N 5315 Advanced Patho
/| /| /| /|
Hematologic Module 4 questions /| /| /| /|
with answers /|
What is the peripheral zone of platelet? - CORRECT ANSWERS
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✔✔Outermost layer. Made of phospholipids. Contains many /| /| /| /| /| /| /|
receptors responsible for platelet adhesion and aggregation
/| /| /| /| /| /|
What is the sol-gel of the platelet - CORRECT ANSWERS ✔✔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 - CORRECT ANSWERS
/| /| /| /| /| /| /| /| /| /|
✔✔Innermost layer contains calcium dense granules and alpha /| /| /| /| /| /| /| /|
granules
What are the four phases of platelet plug formation? - CORRECT
/| /| /| /| /| /| /| /| /| /| /|
ANSWERS ✔✔Activation, adherence, aggregation, and secretion
/| /| /| /| /|
What is the first step or phase of platelet plug formation and
/| /| /| /| /| /| /| /| /| /| /| /|
explain - CORRECT ANSWERS ✔✔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 - CORRECT
/| /| /| /| /| /| /| /| /| /|
ANSWERS ✔✔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 - CORRECT
/| /| /| /| /| /| /| /| /| /|
ANSWERS ✔✔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 - CORRECT ANSWERS
/| /| /| /| /| /| /| /| /| /| /|
✔✔Secretion- during this phase the platelet granules release their /| /| /| /| /| /| /| /| /|
contents.
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 - CORRECT ANSWERS
/| /| /| /| /| /| /| /| /| /|
✔✔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 -
/| /| /| /| /| /| /| /| /| /| /|
CORRECT ANSWERS ✔✔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 -
/| /| /| /| /| /| /| /| /| /| /|
CORRECT ANSWERS ✔✔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
/|
7 .Fibrinogen
/|
8. Fibrin
/|
9. XIII
/|
10. XII /|
11. VIII /|
12. IX /|
13. Antithrombin/|
/| /| /| /|
Hematologic Module 4 questions /| /| /| /|
with answers /|
What is the peripheral zone of platelet? - CORRECT ANSWERS
/| /| /| /| /| /| /| /| /| /|
✔✔Outermost layer. Made of phospholipids. Contains many /| /| /| /| /| /| /|
receptors responsible for platelet adhesion and aggregation
/| /| /| /| /| /|
What is the sol-gel of the platelet - CORRECT ANSWERS ✔✔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 - CORRECT ANSWERS
/| /| /| /| /| /| /| /| /| /|
✔✔Innermost layer contains calcium dense granules and alpha /| /| /| /| /| /| /| /|
granules
What are the four phases of platelet plug formation? - CORRECT
/| /| /| /| /| /| /| /| /| /| /|
ANSWERS ✔✔Activation, adherence, aggregation, and secretion
/| /| /| /| /|
What is the first step or phase of platelet plug formation and
/| /| /| /| /| /| /| /| /| /| /| /|
explain - CORRECT ANSWERS ✔✔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 - CORRECT
/| /| /| /| /| /| /| /| /| /|
ANSWERS ✔✔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 - CORRECT
/| /| /| /| /| /| /| /| /| /|
ANSWERS ✔✔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 - CORRECT ANSWERS
/| /| /| /| /| /| /| /| /| /| /|
✔✔Secretion- during this phase the platelet granules release their /| /| /| /| /| /| /| /| /|
contents.
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 - CORRECT ANSWERS
/| /| /| /| /| /| /| /| /| /|
✔✔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 -
/| /| /| /| /| /| /| /| /| /| /|
CORRECT ANSWERS ✔✔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 -
/| /| /| /| /| /| /| /| /| /| /|
CORRECT ANSWERS ✔✔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
/|
7 .Fibrinogen
/|
8. Fibrin
/|
9. XIII
/|
10. XII /|
11. VIII /|
12. IX /|
13. Antithrombin/|
