Coagulation and Platelet Function Quiz
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Questions and Answers

What does plasmin primarily digest in the body?

  • Fibrin fibers and other coagulants (correct)
  • Vitamin K
  • Fibrin fibers only
  • Platelet aggregates

Which of the following is NOT a factor contributing to normal coagulation?

  • Vitamin K
  • Calcium ions
  • Plasminogen (correct)
  • Normal platelets

Which condition is associated with excessive bleeding due to a deficiency in clotting factors?

  • Protein S deficiency
  • Vitamin K deficiency (correct)
  • Increased platelet count
  • Iron overload

What is the function of warfarin in relation to blood clotting?

<p>Interferes with the action of vitamin K (D)</p> Signup and view all the answers

What role do calcium ions play in coagulation?

<p>They are essential for clotting factor function (A)</p> Signup and view all the answers

What is the diameter range of megakaryocytes?

<p>35-160 μm (B)</p> Signup and view all the answers

What is the typical survival time of platelets in the circulation?

<p>8-12 days (C)</p> Signup and view all the answers

Which structure serves as the main site for storage of Ca2+ in platelets?

<p>Canalicular system (C)</p> Signup and view all the answers

What factor serves as an adhesion bridge between subendothelial collagen and platelets?

<p>Von Willebrand factor (C)</p> Signup and view all the answers

What is the primary site of platelet destruction in the body?

<p>Spleen (D)</p> Signup and view all the answers

Which of the following components is NOT part of the platelet's physical structure?

<p>Neurons (A)</p> Signup and view all the answers

What role do platelets play in closing small ruptures in blood vessels?

<p>Fusing with endothelial cells (B)</p> Signup and view all the answers

What is the normal blood platelet count range in cu/mm of blood?

<p>150,000-450,000 (D)</p> Signup and view all the answers

What is the minimum RBC count that defines polycythemia?

<p>7 million/cu mm (B)</p> Signup and view all the answers

Which type of polycythemia is associated with a RBC count above 14 million/cu mm?

<p>Polycythemia vera (D)</p> Signup and view all the answers

Which condition can lead to secondary polycythemia?

<p>Pneumonia (B)</p> Signup and view all the answers

What is a common characteristic of anemia?

<p>Decrease in hemoglobin content (D)</p> Signup and view all the answers

Which type of anemia is caused by the inability to absorb enough iron?

<p>Iron deficiency anemia (A)</p> Signup and view all the answers

What type of anemia is specifically linked to blood loss after rapid hemorrhage?

<p>Hemorrhagic anemia (B)</p> Signup and view all the answers

Which condition contributes to abnormal hemoglobin levels?

<p>Thalassemia (A)</p> Signup and view all the answers

What is a physiological condition that can cause secondary polycythemia?

<p>Increased metabolism (B)</p> Signup and view all the answers

What is primarily involved in the phagocytosis of red blood cells?

<p>Macrophages (B)</p> Signup and view all the answers

What is the average lifespan of red blood cells in circulation?

<p>120 days (D)</p> Signup and view all the answers

Which substance is a result of the breakdown of heme in red blood cells?

<p>Bilirubin (A)</p> Signup and view all the answers

What component of hemoglobin is reused for protein synthesis?

<p>Globin (C)</p> Signup and view all the answers

Where is bilirubin excreted after it's formed from heme?

<p>Feces (C)</p> Signup and view all the answers

What is responsible for transporting iron in the bloodstream?

<p>Transferrin (A)</p> Signup and view all the answers

What process regenerates erythrocytes in response to low oxygen levels?

<p>Erythropoiesis (C)</p> Signup and view all the answers

What is the initial product of heme degradation?

<p>Biliverdin (C)</p> Signup and view all the answers

Which vitamin is associated with red blood cell production?

<p>Vitamin B12 (C)</p> Signup and view all the answers

What molecule binds to iron in the liver for storage?

<p>Ferritin (B)</p> Signup and view all the answers

Which condition is NOT associated with high erythropoietin levels and polycythemia?

<p>Hypothyroidism (D)</p> Signup and view all the answers

What is the role of intrinsic factor in erythropoiesis?

<p>Facilitates the absorption of vitamin B12 (D)</p> Signup and view all the answers

Which vitamin is crucial for the maturation of red blood cells (RBCs)?

<p>Vitamin B12 (A)</p> Signup and view all the answers

What percentage of the body's total iron is found in hemoglobin?

