General concepts
Name of the process of RBC production
Erythropoiesis
Which lab value would be drawn to assess the status of the extrinsic pathway within the clotting cascade?
PT- Prothrombin Time.
Which coagulation factor is obtained from the diet?
Calcium
What are the three major factors involved with Virchow's Triad?
1. Endothelial Injury
2. Venous Stasis
3. Hypercoagulability.
Genetic hemoglobinopathy in which the production of either alpha and/or beta chains from hemoglobin molecules are either reduced or absent
Thalassemia
Glycoprotein synthesized and secreted by the kidneys. In cases of CKD there is a reduction of it causing anemia
Erythropoietin
Unconjugated bilirubin needs to bind to this in order to become water soluble conjugated bilirubin so that it can be excreted in the bile
Albumin
Derived from arachidonic acid, this lipid mediator is continuously produced by healthy endothelial cells and it functions to reduce platelet adherence and promote vasodilation.
Prostacyclin
A young healthy patient presents with an unexplained/unprovoked PE. What autosomal dominant clotting disorder will they likely be tested for?
Factor V Lieden
(mutation of F5 gene)
Extrinsic causes of hemolytic anemia include immune, mechanical, clotting disorders, and meds. What are some intrinsic causes?
Abnormal HgB
Membrane or enzyme defects
___ and ____ are required for a high rate of DNA synthesis needed to produce RBCs & WBCs.
Vitamin B12; Folate
Endothelial cells release this as an inhibitor of platelet activation/aggregation
nitric oxide - NO
which clotting factors are associated with the intrinsic pathway?
VIII, IX, XI, XII
There are 3 types of hemophilia with type A being the most common. Which factor is associated with it?
Factor VIII
(Ate=8)
Hemophilia B- IX (B-nine, benign)
Hemophilia C- XI (IDK)
Name of enzyme that supports rapid platelet aggregation (Thromboxane A2) and Vasoconstriction when activated.
Cyclooxgenase
T/F- The majority of our iron is obtained from our diet
False:
95%- is recycled from breakdown of RBCs in spleen
5%- From dietary absorption
The very first step of achieving hemostasis is what?
Vasoconstriction
Protein C binds to Protein S in order to inactivate which cofactors?
VIII, V
In type 1 von willebrand factor disease, the treatment of choice is DDAVP which is a synthetic antidiuretic hormone. Which specific receptor does this act on?
Type 2 vasopressin receptor
(increases VWF and Factor VIII)
What protein found on endothelial cells binds to thrombin in order to activate protein C?
Thrombomodulin
Name for process that occurs during sickle cell disease in which there is an increased removal rate of RBCs within the spleen. This may lead to the need for a splenectomy
Extravascular hemolysis
Which enzyme is essential for converting fibrinogen into fibrin?
Thrombin
Which protease factors are reliant on Vit K?
II
VII
IX
X
(2+7=9 and then if you add one more you get 10!)
T/F- Gerontological considerations for blood and clotting include
1. Increased incidence of anemia
2. Alterations in bone marrow
3. Decreased coagulability
False-
#3 should be Increased Hypercoagulability.
This condition is common in pediatrics and can result in hearing loss, intellectual disability, and encephalopathy if left untreated.
Hyperbilirubinemia