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N 5315 Advanced Patho Hematologic Module
4 Exam Questions With Correct Answers
(Verified And Updated)
What is the peripheral zone of platelet? - Answer✔Outermost layer. Made of phospholipids.
Contains many receptors responsible for platelet adhesion and aggregation
What is the sol-gel of the platelet - Answer✔It is the outermost layer made of possible if it
contains many receptors responsible for platelet adhesion and aggregation
What is the organelle zone of platelets - Answer✔Innermost layer contains calcium dense
granules and alpha granules
What are the four phases of platelet plug formation? - Answer✔Activation, adherence,
aggregation, and secretion
What is the first step or phase of platelet plug formation and explain - Answer✔Activation is the
first step. In physiological states. Platelets circulate without adhering to the intact endothelium.
An injury to the endothelium exposes thev WF, fibronectin, collagen and from thrombospondin..
Collagen is a potent activator and when the sub endothelial collagen is exposed by an injury. The
platelets become charged AKA activated. Platelets and become aware of the injury and undergo
a shape change that increases their ability to adhere to the site of injury.
The second step in platelet plug formation is - Answer✔Adherence is a process by which
platelets attached to the injured endothelium. Adherence begins with the vWF. Circulating vWF
binds to the exposed subendothelial collagen and to the GP Ib/IX/V receptors on circulating
platelets. Collagen then binds with the GP VI receptor. The binding of collagen with the GP VI
receptor results in the activation of the GPIIb/IIIa and GPIa/IIa receptors. vWF then binds with
the GPIIb/IIIa receptors and collagen further binds with the GPIa/IIa receptors. This collective
binding anchors the platelets in place
The third step in platelet plaque formation is - Answer✔Aggregation- is the process by which
platelets bind to one other. There are multiple GPIIb/IIIa receptors on one platelet and when
activated (as described above) they have a greater affinity for fibrinogen. Fibrinogen is able to
bind to two GPIIb/IIIa receptors simultaneously and thereby bind platelets together
The fourth step in platelet plug formation is - Answer✔Secretion- during this phase the platelet
granules release their contents.
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a. ADP- enhances adhesion, activates platelets and recruits platelets
b. Serotonin recruits platelets.
c. Fibronectin and thrombospondin are proteins which stabilize platelets that are adhered to the
site of injury.
d. Thromboxane A2- is a product of the arachidonic acid pathway but is stored inside the platelet
too. It causes vasoconstriction and enhances platelet aggregation.
e. Growth factors promote tissue repair however they have a role in the development of
atherosclerosis.
The final step in platelet plug formation - Answer✔The platelet plug is stabilized by fibrin and
XIIIa which are the end products of the coagulation cascade.
What is the extrinsic pathway arms of the coagulation cascade - Answer✔Extrinsic pathway is
considered the primary pathway of coagulation. It is activated when Tissue Factor is exposed at
the site of injury. The process starts with a vascular injury which results in the exposure of
Tissue Factor (III) which has a cell receptor for factor VII. (As a side note lipid filled
macrophages in atherosclerotic plaques contain a large amount of tissue factor which increases
the likelihood of arterial thrombus formation from plaque ruptures). Once exposed TF binds with
VII to form the TF/VIIa complex. TF/VIIa activates X = Xa. Activated factor Xa binds with
activated Va and calcium to form the prothrombinase complex. The prothrombinase complex
converts factor II (prothrombin) to activated factor IIa (thrombin). Thrombin (activated factor
IIa) then moves on to activate 4 factors. It activates factor I (fibrinogen) to activated factor Ia
(fibrin) and it also activates factors V, VIII & XIII. You can see the action of thrombin on your
screen marked with blue lines. Fibrin (activated factor Ia) is placed over the platelet plug and
activated factor XIIIa stabilizes the fibrin.
What is the intrinsic pathway arms of the coagulation cascade - Answer✔The clinical
significance of the intrinsic pathway is not entirely understood, because a deficiency of factor
XII (Hageman factor) does not cause bleeding. As such the intrinsic pathway's main function is
thought to be one which enhances the extrinsic pathway. This pathway is activated when the
blood is exposed to negative charges which are found on the molecules of ADP and ATP. This
exposure activates factor XII (Hageman factor). Activated factor XIIa then activates factor XI.