<p>65% (D)</p> Signup and view all the answers

What type of anemia is caused by a deficiency of vitamin B12?

<p>Megaloblastic anemia (B)</p> Signup and view all the answers

Which factor is NOT crucial for erythropoiesis?

<p>Zinc (A)</p> Signup and view all the answers

Where is most vitamin B12 stored in the body?

<p>In the liver (A)</p> Signup and view all the answers

What is the active form of transferrin called?

<p>Transferrin (A)</p> Signup and view all the answers

What is the primary reason bilirubin is bound to albumin?

<p>To increase the solubility of the whole molecule (D)</p> Signup and view all the answers

What is the normal range of bilirubin levels?

<p>1 to 16 µmol/l (C)</p> Signup and view all the answers

What bilirubin level is associated with jaundice?

<p>2 mg/dl (C)</p> Signup and view all the answers

What type of cell is a reticulocyte a precursor to?

<p>Red blood cell (B)</p> Signup and view all the answers

Which unit of blood cell formation specifically refers to erythrocytes?

<p>CFU-E (C)</p> Signup and view all the answers

Which type of stem cells differentiate into lymphocytes?

<p>Lymphoid stem cells (D)</p> Signup and view all the answers

What is the role of albumin concerning unconjugated bilirubin?

<p>Prevent unconjugated bilirubin from entering tissues (D)</p> Signup and view all the answers

Which of the following is not a type of white blood cell mentioned?

<p>Platelet (B)</p> Signup and view all the answers

Flashcards

High Erythropoietin Levels

Elevated levels of erythropoietin, a hormone that stimulates red blood cell production, are often seen in conditions like anemia, high altitude, heart failure, and lung disease.

Polycythemia

An increase in the number of red blood cells in the blood, often a result of high erythropoietin levels.

Kidney's Role in RBC Formation

The kidneys produce erythropoietin, a hormone that stimulates the bone marrow to produce red blood cells.

Hemoglobin

A protein found in red blood cells that carries oxygen from the lungs to the rest of the body.

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Hb A

The most common type of hemoglobin found in adults.

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Hb A2

A minor type of hemoglobin found in adults.

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Hb F (Fetal Hb)

The primary type of hemoglobin found in fetuses and newborns. It has a higher affinity for oxygen than Hb A.

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Iron Metabolism

The process by which the body absorbs, stores, and uses iron, a critical component of hemoglobin.

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Primary Polycythemia

A disease characterized by an extremely high RBC count (above 14 million/cu mm) often accompanied by an elevated white blood cell count (above 24,000/cu mm). It's caused by a malignancy in the red bone marrow.

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Secondary Polycythemia

An increase in RBC count due to various factors like respiratory disorders, heart disease, exercise, or hormonal changes. It's not a disease itself, but a response to a condition.

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Anemia

A condition characterized by a reduction in the number of red blood cells, hemoglobin content, or packed cell volume.

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Hemorrhagic Anemia

A type of anemia caused by blood loss, either internally or externally.

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Hemolytic Anemia

A type of anemia caused by the premature destruction of red blood cells.

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Aplastic Anemia

A type of anemia caused by a failure of the bone marrow to produce enough red blood cells, white blood cells, and platelets.

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Pernicious Anemia

A type of anemia caused by a deficiency of vitamin B12, resulting in large red blood cells (macrocytic).

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Extravascular Pathway

The primary pathway for the destruction of old or damaged red blood cells (RBCs) outside of the bloodstream, primarily within the liver, spleen, and bone marrow.

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Phagocytosis of RBCs

The process by which macrophages in the liver, spleen, and bone marrow engulf and destroy old or damaged red blood cells.

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Hemoglobin Breakdown

The breakdown of hemoglobin, the oxygen-carrying protein in red blood cells, into its constituent parts: globin and heme.

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Globin

The protein component of hemoglobin that is broken down into amino acids, which are reused for protein synthesis.

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Heme Breakdown

The breakdown of heme, a non-protein component of hemoglobin, into iron (Fe2+) and biliverdin.

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Biliverdin

A green pigment formed from the breakdown of heme. It is further converted to bilirubin, which is then excreted.

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Bilirubin

A yellow pigment produced from the breakdown of heme, excreted in bile and urine.

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Iron Recycling

The process by which iron released from the breakdown of heme is recycled for use in the formation of new red blood cells.

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Jaundice

Yellowing of the skin and whites of the eyes, caused by a buildup of bilirubin in the blood.

