Separation of Lanthanides/ Lanthanides and Actinides
Hemostasis in Pathology
1. What is normal hemostasis? Normal hemostasis- process by which bleeding at any site arrested by the formation of a hemostatic plug. 1. Followed by removal of plug so that normal flow of blood through vessels is maintained.
2. Components of hemostasis Blood vessels- vasoconstriction Platelets Coagulation Fibrinolytic system Inhibitor of coagulation
3. Blood vessels Endothelial vessels activate Coagulation cascade Fibrinolytic systems Protein C systems vWF
4. Properties of blood vessels Prothrombotic prop. vWF Tissue factor –factor 3 + thromboplastin Fibrinolysis inhibitor- PAIs
5. Antithrombotic prop. Antiplatelet effect- prostacyclins, nitric oxide Anticoagulant effect –thrombomodulin Thrombomodulin inactivates thrombin to make it an anticoagulant! Fibrinolysis properties- t-PA Clear fibrin deposits from endothelial surfaces.
6. Role of platelets Platelet adhere to exposed subendotheliat collagen Adhered platelet undergo release reaction resulting in formation of aggregation. 1. adhesion-vWF- glycoprotein Ib assoc. 2. secretion/release- Ca2+ , ADP, thromboxane A2 3.aggregation-glycoprotein 2b- 3a receptors Conformational changes of GP2b-3a allows platelet to bind fibrinogens.
7. 2 pathways of coagulation Intrinsic Extrinsic *final common pathway= Prothrombin thrombin
9. Control of coagulation Antithrombin protein C and S Fibrinolytic cascade Plasminogenplasmin FSP (fibrin split products) D-dimer is the most important FSP
10. Summary of hemostasis Primary hemostasis BV constriction Platelet plug formation Secondary hemostasis Activation of clotting cascade Deposition &stabilisation of fibrin
16. Clasification of ITP Children / adult onset Acute / chronic Primary / secondary (idiopathic)
17. Acute-children (post-infection) Chronic-adult (> female, 20-40 yrs. Old) Autoimmune disorders AntiplateletAb (IgG) IgG coated platelets removed by spleen > megakaryocytes in bone marrow *blood picture !!! Very important.
18. Characteristic of ITP Sudden onset of bruising / petechiae Case history of infectious disease Appear respiratory tract infection in about 3 weeks prior to onset of bleeding Dangerous-intracerebellar hemorrhage <20,000 platelet count.
20. Additional infos t-PA most important plasminogen. plasminogen is activated by streptokinase. To prevent excessive thrombi destruction, free plasminogen quickly bind to α2-antiplasmin.
21. PAIs Endothelial cells regulate anticoagulation balance by secreting PAIs. (plasminogen activation inhibitor) PAI-block fibrinolysis, procoagulationefct. increased by certain cytokines. role in I.V thrombosis accompanying severe inflammation.