Thrombotic Microangiopathies and ADAMTS13
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Questions and Answers

What is the primary characteristic of thrombotic microangiopathies (TMAs)?

  • Increased white blood cell count
  • Disseminated thrombus formation in arterioles and capillaries (correct)
  • Hypercoagulation in veins
  • Decreased blood flow in large arteries
  • What does ADAMTS13 primarily regulate?

  • Platelet production in bone marrow
  • Blood pressure levels
  • The size of von Willebrand factor (VWF) (correct)
  • The secretion of blood plasma proteins
  • Which of the following conditions is characterized by thrombocytopenia and microangiopathic hemolytic anemia?

  • Hemophilia
  • Hypoalbuminemia
  • Thrombotic Thrombocytopenic Purpura (TTP) (correct)
  • Chronic leukemia
  • Where is ADAMTS13 primarily synthesized?

    <p>Liver and vascular endothelial cells</p> Signup and view all the answers

    What mechanism leads to mechanical destruction of red blood cells in MAHA?

    <p>Intravascular coagulation with fibrin-rich thrombi</p> Signup and view all the answers

    What can result from the formation of platelet-rich thrombi in the microvasculature?

    <p>Ischemic end-organ damage</p> Signup and view all the answers

    Which of the following describes the role of C-terminal domains in ADAMTS13?

    <p>They regulate protein latency</p> Signup and view all the answers

    Which bond does ADAMTS13 cleave to regulate VWF size?

    <p>Tyr1605-Met1606</p> Signup and view all the answers

    Which form of ADAMTS13 is found in acute TTP?

    <p>Open form</p> Signup and view all the answers

    What is the consequence of the increased platelet aggregation due to ultra large VWF multimers?

    <p>Thrombus formation</p> Signup and view all the answers

    Study Notes

    Thrombotic Microangiopathies (TMAs)

    • A group of diverse disorders marked by the formation of thrombi in arterioles and capillaries.
    • Associated with endothelial injury or swelling, leading to thrombocytopenia and microangiopathic hemolytic anemia (MAHA).
    • MAHA involves the destruction of red blood cells during traversal through platelet and fibrin-rich thrombi due to intravascular coagulation.

    ADAMTS13

    • ADAMTS13 is an enzyme known as a disintegrin and metalloproteinase, crucial for blood coagulation processes.
    • Located on chromosome 9q34.2, the gene comprises 29 exons and is synthesized in the liver and vascular endothelial cells.
    • Features a multi-domain structure responsible for binding and cleaving von Willebrand factor (VWF), particularly regulating its size by processing ultra-large multimers.
    • Functions to cleave the Tyr1605-Met1606 bond in the VWF A2 domain, preventing excessive platelet aggregation and thrombus formation.
    • Exists primarily in a closed form in circulation; the open form is associated with acute Thrombotic Thrombocytopenic Purpura (TTP).

    Thrombotic Thrombocytopenic Purpura (TTP)

    • A rare form of thrombotic microangiopathy (TMA).
    • Characterized by microangiopathic hemolytic anemia (MAHA), severe thrombocytopenia, and ischemic damage to organs.
    • Results from the formation of platelet-rich thrombi in the microvasculature, leading to significant clinical manifestations and potential end-organ damage.
    • Incidence rates are low, highlighting the rarity of this condition.

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    Description

    Explore the critical relationship between thrombotic microangiopathies (TMAs) and the enzyme ADAMTS13. Understand the implications of endothelial injury, thrombocytopenia, and how ADAMTS13 regulates blood coagulation. This quiz delves into the biochemical mechanisms that prevent excessive thrombus formation.

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