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Causes of Jaundice

Jaundice can be caused by various factors, including liver disease, blocked bile ducts, and increased red blood cell breakdown.

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Bilirubin-Albumin Complex

A molecule formed when bilirubin binds to albumin, increasing its solubility and preventing its free diffusion into other tissues.

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Unconjugated Bilirubin

Bilirubin that is not yet attached to albumin, making it less soluble and potentially toxic to tissues.

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Why is bilirubin bound to albumin?

Albumin binding increases the solubility of bilirubin, preventing it from freely entering other tissues and causing damage.

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Normal Bilirubin Range

The typical range of bilirubin levels in the blood, typically between 1 and 16 μmol/l.

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Red Blood Cell

The most common type of blood cell, responsible for carrying oxygen throughout the body.

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Blood Film

A microscopic examination of a blood sample to analyze the different cell types present.

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Platelets

Small, cell-like fragments in the blood that help stop bleeding by forming blood clots.

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Plasmin

An enzyme that breaks down fibrin clots. It is activated from plasminogen, a protein found in plasma.

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Fibrinolysis

The process of dissolving blood clots. It is primarily mediated by plasmin.

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Vitamin K deficiency

Can lead to excessive bleeding due to insufficient activation of several clotting factors (prothrombin, Factor VII, Factor IX, Factor X, and protein C).

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Hemophilia

A genetic disorder characterized by a deficiency in clotting factors, resulting in excessive bleeding.

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Thrombocytopenia

A condition with a low platelet count, leading to increased risk of bleeding.

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Megakaryocyte Size

Megakaryocytes are large cells with a diameter ranging from 35 to 160 micrometers.

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Platelet Size

Platelets are tiny cell fragments, measuring 2 to 3 micrometers in diameter.

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Platelet Formation

Platelets are formed within the cytoplasm of megakaryocytes and released into the bloodstream.

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Platelet Survival

Platelets typically last for 8 to 12 days in circulation.

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Platelet Destruction

Most platelets are destroyed in the spleen.

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Platelet Plug Formation

Platelet plugs are formed when platelets adhere to damaged blood vessel walls, forming a clot.

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Platelet Function - Hemostasis

Platelets are essential for hemostasis, the process of stopping bleeding.

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Platelet Count

A normal platelet count in blood is between 150,000 and 450,000 per cubic millimeter.

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Study Notes

Blood Physiology Overview

  • Blood is a connective tissue in fluid form, considered the fluid of life. It transports oxygen from the lungs to the body and carbon dioxide from the body to the lungs.
  • Blood is red in color. Arterial blood is scarlet red due to oxygenated hemoglobin (HbO2), and venous blood is purple-red due to higher carbon dioxide content.
  • The average adult blood volume is 5 liters. In newborns, it's 450 ml. Blood volume increases during growth and reaches 5 liters at puberty. In females, the average volume is slightly less (about 4.5 liters).

Blood Composition

  • Blood is composed of two parts:
    • Plasma constitutes 55% of blood volume. It's mostly water (90%) plus ions and plasma proteins (albumin, globulins, fibrinogen).
    • Formed elements (red blood cells, white blood cells, and platelets) make up the remaining 45% of blood volume.
  • Normal hematocrit values differ slightly between males and females
    • Males: 47% ± 5%
    • Females: 42% ± 5%

Blood Functions

  • Transport: carries oxygen, carbon dioxide, nutrients, hormones, and waste products.
  • Homeostasis: regulates body temperature and extracellular fluid (ECF) pH.
  • Protection against infections: white blood cells and antibodies.
  • Blood clotting: prevents blood loss

Blood Cell Formation (Hematopoiesis)

  • Erythropoiesis: formation of red blood cells (RBCs).
  • Leucopoiesis: formation of white blood cells (WBCs).
  • Thrombopoiesis: formation of platelets.
  • In utero, RBCs are produced in the yolk sac, liver, spleen, and eventually bone marrow. After birth, red bone marrow in flat bones and the proximal epiphyses of long bones produces RBCs.

Red Blood Cells (RBCs)

  • Characteristics: biconcave discs, ~7.5 μm diameter, flexible membrane, no mitochondria or ribosomes, anaerobic glycolysis, and a lifespan of 120 days.
  • Typical count: 4.7-5.2 million/mm³.
  • Hemoglobin (Hb) concentration: 14-16 g/dL.
  • Normal Hb types include Hb A (most common in adults), Hb A2, and Hb F (fetal).
  • Function: oxygen transport, carbon dioxide transport, and acting as a buffer.

