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Pathoma: Hemostasis And Related Disorders – Qs & As
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Pathoma: Hemostasis And Related Disorders – Qs & As
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Pathoma: Hemostasis And Related Disorders – Qs & Asprimary hemostasis Right Ans - goal is to make a platelet plug as a
temporary solution to vessel injury
primary hemostasis pic Right Ans -
primary hemostasis: what happens after injury to the vessel endothelium
Right Ans - 1. there is transient vasoconstirction that occurs
- decrease the blood flow to there before any hemostasis can begin
primary hemostasis: vasoconstriction mediated by Right Ans - 1. neural
reflex
2. endothelial cells release endothelin
endothelin Right Ans -
primary hemostasis: after vasoconstriction, then Right Ans - platelet
adhesion
primary hemostasis: platelet adhesion Right Ans - 1. vWF is released by
two sources;
- platelets via the alpha granules
- endothelial cells in the weibel pilade body
2. vWF binds to the exposed subendothelial collagen
- works as a nidus for platelet adhesion
primary hemostasis: after platelet adhesion Right Ans - platelet
aggregation
primary hemostasis: platelet activation Right Ans - 1. GP1B receptor binds
to vWF
- this causes shape change and activation
primary hemostasis: aggregation Right Ans - 1. the platelets release
important molecules such as
1. ADP
- from the desne granules
,- induces platelets to express the GPIIbIIIa receptor that is essental for
aggregation
2. thromboxane A2
-- derived from platelet COX
- allows for further aggregation
thromboxane A2 Right Ans -
classic signs and symptoms of disorders of primary hemostasis Right Ans -
1. mucosal and skin bleeding
- epistaxis, hemoptysis, occult blood, hematochezia, hematuria, menhorragia
2. skin bleeding
- petichiae are small pinpoint
- purpura
- echymosses
--- easy burising
epistaxis Right Ans -
hemoptysis Right Ans -
occult blood Right Ans - no
hematochezia Right Ans -
hematuria Right Ans -
petichiae Right Ans -
purpura Right Ans -
echymosis Right Ans -
Useful lab studies Right Ans - 1. platelet count
2. bleeding time
- bit outdated
3. blood smear
- size,
4. bone marrow biopsy
, - are the megakaryocytes normal
idiopathic thrombocytopenic purpura: what it do Right Ans - AI production
of IgG against platelet surface protein
-- e.g. GpIIbIIIa
idiopathic thrombocytopenic purpura: fun fact Right Ans - most common
cause of thrombocytopenia in the blood in *both children and adults*
idiopathic thrombocytopenic purpura: IgG Right Ans - they are produced
by plasma cells in the spleen
then, the Ab bound platelets are alter consumed by the macrophages in the
spleen
idiopathic thrombocytopenic purpura: forms Right Ans - acute
- think children
chronic
- think adults, think ppl with AI disease
idiopathic thrombocytopenic purpura: acute form Right Ans - children
1. thrombocytopenia weeks after infection or immunization
2. self0limiting d/o within weeks of pt
Tx: support, esp. with really bad thrombocytopenia
idiopathic thrombocytopenic purpura: chronic form Right Ans - 1. usually F
of child bearing age
2. may be primary or secondary
idiopathic thrombocytopenic purpura: pregnant women Right Ans - may
cause a short lived thrombocytopenia in the offspring
0 this is due to the fact that the anti platelet IgG can cross the placenta; this is
something to look out for with women with lupus
idiopathic thrombocytopenic purpura: labs Right Ans - 1. decreased
platelets
2. PT/PTT norma; this is bc the coagulation cascade is not affected
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