Activated factor XIa activates IX. Activated factor IXa then activates factor X. Activated factor
Xa then forms the prothrombinase complex in the common pathway.
Coagulation Cascade Key Plasma Proteins
1.Tissue Factor
2.VII
3.X
4 .Prothrombinase Complex
5. Prothrombin
6. Thrombin
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7 .Fibrinogen
8. Fibrin
9. XIII
10. XII
11. VIII
12. IX
13. Antithrombin
14. Protein C
15. Protein S
16.t-PA - Answer✔1. Initiator of extrinsic pathway.
2. Forms complex with tissue factor (III) and activates factors IX and X
3. Activates Prothrombin through activated Xa form
4. (prothrombin and activated factors X and V) that activates prothrombin into thrombin
5. Factor II, source of thrombin that activates fibrinogen
6. cleaves the extracellular domain of G-protein-coupled protease-activated receptors (PARs),
thereby initiating transmembrane signaling.
7. moves between the beta and gamma regions but is removed during the formation of serum;
precursor of fibrin clot
8. Used to stabilize clot
9. Fibrin - stabilizing factor - cross links fibrin through XIIIa to strengthen clot
10. Hageman Factor. Initiator of intrinsic pathway
11. VIIIa is a component of tenase complex
12. IXa is a component of tenase complex, activates factor X
13. it inhibits thrombin and several activated clotting factors (e.g., VIIa, IXa, Xa, XIa, XIIa).
14. in the circulation binds to thrombomodulin in a thrombin-dependent manner and is converted
to activated protein C
15. degrades factors Va and VIIIa
16. a serine protease that reaches maximal enzymatic activity after binding to fibrin and
proteolytically activates plasminogen to plasmin
What is the coagulation cascade - Answer✔The coagulation cascade is the second arm of
hemostasis. This process involves quite a few steps and there are many players involved. It can
3|Page
N 5315 Advanced Patho Hematologic Module
4 Exam Questions With Correct Answers
(Verified And Updated)
What is the peripheral zone of platelet? - Answer✔Outermost layer. Made of phospholipids.
Contains many receptors responsible for platelet adhesion and aggregation
What is the sol-gel of the platelet - Answer✔It is the outermost layer made of possible if it
contains many receptors responsible for platelet adhesion and aggregation
What is the organelle zone of platelets - Answer✔Innermost layer contains calcium dense
granules and alpha granules
What are the four phases of platelet plug formation? - Answer✔Activation, adherence,
aggregation, and secretion
What is the first step or phase of platelet plug formation and explain - Answer✔Activation is the
first step. In physiological states. Platelets circulate without adhering to the intact endothelium.
An injury to the endothelium exposes thev WF, fibronectin, collagen and from thrombospondin..
Collagen is a potent activator and when the sub endothelial collagen is exposed by an injury. The
platelets become charged AKA activated. Platelets and become aware of the injury and undergo
a shape change that increases their ability to adhere to the site of injury.
The second step in platelet plug formation is - Answer✔Adherence is a process by which
platelets attached to the injured endothelium. Adherence begins with the vWF. Circulating vWF
binds to the exposed subendothelial collagen and to the GP Ib/IX/V receptors on circulating
platelets. Collagen then binds with the GP VI receptor. The binding of collagen with the GP VI
receptor results in the activation of the GPIIb/IIIa and GPIa/IIa receptors. vWF then binds with
the GPIIb/IIIa receptors and collagen further binds with the GPIa/IIa receptors. This collective
binding anchors the platelets in place
The third step in platelet plaque formation is - Answer✔Aggregation- is the process by which
platelets bind to one other. There are multiple GPIIb/IIIa receptors on one platelet and when
activated (as described above) they have a greater affinity for fibrinogen. Fibrinogen is able to
bind to two GPIIb/IIIa receptors simultaneously and thereby bind platelets together
The fourth step in platelet plug formation is - Answer✔Secretion- during this phase the platelet
granules release their contents.
