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SCHC hematology II

QuestionAnswer
What is the normal plt count range? 150,000 to 440,000 x 10^9 /L
List some important molecules for coagulation. Calcium, Vitamin K, fibrinogen
What does TPO do? It's a major humoral component that causes platelet proliferation. It also regulates the production and release of plt.
How does TPO maintain constant # of platelets in the blood? They have a receptor mpl(CD110) which can bind to the megakaryotcye and circulating platelets.
Where are megakaryocytes located in the bone marrow? Near the sinuses.
Where are most of the platelets in the body? Blood stream (~2/3)
What is a site of plt sequestering? The spleen (~1/3)
What's the average lifespan of a plt? 9.5 days
What portion of the megakaryocye is platelets composed of? The cytoplasm.
What is the demarcation membrane system? They are small areas in the cytoplasm that separated.
When plts are decreased, how much TPO is present compared to normal and what does it bind to? TPO is increased and binds to megakaryocyte to increase plt release/shedding
What's the main function of the peripheral zone? Activation, adhesion, aggregation.
What are the main components of the peripheral plt zone? Glycocalyx, phospholipid bilayer, Integral proteins.
Structural zone contains? microtubules, cytoskeletal network, intermediate filaments.
What's the purpose of the structural zone? To provide structure and support.
What disease does the sugar H2O test for? Paroxysmal nocturnal hemoglobinuria; + = presumptive diagnosis but need to do flow cytometry to confirm.
What type of RBC's does the Osmotic fragility test for? Spherocytes, they lyse faster than normal RBC's in hypotonic solns
What are common reasons to perform a sed rate? To see if there is an inflammatory process taking place, multiple myeloma, PID, Lupus, RA, kidney disease.
What is the normal reference range for sed rate? 0 to 20 mm/hr
What other test is almost always requested with a sed rate? C-reactive protein
How is the extrinsic pathway activated? By tissue damage which releases Ca+, or by release of tissue thromboplastin.
What factors are unique to the extrinsic pathway? VII and III (Tissue Factor/TF)
Which factors are used in the common pathway? X, V, II, I
Which factors are unique to the intrinsic pathway? PK, HK, XII, XI, VIII, IX
Which pathway uses the aPTT test and which medication can be monitored by this test? Intrinsic pathway---> can measure heparin or monitor Hemophilia A + B
Which test is commonly used to measure the extrinsic pathway? Which medication? Are there other tests routinely performed simultaneously? PT---> can measure how effective coumadin is, also the INR is also usually performed.
How does heparin stop clotting? It prevents the cleavage of fibrinogen into fibrin.
How does aspirin work? It inactivates the enzyme cyclooxygenase which will prevent the formation and release of thromboxane A2.
What is the organelle zone's function? What is it composed of? Fxn= storage and secretion; contains granules, mitochondria, and glycogen.
List the role of each of these granules in the organelle zone: Dense bodies, alpha granules, lysosomes, peroxisomes. Dense bodies--> non-protein mediators (i.e. ATP, ADP, serotonin) Alpha granules--> protein mediators Lysosomes-->Enzymes peroxisomes--> lipid metabolism.
Name the membrane systems and the their functions. Open canalicular system (Secretion of granule contents) and dense tubular systems (storage of Ca+).
What are the steps in coagulation? vasoconstriction, activation, adhesion, aggregation, fibrin formation, fibrinolysis.
What can cause coag pathway? ADP, thromboxane A2, aracodonic acid, von Willebrand, epinephrine, collagen
What causes the fibrinolysis pathway? extrinsic: tPA, uPA intrinsic: XIIa, XIa, kalikrein exogenous: streptokinase
Inhibitors of the the fibrinolytic pathway? plasminogen activator inhibitors (PAI), alpha2-ntiplasmin, and alpha2-macroglobulin
How do you calculate MCV? hct/RBC x 10
how do you calculate MCH? hgb/rbc x 10
How do you calculate MCHC? hgb/hct x 100
Name the factors in the prothrombin group. What are these factors dependent on? II, VII, IX, X, protein c, protein s , protein z. Vitamin K dependent.
What is the principle of the Sysmex? Sheath flow technology, uses impedance, radio freq. Also can determine avg size of cells from pt to pt.
What is the principle of the Beckman-Coulter analyzer? Uses VCS (Volume, conductivity, scatter). Also uses hydrodynamic focusing.
How is the volume, conductivity, and scatter analyzed? Volume--> impedance Conductivity-->electromagnetic probe Scatter--> helium neon laser
Name the dense body contents and their role in platelet function. ADP--> agonist for plt Ca-->platelet activation Serotonin-->vasoconstriction, plt agonist
What is a thrombus? A clot within a blood vessel
Why do you need to stop taking aspirin products within 10 days of surgery? Aspirin causes an irreversible disruption in the platelet function (Inhibition of COX1). This gives your body time to make new platelets.
What is the reference range for WBC's in an adult? 4-11 x 10^9/L
List some things that could affect the WBC concentration. Time of day, exercise, pregnancy, infection, age, race, gender, stress.
What do CSFs do? They are cytokines that made by endothelial cells, marrow fibroblasts, and wbc's. Regulate production and development of wbc.
What is found in the secondary granules of granulocytes? histaminase, collagenase, and lactoferrin (pinkish colored)
Azurophillic (Primary) granules contain what? myeloperoxidase (purple/blue colored)
Where are the granulocyte pools? BM, PB, marginating in BV, tissues
What are the functions of the BM pool? proliferation, maturation, Storage.
Auer rods are only seen in which cell line? Myeloloid
What is the first identifiable granulocytic stage? Myeloblast
Created by: 25109943