Hemostasis and Coagulation Quiz

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Questions and Answers

What is NOT a common cause of vitamin K deficiency?

Destruction of bacterial flora by antibiotics

Chronic liver disease

Increased dietary intake of vitamin K (correct)

Intestinal malabsorption

How does liver disease contribute to increased bleeding tendencies?

By enhancing the synthesis of coagulation factors

By decreasing the production of clotting factors (correct)

By causing excessive platelet aggregation

By directly damaging the platelets

Which of the following factors is implicated in increasing blood coagulability?

Vitamin K insufficiency

Obesity (correct)

Inadequate hydration

Regular exercise

What is the primary method used to treat hemophilia?

Replacement of deficient clotting factors Signup and view all the answers

Which condition is characterized by impaired platelet functions?

Thrombocytopenia Signup and view all the answers

What is a characteristic feature of macrocytic anemia?

Decreased hemoglobin content per cell Signup and view all the answers

Which type of polycythemia occurs due to a decrease in plasma volume?

Relative polycythemia Signup and view all the answers

What is one of the main risks associated with increased blood viscosity in polycythemia?

Impaired blood flow to tissues Signup and view all the answers

What is a primary cause of pernicious anemia?

Vitamin B12 deficiency Signup and view all the answers

Which step is NOT part of the hemostasis process?

Formation of bile pigments Signup and view all the answers

What is a common genetic cause of abnormal bleeding tendencies?

Hemophilia Signup and view all the answers

What is one of the effects of increased cardiac output due to anemia?

Increased rate of blood flow Signup and view all the answers

Which treatment is used for relative polycythemia?

Giving fluids to dilute blood Signup and view all the answers

What is the main difference between HbF and HbA?

HbA replaces HbF during the first few months of life. Signup and view all the answers

Which of the following describes the primary consequence of HbS?

Formation of sickle-shaped red blood cells and anemia. Signup and view all the answers

What is the normal range for red blood cell count in millions per mL of blood?

4.0 to 5.5 million/mL Signup and view all the answers

Which type of anemia is characterized by red blood cells that are smaller than normal?

Microcytic Signup and view all the answers

What is the main role of HbA1c in diabetic patients?

It measures glucose levels in hemoglobin. Signup and view all the answers

What is the average normal platelet count in millions per mm3?

300,000/mm3 Signup and view all the answers

What is the primary function of albumin in plasma?

Regulate water movement between tissues Signup and view all the answers

What component makes up the largest percentage of blood volume?

Plasma Signup and view all the answers

What are common symptoms associated with anemia?

Pale skin and fatigue Signup and view all the answers

What is the normal range for Prothrombin Time (PT) in seconds?

10 - 14 seconds Signup and view all the answers

Which type of leukocyte is primarily involved in allergic reactions and parasitic infections?

Eosinophil Signup and view all the answers

What is the fate of erythrocytes after their lifespan of 100 to 120 days?

They are removed by phagocytosis in the spleen or liver. Signup and view all the answers

Which of the following hemoglobin types appears first in human development?

HBA1 Signup and view all the answers

What is the function of thrombocytes in the hematologic system?

Facilitate blood clotting Signup and view all the answers

What does homeostasis refer to in the context of the hematologic system?

The maintenance of constant internal body composition Signup and view all the answers

Which blood component is primarily involved in the transport of gases?

Erythrocytes Signup and view all the answers

What is one of the causes of normocytic normochromic anemia?

Decreased production of RBCs due to bone marrow depression Signup and view all the answers

Which type of anemia is characterized by the destruction of red blood cells faster than they can be replaced?

Hemolytic anemia Signup and view all the answers

What is a common manifestation of hemolytic anemia related to red blood cell breakdown?

Jaundice Signup and view all the answers

Which of the following describes hereditary spherocytosis?

RBCs become abnormally spherical and fragile Signup and view all the answers

What condition is specifically caused by defects in hemoglobin leading to sickle-shaped red blood cells?

Sickle cell anemia Signup and view all the answers

Which of the following may lead to microcytic hypochromic anemia due to iron deficiency?

Decreased iron intake Signup and view all the answers

What impact does sickle cell anemia have on blood flow?

