Pathoma Chapter 4- Questions with Complete Solutions
What are the two most important factors released by platelets in platelet degranulation?
Correct Ans-1. ADP
2. TXA2 (thromboxane A2)
What produces thromboxane A2 in degranulation step of primary hemostasis? Correct
Ans-Platelet COX
What does ADP promote in primary hemostasis? Correct Ans-Platelet expression of
GPIIb/IIIa
GPIIb/IIIa vs. GPIb in primary hemostasis Correct Ans-GPIb: expressed by platelets to allow
them to bind to vWF
GPIIb/IIIa: expressed by platelets after degranulation, and helps promote platelet
aggregation; induced by ADP release during degranulation
What molecule helps platelets link together during aggregation and formation of the platelet
plug? Correct Ans-Fibrinogen from plasma
How is the platelet plug stabilized? Correct Ans-Secondary hemostasis (coagulation
cascade)
,Pathoma Chapter 4- Questions with Complete Solutions
Where does ADP in primary hemostasis come from? Correct Ans-Dense granules of
platelets
What are the two possible problems in primary hemostasis? Correct Ans-1. Poor quantity
of platelets
2. Poor quality of platelets
Name the two most important symptoms of primary hemostasis Correct Ans-1. Mucosal
bleeding
2. Skin bleeding
What do endothelial cells sit on top of? Correct Ans-Basement membrane
Hemostasis Correct Ans-Mechanism of repair of blood vessel wall that involves formation
of thrombus (clot) at the site of vessel injury
What are the two stages of hemostasis? Correct Ans-Primary and secondary hemostasis
Goal of primary hemostasis Correct Ans-Formation of platelet plug
What two materials interact in primary hemostasis to form the platelet plug? Correct Ans-
Platelets and the vessel wall
,Pathoma Chapter 4- Questions with Complete Solutions
What is the goal of secondary hemostasis? Correct Ans-Stabilize the platelet plug
What mediates secondary hemostasis? Correct Ans-Coagulation cascade
Name the four steps of primary hemostasis Correct Ans-1. Transient vasoconstriction of
damage vessel
2. Platelet adhesion to the surface of disrupted vessel
3. Platelet degranulation
4. Platelet aggregation
What two things mediated transient vasoconstriction in primary hemostasis? Correct Ans-
1. Neural reflex stimulation
2. Release of endothelin from enothelial cells
In platelet adhesion, how does vWF bind to the vessel? Correct Ans-Binds via collagen
When vessel is damaged, what two structures are exposed that contain collagen, allowing
vWF to bind? Correct Ans-Basement membrane and underlying connective tissue
What do platelets bind to in the second platelet adhesion step of primary hemostasis?
Correct Ans-vWF, which is bound to collagen
, Pathoma Chapter 4- Questions with Complete Solutions
How do platelets bind vWF in second platelet adhesion step of primary hemostasis?
Correct Ans-Via GP1b receptor
Name the two places where vWF comes from Correct Ans-1. Weibel-Palade Bodies of
endothelial cells
2. Alpha granules of platelets
What are the two most important factors the Weibel-Palade Bodies of endothelial cells
release? Correct Ans-1. P-selectin
2. vWF
What occurs in primary hemostasis after platelet adhesion? Correct Ans-Platelet shape
change and then degranulation
Symptoms of mucosal bleeding Correct Ans-Epistaxis, hemoptysis, GI bleeding, hematuria,
menorrhagia, intracranial bleeding with severe thrombocytopenia
What is epistaxis Correct Ans-Nose bleed
What is the most common type of mucosal bleeding with primary hemostatic disorders?
Correct Ans-Epistaxis (nose bleed)
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