Pathoma Chapter 4 Exam
Study Guide
Latest Updated Study
Guide 2024/2025
What do endothelial cells sit on top of? - ansBasement
membrane
Hemostasis - ansMechanism of repair of blood vessel wall that
involves formation of thrombus (clot) at the site of vessel injury
What are the two stages of hemostasis? - ansPrimary and
secondary hemostasis
Goal of primary hemostasis - ansFormation of platelet plug
What two materials interact in primary hemostasis to form the
platelet plug? - ansPlatelets and the vessel wall
What is the goal of secondary hemostasis? - ansStabilize the
platelet plug
What mediates secondary hemostasis? - ansCoagulation cascade
Name the four steps of primary hemostasis - ans1. Transient
vasoconstriction of damage vessel
2. Platelet adhesion to the surface of disrupted vessel
3. Platelet degranulation
4. Platelet aggregation
What two things mediated transient vasoconstriction in primary
hemostasis? - ans1. Neural reflex stimulation
2. Release of endothelin from enothelial cells
In platelet adhesion, how does vWF bind to the vessel? -
ansBinds via collagen
,Pathoma Chapter 4 Exam
Study Guide
Latest Updated Study
Guide 2024/2025
When vessel is damaged, what two structures are exposed that
contain collagen, allowing vWF to bind? - ansBasement
membrane and underlying connective tissue
What do platelets bind to in the second platelet adhesion step of
primary hemostasis? - ansvWF, which is bound to collagen
How do platelets bind vWF in second platelet adhesion step of
primary hemostasis? - ansVia GP1b receptor
Name the two places where vWF comes from - ans1. Weibel-
Palade Bodies of endothelial cells
2. Alpha granules of platelets
What are the two most important factors the Weibel-Palade
Bodies of endothelial cells release? - ans1. P-selectin
2. vWF
What occurs in primary hemostasis after platelet adhesion? -
ansPlatelet shape change and then degranulation
What are the two most important factors released by platelets in
platelet degranulation? - ans1. ADP
2. TXA2 (thromboxane A2)
What produces thromboxane A2 in degranulation step of
primary hemostasis? - ansPlatelet COX
What does ADP promote in primary hemostasis? - ansPlatelet
expression of GPIIb/IIIa
,Pathoma Chapter 4 Exam
Study Guide
Latest Updated Study
Guide 2024/2025
GPIIb/IIIa vs. GPIb in primary hemostasis - ansGPIb: expressed
by platelets to allow them to bind to vWF
GPIIb/IIIa: expressed by platelets after degranulation, and helps
promote platelet aggregation; induced by ADP release during
degranulation
What molecule helps platelets link together during aggregation
and formation of the platelet plug? - ansFibrinogen from plasma
How is the platelet plug stabilized? - ansSecondary hemostasis
(coagulation cascade)
Where does ADP in primary hemostasis come from? - ansDense
granules of platelets
What are the two possible problems in primary hemostasis? -
ans1. Poor quantity of platelets
2. Poor quality of platelets
Name the two most important symptoms of primary hemostasis
- ans1. Mucosal bleeding
2. Skin bleeding
Symptoms of mucosal bleeding - ansEpistaxis, hemoptysis, GI
bleeding, hematuria, menorrhagia, intracranial bleeding with
severe thrombocytopenia
What is epistaxis - ansNose bleed
What is the most common type of mucosal bleeding with
primary hemostatic disorders? - ansEpistaxis (nose bleed)
, Pathoma Chapter 4 Exam
Study Guide
Latest Updated Study
Guide 2024/2025
Feared complication of severe thrombocytopenia -
ansIntracranial bleeding
Name four symptoms of skin bleeding associated with primary
hemostatic disorders - ansPetechiae, purpura, ecchymoses,
excess bruising
Petechiae size - ans1-2 mm
Purpura size - ansOver 3 mm
Ecchymoses size - ansOver 1 cm
Is it a qualitative or quantitative problem with petechiae,
purpura, and ecchymoses? - ansQuantitative
Normal and abnormal platelet count - ans150-400K/uL
Symptoms when under 50,000 (50 K/uL)
Normal bleeding time - ans2-7 minutes
When is normal bleeding time prolonged? - ansQualitative and
quantitative platelet disorders
What are you assessing with blood smear? - ansUsed to assess
rough estimate of number of platelets and platelet size
What produce platelets, and how do you assess them apart from
blood smear? - ansMegakaryocytes produce platelets; assess
with bone marrow biopsy
Disease characterized by autoimmune production of IgG against
platelet antigens such as GPIIb/IIIa - ansIdiopathic
thrombocytopenic purpura (ITP