1|Page
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a. ADP- enhances adhesion, activates platelets and recruits platelets
b. Serotonin recruits platelets.
c. Fibronectin and thrombospondin are proteins which stabilize platelets that are adhered to the
site of injury.
d. Thromboxane A2- is a product of the arachidonic acid pathway but is stored inside the platelet
too. It causes vasoconstriction and enhances platelet aggregation.
e. Growth factors promote tissue repair however they have a role in the development of
atherosclerosis.
The final step in platelet plug formation - Answer✔The platelet plug is stabilized by fibrin and
XIIIa which are the end products of the coagulation cascade.
What is the extrinsic pathway arms of the coagulation cascade - Answer✔Extrinsic pathway is
considered the primary pathway of coagulation. It is activated when Tissue Factor is exposed at
the site of injury. The process starts with a vascular injury which results in the exposure of
Tissue Factor (III) which has a cell receptor for factor VII. (As a side note lipid filled
macrophages in atherosclerotic plaques contain a large amount of tissue factor which increases
the likelihood of arterial thrombus formation from plaque ruptures). Once exposed TF binds with
VII to form the TF/VIIa complex. TF/VIIa activates X = Xa. Activated factor Xa binds with
activated Va and calcium to form the prothrombinase complex. The prothrombinase complex
converts factor II (prothrombin) to activated factor IIa (thrombin). Thrombin (activated factor
IIa) then moves on to activate 4 factors. It activates factor I (fibrinogen) to activated factor Ia
(fibrin) and it also activates factors V, VIII & XIII. You can see the action of thrombin on your
screen marked with blue lines. Fibrin (activated factor Ia) is placed over the platelet plug and
activated factor XIIIa stabilizes the fibrin.
What is the intrinsic pathway arms of the coagulation cascade - Answer✔The clinical
significance of the intrinsic pathway is not entirely understood, because a deficiency of factor
XII (Hageman factor) does not cause bleeding. As such the intrinsic pathway's main function is
thought to be one which enhances the extrinsic pathway. This pathway is activated when the
blood is exposed to negative charges which are found on the molecules of ADP and ATP. This
exposure activates factor XII (Hageman factor). Activated factor XIIa then activates factor XI.
Activated factor XIa activates IX. Activated factor IXa then activates factor X. Activated factor
Xa then forms the prothrombinase complex in the common pathway.
Coagulation Cascade Key Plasma Proteins
1.Tissue Factor
2.VII
3.X
4 .Prothrombinase Complex
5. Prothrombin
6. Thrombin
2|Page
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7 .Fibrinogen
8. Fibrin
9. XIII
10. XII
11. VIII
12. IX
13. Antithrombin
14. Protein C
15. Protein S
16.t-PA - Answer✔1. Initiator of extrinsic pathway.
2. Forms complex with tissue factor (III) and activates factors IX and X
3. Activates Prothrombin through activated Xa form
4. (prothrombin and activated factors X and V) that activates prothrombin into thrombin
5. Factor II, source of thrombin that activates fibrinogen
6. cleaves the extracellular domain of G-protein-coupled protease-activated receptors (PARs),
thereby initiating transmembrane signaling.
7. moves between the beta and gamma regions but is removed during the formation of serum;
precursor of fibrin clot
8. Used to stabilize clot
9. Fibrin - stabilizing factor - cross links fibrin through XIIIa to strengthen clot
10. Hageman Factor. Initiator of intrinsic pathway
11. VIIIa is a component of tenase complex
12. IXa is a component of tenase complex, activates factor X
13. it inhibits thrombin and several activated clotting factors (e.g., VIIa, IXa, Xa, XIa, XIIa).
14. in the circulation binds to thrombomodulin in a thrombin-dependent manner and is converted
to activated protein C
15. degrades factors Va and VIIIa
16. a serine protease that reaches maximal enzymatic activity after binding to fibrin and
proteolytically activates plasminogen to plasmin
What is the coagulation cascade - Answer✔The coagulation cascade is the second arm of
hemostasis. This process involves quite a few steps and there are many players involved. It can
3|Page