RBC Differentiation Stages

  • A committed stem cell differentiates into a series of stages to reach a mature erythrocyte, these include:
    • Proerythroblast
    • Basophilic erythroblast
    • Polychromatophilic erythroblast
    • Orthochromatophilic erythroblast
    • Reticulocyte
  • Reticulocytes are immature erythrocytes that lose their nuclei and enter the circulation to mature.
  • In cases of rapid RBC production, reticulocytes appear in circulation.

Erythropoiesis

  • RBC development is characterized by:
    • Decreased cell size
    • Nucleus disappearance
    • Hemoglobin (Hb) appearance

Regulation of RBC Production

  • Erythropoiesis is stimulated by erythropoietin, a hormone produced mainly by the kidneys in response to hypoxia (low oxygen levels).
  • Hypoxia can result from: low RBC count (anemia), hemorrhage, high altitude, prolonged heart failure, and lung disease
  • Other factors outside bone marrow (e.g., muscular exercise, emotional conditions) influence the release of RBCs
  • Factors affecting erythropoiesis include: iron, vitamins (B12 and folic acid), and protein intake.

Hemoglobin

  • A hemoglobin molecule is composed of four globin protein chains, each with a heme group.
  • The heme group contains an iron atom, which allows for oxygen binding.
  • Normal types of hemoglobin are Hb A, Hb A2, and Hb F

Iron Metabolism

  • Iron is an essential component of hemoglobin and other structures.
  • Most iron is stored in the liver as ferritin, for use by red bone marrow.
  • Iron metabolism process includes absorption, transport, storage, utilization, and excretion.

White Blood Cells (WBCs)

  • Types are:
    • Granulocytes: neutrophils, eosinophils, and basophils
    • Agranulocytes: lymphocytes, and monocytes
  • Normal range in blood: 4000−11,000/μL.
  • Lifespan varies considerably between different types

Phagocytosis

  • Definition: Cellular ingestion of a foreign particle.
  • Function: Neutrophils and Macrophages defend against infections.

Diapedesis, Chemotaxis, and Margination

  • Diapedesis: The movement of WBCs out of blood vessels and into interstitial tissues.
  • Chemotaxis: Chemical signal that draws WBCs to the site of injury or infection.
  • Margination: The sticking of WBCs to the inner wall of blood vessels before diapedesis

Intravascular Anticoagulants

  • Endothelial Surface Factors
    • The smoothness of the endothelial cell surface
    • A layer of glycocalyx on the endothelium
    • Thrombomodulin, a protein bound to the endothelial membrane.
  • NO and prostacyclin
  • Prevent clotting in healthy blood vessels

Disorders of Erythrocytes

  • Polycythemia: Increased RBC count.
    • Primary (polycythemia vera): Due to bone marrow malignancy.
    • Secondary: caused by factors like respiratory disorders, congenital heart disease, or heart disease
  • Anemia: Reduced RBC count, hemoglobin content, or packed cell volume.
    • Blood loss anemia
    • Iron deficiency anemia
    • Pernicious anemia (B12 deficiency)
    • Megaloblastic anemia (folic acid deficiency)

Pathophysiology of Jaundice

  • Jaundice is caused by elevated bilirubin levels in the blood.
  • Bilirubin is a breakdown product of heme.
  • The normal pathway involves conjugation of bilirubin in the liver, making it water-soluble and excretable in the bile, then in urine and feces.
  • Disruption of this pathway causes jaundice.
    • Pre-hepatic: excess red blood cell breakdown, common in newborns and individuals with autoimmune disorders
    • Intrahepatic: faulty liver processing of bilirubin, often seen with generalized liver problems like hepatitis or cirrhosis
    • Post-hepatic: bile duct obstruction, and common causes are gallstones or tumor blocking the flow

Neonatal Jaundice

  • Common in premature infants, generally transient and resolves within 10 days.
  • Elevated bilirubin can lead to kernicterus, a serious neurological condition.
  • Phototherapy is often used to reduce bilirubin levels
  • In cases of elevated bilirubin in the first 24 hours or more than 10 days, further investigation is needed.

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Test your knowledge on coagulation and platelet function with this engaging quiz. Explore questions about blood clotting factors, platelet structure, and their physiological roles in the body. Perfect for students studying hematology or related medical fields.

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