front 50

Funtion of PDGF

Back 50

to help muscle repairs.

Front 51

Role of platlets in primaty hemostasis.

Back 51

formation of platelet plug

Front 52

Role of platlets in secoundary hemostasis.

Back 52

release granual contents to help activate coagulation plasma proteins.

Front 53

Role of platletets in hemostasis

Back 53

roles in primary, Secoundary, and fibrinolysis. Surveillanvce of vessel integrity, repair small gaps in endothelial cells, healing of injured tissue via PDGF.

Front 54

platlet activation in response to

Back 54

in rensponce to vessel injury.

Front 55

Steps in platlet activation to form platlet plug

Back 55

Adhestion, shape change, aggregation, and release of granular contents that initiates coagulation proteins in the plasma for secoundary aggregation.

Front 56

Platlet adhetion requires

Back 56

a bridge of vWF between platlet and collagen, also glycoprotein Ib /IX receptor on platlet.

Front 57

In platlet adhesion, sticking to

Back 57

exposed subendothelial collagen in foreign surface.

Front 58

Shape of activated platlet

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shape is pseudopods

Front 59

Shape of non activated platlet

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sphere.

Front 60

aganost for platelet aggregation

Back 60

ADP release by platlets and exposed vascular endothelium

Front 61

Fucntion of fribrinogen in platlet aggregation

Back 61

to serve as a bridge between adjacent platlets.

Front 62

When do glycoprotein IIB-IIIA become activated

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When platlet activation with any agonost such as VWF binding to GPIb/IX triggers intracelular signaling during platlet adhesion.

Front 63

what required to “connect” platelets in platlet aggegation

Back 63

Fibrinogen serves as bridge between adject platlets.

Front 64

vWF is secreted by

Back 64

subendothelial and alpha granuals.

Front 65

Stages of platelet aggregation depends on

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it is depent upon the stimulas strength.

Front 66

Primary aggregation responds to

Back 66

response to small stimulus or small agonist.

Front 67

Charectorestics of primary aggregation

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reversable, contraction of microfilaments, organelles pulled into center of platelet, Shape change, slight release of ganuales, small platlet aggregation.

Front 68

Primary aggregation involes contraction of

Back 68

involes contraction of microfilaments

Front 69

Organelles in the primary aggregation

Back 69

they are pulled into center of platelet.

Front 70

Secoundary agggation reponse to

Back 70

repose to stronger stimulus / agonist.

Front 71

When do platlet release secretion

Back 71

only if the stimulus is strong enough. Slight release in primary aggregation, and total release in secondary aggregation.

Front 72

Charectorestics of secoundary stimulus

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irreversible, total shape change, large platelet plug, total release of granular contents.

Front 73

Slight release of granuals contents in

Back 73

primary aggregation, due to weak stimulas

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Total release of granular contents

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in secoundary aggregation, due to strong stimulas

Front 75

Platlet secrete granular contents into

Back 75

plasma

Front 76

End result of platlet activation

Back 76

platelet plug

Front 77

Charectorestics of minor bleed

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clot within 10 minutues, cut involves only capilaries and small vessels.

Front 78

Charectorestics of deep injury

Back 78

cut involves more than capillaries and small vessels. Coagulation protein cascade is activated.

Front 79

Clot retraction

Back 79

contraction of platelet microfilaments on clot periphery.

Front 80

Thromboxan A2 (TXA2) function

Back 80

it stimulate other platelets like a flash mob and stimulate vasoconstriction. It is a powerful stimulator of further platelet aggregation.

Front 81

Drugs inhibit platlet aggregationand how

Back 81

asprin by inhibit cyclo-oxygenase

Front 82

Checks and balances in endothelium

Back 82

inhibit platlet aggregation, adhetion and constriction of vessels to promote vasodilation.

Front 83

Components of primary hemostasis

Back 83

componenets are platlets and vessels..

Front 84

when would be request to evaluate primary hemostasis

Back 84

when bleed longer with monor injures to small vessels. or when patient may have pathological clotting.

Front 85

Screening tests to evaluate primary hemostasis

Back 85

platelet count or evalualte smear, platlet funtional test such as bleeding time.

Front 86

Procedure for template bleeding time

Back 86

cut skin where there are no veins, controlled with blood pressure cuff at constant pressure, blood blotted to a filter paper every 30 seconds, time noted when there is no more blood wicks into filter paper which should be less than 10 min for normal.

Front 87

Refarance range for bleed time test

Back 87

< 10 minute.

Front 88

Conditions assosiated with prolonged bleed time

Back 88

von Willebrand disease, Bernard- soulier syndrome, Glanzmann's thrombasthenia, coangential storage pool disease, afibrinogenemi, severe hypofibrinogenenemia, Ehlers-Danlos syndrom, uremia, acquired platlet function defect.

Front 89

Principle on platlets aggregation studies

Back 89

confometory test for platelet function. Its in vitro study on effects of platlet activators on a patients platlets.

Front 90

platelet activators/agents/agonists that used in platlets aggregation studies.

Back 90

ADP, collagen, thrombin, Ristocetin, Epinephrine.

Front 91

type of patient sample for platlet aggregation studies

Back 91

platlet rich plasma

Front 92

tube for platlet aggregation studies

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sodium citrate, blue top, in plastic tube

Front 93

specimen process for platlet aggregation studies

Back 93

in room temperature by two step centrifugation.

Front 94

hemolysed specimen in platlet aggregation studies

Back 94

not accepted. ADP in red cells.

Front 95

lepimic specimen in platlet aggregation studies

Back 95

not aceptd. Must be fasting before specimen collection

Front 96

asprin protocols for platlet aggregation studies

Back 96

patient should not have taken asprin within the last week.

Front 97

control for platlet aggregation studies

Back 97

normal donor is the control

Front 98

3 factors must be aware of for platlet aggregation studies procedure

Back 98

PH, constant stirring, size and shape of curvette and stir bar.

Front 99

PH for platlet aggregation studies

Back 99

optimal is 8. it can be between 7.5 - 8.5

Front 100

Priciple of platlet aggregometer

Back 100

when platlet agregate, granuals move towards center and platelets transmit more light. Process may occur in either primary or secondary aggression or both.

Front 101

in platlet aggregometer, increased trasmited light mean

Back 101

it mean more platlet aggregation. Granuals move towards center and platlets trasmot more light.

Front 102

primary phase of platlet aggegation in aggregometer

Back 102

usually weak stimulas, characteristically one wave on desitometer.

Front 103

Secoundary phase of platlet aggegation in aggregometer

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Strong stimulas, double wave on desitometer.

Front 104

two cocnformatory tests for primary hemostasis

Back 104

platlet aggregations tudies with platlet aggregometry, and platelet function analyzer.

Front 105

How platelet function analyzer uses aganists

Back 105

uses agnonists imbedded into a membrane in a disposable cartilage.

Front 106

spimen for platelet function analyzer

Back 106

whole blood that Aspirated throught the cartilage,

Front 107

In platelet function analyzer, when platelet aggregation occur

Back 107

platlet plug, blood flow stop

Front 108

in platelet function analyzer, results expressed as

Back 108

expressed as closure time

Front 109

Normal platelet function analyzer result

Back 109

< 164 sec

Front 110

Platelet secretion studies

Back 110

done in ref labs, that releases granuals are measured with chemiluminescence or carbon 14 label.

Front 111

Flow cytometry for platlet function test

Back 111

measure recepters on platlets surface, and can help diagnose certain platlet function diseases.

Front 112

thrombopoietin

Back 112

its the response that cause playlets release from bone marrow.