HEMATOLOGY

• What are the coagulation factors involved ONLY in the EXTRINSIC pathway?

  Factor VII
• What coagulation factor/s are involved in the INTRINSIC pathway?

  Factor VIII, IX, XI, XII, prekallikrein, high-molecular weight kininogen
• What coagulation factor activates in the form of a fibrin clot?

  Factor I
• What coagulation factors play as cofactors?

  Factor V, VIII, HMWK
• What coagulation factors activate as serine proteases?

  Factor II, VII, IX, X, XI, XII, and prekallikrein
• What coagulation factors are vitamin K dependent?

  II, VII, IX, X
• What coagulation factor activates as a transglutaminase?

  Factor XIII
• What coagulation is NOT produced by the liver?

  Factor III, IV, VIII
• what Coagulation factor is also known as Fletcher factor?

  Prekallikrein
• What coagulation factor is also known as Fitzgerald factor?


  HMWK
• What coagulation factor is also known as Laki-lorand factor?

  Factor XIII or Fibrin-stabilizing factor
• Bleeding time is the primary hemostasis test for platelet and vascular function
• The Ivy method is done with a blood pressure cuff inflated to 40 mmHg , a calibrated spring-loaded lancet to trigger the volar surface of the forearm a few inches distal to the antecubital crease and the resulting blood will be blotted every 30 seconds with filter paper until the bleeding stops.
• Coagulation factors are also known as enzyme precursors or zymogens.
• Factor VIII or vWF is synthesized in the megakaryocytes.
• Castor oil/ Hirschboeck is performed to test clot retraction time by observing a formation of dimpling/droplet like serum on the surface of blood drop
• Blood film taken from a capillary puncture has sometime been referred to as the "poor man's aggregation test"
• Normal platelet estimate is 200,000 to 400,000/uL
• Thrombocytosis is seen in polycythemia vera, splenectomy, idiopathic thrombocythemia, and CML.
• Thombocytopenia is seen in thrombocytopenic purpura, aplastic anemia, acute leukemia, pernicious anemia, Gaucher's diseases and sometimes post-chemotherapy and radiation.
• What factor is deficient in hemophilia A?


  Factor VIII
• What factor is deficient in vWF?

  Factor VIII
• What factor is deficient in hemophilia B?


  Factor IX
• What factor is deficient in hemophilia C?

  Factor XI
• Hemophilia C is common in Eastern European Jewish descent or Ashkenazi Jews
• The most commonly acquired coagulopathy is ACOTS or acute coagulopathy of traumatic shock accounting for most fatal hemorrhage.
• Commonly acquired coagulopathy include liver disease, vitamin K deficiency, and renal failure.
• Factors that are absent in AGED PLASMA include factors V and VIII
• Factors absent in adsorbed plasma include factors II, VII, IX, and X.
• Factors that are absent in fresh serum include factors I, V, VIII, and XIII
• Factors that are absent in aged serum include factors I, II, V, VIII, and XIII
• An initial vWD workup includes CBC to rule out thrombocytopenia and PT and PTT to assess the coagulation system.
• Changes in blood at room temperature after 3 hours:

  • degenerative cellular changes
  • WBCs may show vacuolation of the cytoplasm, more homogenous nuclei, irregular or poorly defined cytoplasmic borders, and development of irregularly shaped nuclei
  • Platelets will INCREASE in size then disintegrate
• Changes in blood at room temperature after 6 hours:

  • RBCs will begin to swell causing an increase in MCV
  • Decreased ESR
  • Increased OFT
• Light blue-top tube for coagulation studies have 1 part 0.109 M (3.2%) sodium citrate (trisodium citrate dehydrate) to 9 parts whole blood. This buffered 0.109 M citrate may increase the stability of factor V and VIII
• Excessive citrate in plasma will falsely increase PT and APTT
• In skin punctures, blood has LOWER RBC count, hematocrit, hemoglobin and platelet counts but HIGH WBC count
• Warming of the site for puncture can increase blood flow by sevenfold
• Phlebotomists should carry RED, puncture-resistant containers in their collection trays.
• Pilot's fluid is used for manual counting of eosinophils