Study Guide
Latest Updated Study
Guide 2024/2025
What do endothelial cells sit on top of? - ansBasement
membrane
Hemostasis - ansMechanism of repair of blood vessel wall that
involves formation of thrombus (clot) at the site of vessel injury
What are the two stages of hemostasis? - ansPrimary and
secondary hemostasis
Goal of primary hemostasis - ansFormation of platelet plug
What two materials interact in primary hemostasis to form the
platelet plug? - ansPlatelets and the vessel wall
What is the goal of secondary hemostasis? - ansStabilize the
platelet plug
What mediates secondary hemostasis? - ansCoagulation cascade
Name the four steps of primary hemostasis - ans1. Transient
vasoconstriction of damage vessel
2. Platelet adhesion to the surface of disrupted vessel
3. Platelet degranulation
4. Platelet aggregation
What two things mediated transient vasoconstriction in primary
hemostasis? - ans1. Neural reflex stimulation
2. Release of endothelin from enothelial cells
In platelet adhesion, how does vWF bind to the vessel? -
ansBinds via collagen
,Pathoma Chapter 4 Exam
Study Guide
Latest Updated Study
Guide 2024/2025
When vessel is damaged, what two structures are exposed that
contain collagen, allowing vWF to bind? - ansBasement
membrane and underlying connective tissue
What do platelets bind to in the second platelet adhesion step of
primary hemostasis? - ansvWF, which is bound to collagen
How do platelets bind vWF in second platelet adhesion step of
primary hemostasis? - ansVia GP1b receptor
Name the two places where vWF comes from - ans1. Weibel-
Palade Bodies of endothelial cells
2. Alpha granules of platelets
What are the two most important factors the Weibel-Palade
Bodies of endothelial cells release? - ans1. P-selectin
2. vWF
What occurs in primary hemostasis after platelet adhesion? -
ansPlatelet shape change and then degranulation
What are the two most important factors released by platelets in
platelet degranulation? - ans1. ADP
2. TXA2 (thromboxane A2)
What produces thromboxane A2 in degranulation step of
primary hemostasis? - ansPlatelet COX
What does ADP promote in primary hemostasis? - ansPlatelet
expression of GPIIb/IIIa
,Pathoma Chapter 4 Exam
Study Guide
Latest Updated Study
Guide 2024/2025
GPIIb/IIIa vs. GPIb in primary hemostasis - ansGPIb: expressed
by platelets to allow them to bind to vWF
GPIIb/IIIa: expressed by platelets after degranulation, and helps
promote platelet aggregation; induced by ADP release during
degranulation
What molecule helps platelets link together during aggregation
and formation of the platelet plug? - ansFibrinogen from plasma
How is the platelet plug stabilized? - ansSecondary hemostasis
(coagulation cascade)
Where does ADP in primary hemostasis come from? - ansDense
granules of platelets
What are the two possible problems in primary hemostasis? -
ans1. Poor quantity of platelets
2. Poor quality of platelets
Name the two most important symptoms of primary hemostasis
- ans1. Mucosal bleeding
2. Skin bleeding
Symptoms of mucosal bleeding - ansEpistaxis, hemoptysis, GI
bleeding, hematuria, menorrhagia, intracranial bleeding with
severe thrombocytopenia
What is epistaxis - ansNose bleed
What is the most common type of mucosal bleeding with
primary hemostatic disorders? - ansEpistaxis (nose bleed)
, Pathoma Chapter 4 Exam
Study Guide
Latest Updated Study
Guide 2024/2025
Feared complication of severe thrombocytopenia -
ansIntracranial bleeding
Name four symptoms of skin bleeding associated with primary
hemostatic disorders - ansPetechiae, purpura, ecchymoses,
excess bruising
Petechiae size - ans1-2 mm
Purpura size - ansOver 3 mm
Ecchymoses size - ansOver 1 cm
Is it a qualitative or quantitative problem with petechiae,
purpura, and ecchymoses? - ansQuantitative
Normal and abnormal platelet count - ans150-400K/uL
Symptoms when under 50,000 (50 K/uL)
Normal bleeding time - ans2-7 minutes
When is normal bleeding time prolonged? - ansQualitative and
quantitative platelet disorders
What are you assessing with blood smear? - ansUsed to assess
rough estimate of number of platelets and platelet size
What produce platelets, and how do you assess them apart from
blood smear? - ansMegakaryocytes produce platelets; assess
with bone marrow biopsy
Disease characterized by autoimmune production of IgG against
platelet antigens such as GPIIb/IIIa - ansIdiopathic
thrombocytopenic purpura (ITP