Blocked blood flow due to rigid cells Signup and view all the answers

Which factor is NOT associated with the development of aplastic anemia?

Iron deficiency Signup and view all the answers

Study Notes

Pathophysiology of Hematologic System

Components of the Hematologic System include all blood elements (plasma, blood cells) and lymphoid organs (e.g., spleen, bone marrow).
Plasma minus clotting factors equals serum.

Blood Components

Plasma constitutes 55% of total blood volume.
Plasma is mostly water (91%).
Soluble blood proteins make up 7% of plasma.
Hormones, nutrients, and electrolytes account for the remaining 2%.
Blood elements (red blood cells, white blood cells, blood platelets) make up 45% of total blood volume.

Plasma

Plasma is the liquid portion of blood.
It's pale yellow and composed of 91% water and 9% other substances.
It contains suspended substances that don't settle out (colloid).
Key plasma proteins include albumin (regulates water movement), globulin (immune system/transport), and fibrinogen (blood cell formation).

Blood Cells

Blood cells include erythrocytes (RBCs), leukocytes (WBCs), and thrombocytes (platelets).
Leukocytes (WBCs) are further categorized into granulocytes (neutrophils, eosinophils, basophils) and agranulocytes (lymphocytes, monocytes).
Lymphocytes are subdivided into T lymphocytes and B lymphocytes.

Functions of the Hematologic System

Transport Medium: RBCs and plasma transport gases, nutrients, vitamins, hormones, and waste products.
Defensive Function: White blood cells, through phagocytosis, defend against invading microorganisms; antibodies and sensitized T lymphocytes also help.
Hemostatic Function: Platelets and coagulation factors stop blood extravasation (bleeding) due to vessel injury.
Homeostatic Function: The whole blood maintains a constant internal environment composition.

Fate of Erythrocytes (RBCs)

RBCs cannot divide, grow, or synthesize proteins.
Their lifespan is 100-120 days.
They're removed by phagocytosis in the spleen or liver.
New RBCs are produced in the bone marrow.
RBC production increases when oxygen levels decrease or during pregnancy.

Hemoglobin

Hemoglobin is the protein in red blood cells that transports oxygen from lungs to tissues and carbon dioxide from tissues to lungs.
Hemoglobin consists of four globulin chains.

Types of Hemoglobin

HbA1: The major hemoglobin in humans, appearing 12 weeks after birth (minor component of normal adult hemoglobin).
HbF: Synthesized during fetal development and in newborn infants, replaced by HbA in the first few months of life
HbA1c: Has glucose residues attached to beta-globin chains and increased levels indicate poor blood sugar control. HbA1c can be used as a monitoring tool for diabetes control.

HBS (Sickle Cell Anemia)

HBS contains two mutant beta-globin chains.
Glutamate at position 6 is replaced by valine in mutant chains.
RBCs in HBS have a shorter lifespan (less than 20 days compared to 120 days for normal RBCs).
Anemia is a consequence of HBS.

Red blood cell count: 4.0 to 5.5 million/mL of blood for both genders.
Hemoglobin: 14.0-17.5 gm/100mL for males; 12.0-16.0 gm/100mL for females.
Hematocrit (percentage of red blood cells): 42-52% for males; 36-48% for females.

Total leukocyte count: 4,000-11,000/mm3.
Classification (differential leukocyte count): Granulocytes (neutrophils, eosinophils, basophils); Agranulocytes (lymphocytes, monocytes).
Specific percentages for each type of leukocyte are provided.

Platelet count: 150,000-400,000/mm3 (average 300,000/mm3).
Bleeding time: normally 1-6 minutes.
Coagulation Tests:
- Whole blood coagulation time: 6-10 minutes
- Activated partial thromboplastin time: 30-40 seconds
- Prothrombin time: 10-14 seconds

Anemia

Decreased red blood cell count or hemoglobin percentage, or both, leading to decreased oxygen transport to tissues.
Common symptoms include pale or yellowish skin, fatigue, cold hands and feet, headache, and shortness of breath.

Types of Anemia

Classified based on red blood cell morphology:
- Microcytic: small size and lower hemoglobin content.
- Macrocytic: larger size.
- Hypochromic: reduced hemoglobin content.

Normocytic Normochromic Anemia

Results from decreased production or excessive loss of RBCs.
Causes include bone marrow depression (aplastic anemia) from radiation, chemicals, chemotherapy, infections, or massive hemorrhage, or hemolysis of RBCs.

Hemolytic Anemia

Red blood cells are destroyed faster than bone marrow can replace them.
Acquired causes include chemical/bacterial toxins, drugs, snake venom, autoimmune disorders (incompatible blood transfusions), cancers, and certain viral/parasitic infections (malaria).
Hereditary causes include hereditary spherocytosis, sickle cell anemia, and thalassemia.

Manifestations of Hemolytic Anemias

Common anemia symptoms.
Jaundice (yellowing of skin and mucous membranes) due to increased blood bilirubin.
Sickling of RBCs in sickle cell anemia results in increased blood viscosity and reduced blood flow to tissues leading to hypoxia and pain.
Splenomegally (enlarged spleen).

Microcytic Hypochromic Anemia

Smaller RBCs with lower hemoglobin.
Causes include iron deficiency (low iron intake, poor absorption, or chronic blood loss)

Macrocytic Anemia

Larger RBCs.
Causes include vitamin B12 or folic acid deficiency.

Pathophysiological Effects of Anemia

Decreased blood viscosity
Increased blood flow rate
Increased venous return
Increased cardiac output to compensate for decreased oxygen content in blood
Excessive production of bile pigments in hemolytic anemia causes jaundice
In pernicious anemia (lack of vitamin B12), sensory disturbances due to spinal cord degeneration.

Polycythemia

High RBC count.
Relative Polycythemia: Decreased plasma volume; increased RBC concentration.
Primary Polycythemia: Bone marrow makes too many RBCs, also producing too many white blood cells and platelets; thickening the blood and causing complications like blood clots or bleeding.
Secondary Polycythemia: Caused by chronic hypoxia (e.g., high altitude).

Manifestations of Polycythemia

Increased blood volume
Increased blood viscosity
Risk of thrombosis
Occlusion of small blood vessels
Impaired blood flow to tissues (ischemia)
Hepatosplenomegally.

Pathophysiology of Hemostasis

Definition: Stoppage of bleeding when a blood vessel is injured.
Steps:
- Vasoconstriction of blood vessels.
- Formation of a platelet plug.
- Formation of a blood clot.
- Growth of fibrous tissue.

Abnormalities in Coagulation Process

Causes of increased bleeding tendencies: genetic (like hemophilia), acquired (vitamin K deficiency, liver diseases), or drug-induced.
Characteristics: prolonged clotting time.

Hemophilia

Rare bleeding disorder due to clotting factor deficiency.
Manifestations: mild to severe bleeding problems, excessive bleeding with trauma or surgery, and internal bleeding within soft tissues (muscles, joints).
Treatment: injury prevention and factor replacement therapy.

Vitamin K Deficiency

Vitamin K is necessary for clotting factors (II, VII, IX, and X) synthesis.
Sources are exogenous (dietary) and endogenous (intestinal bacteria).
Causes of deficiency include malabsorption, antibiotic-induced bacterial flora destruction, and certain medications.
Treatment includes vitamin K administration and deficient factor supplementation.

Liver Diseases

Liver produces clotting factors.
Liver disease reduces clotting factor production causing coagulation defects resulting in increased bleeding tendencies.
Examples: hepatitis, cirrhosis, liver cancer, liver failure

Drug-Induced Abnormalities (increased bleeding)

Anticoagulants like Warfarin and heparin inhibit blood clotting

Abnormalities in Blood Platelets

Decreased platelet count or impaired platelet function leads to increased bleeding tendencies.
Characteristics: prolonged bleeding time.

Increased Blood Coagulability

Causes may include underlying inherited disorders of coagulation, obesity, cancer, sepsis, polycythemia, prolonged bed rest, venous stasis, and trauma/surgery.
Danger: increased risk of thrombosis.

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Description

Test your knowledge on hemostasis and coagulation processes. This quiz covers various conditions related to vitamin K deficiency, liver disease, and hemophilia treatment. Understand the factors that affect blood coagulation and platelet function.