1Identify the bone marrow cell from which platelets arise
Megakaryocytes
2Identify the two stages of hemostasis in which platelets are important
Primary and secondary hemostasis
3Describe the internal structure of platelets regarding their cytoplasm and nucleus
Granular cytoplasm but no nuclear material
4Identify the location of platelets and RBCs within a blood vessel during flow
Near the center of the blood vessel
5Identify the duration thrombocytes initially remain in the spleen after entering
Two days
6Specify the normal distribution of platelets between systemic circulation and the splenic pool
2/3 in systemic circulation; 1/3 in the spleen
7State the average life span of a platelet
9.0 days ± 1 day
8Identify the expected number of platelets per 100x field on a Wright-stained PBS
7 to 21 cells
9Identify the average diameter of a normal platelet
2.5 μm (or 2 to 4 μm)
10Enumerate the three major functions of platelets
To form an aggregate plug, to participate in plasma coagulation, and to preserve the endothelial lining
11Provide the alternative name (aka) for Reticulated Platelets
Stress platelets
12Identify the condition for which Reticulated Platelets appear as a compensation
Thrombocytopenia
13Identify the component found in Reticulated Platelets that indicates they were newly released from megakaryocytes
RNA
14Specify the diameter and Mean Platelet Volume (MPV) of Reticulated Platelets
Diameter > 6 μm; MPV 12 to 14 fL
15Identify the two clinical uses for monitoring Reticulated Platelets
Differentiate bone marrow failure from peripheral destruction and early predictor of bone marrow recovery
16Provide the reference range for Mean Platelet Volume (MPV)
6.8 to 10.2 fL
17Identify the effect of EDTA on platelets and the resulting change in MPV
Causes swelling of platelets (approx. 20% increase in MPV)
18State the ideal age for an EDTA specimen to be used for platelet sizing
1 to 4 hours old
19Identify the inheritance pattern and two categories of infections (TORCH) associated with WAS (Wiskott-Aldrich Syndrome)
X-linked inheritance; Toxoplasma, Rubella, Cytomegalovirus, Herpesvirus
20Enumerate the three diseases associated with MYH9 gene mutations that feature large platelets
Fechtner, Sebastian, and Epstein syndromes
21Identify the four characteristics of MHA (May-Hegglin Anomaly)
Leukopenia, variable thrombocytopenia, giant platelets, and Dohle body-like inclusions in leukocytes
22Describe the shape of resting and circulating platelets
Biconvex or disk-shaped
23Describe the shape of activated platelets
Spherical with pseudopods
24Identify the appearance of platelet cytoplasm on a Wright-stained PBS
Lavender and granular
25Differentiate between the chromomere and the hyalomere of the platelet cytoplasm
Chromomere is centrally located and granular; Hyalomere is peripherally located and non-granular
26Provide the alternative name (aka) for Megakaryocytopoiesis
Megakaryopoiesis
27Define Megakaryocytopoiesis
Process by which megakaryocytes develop from hematopoietic stem cell (HSC)
28Provide the alternative names (aka) for Thrombopoietin (TPO)
MGDF and Megakaryocyte growth and development factor
29Identify the organ primarily responsible for the production of TPO
Liver
30State the molecular weight and the percentage of homology TPO possesses with erythropoietin (EPO)
70,000 Dalton molecule; 23% homology
31Identify the specific TPO receptor site present at all maturation stages from BFU-Meg to PLTs
MPL
32Describe the relationship between plasma TPO concentration and platelet/megakaryocyte mass
Inversely proportional
33Enumerate three major functions of TPO
Stimulates megakaryocytopoiesis, induces proliferation and maturation of megakaryocytes, and induces thrombocytopoiesis
34Enumerate the three cytokines that function with TPO to stimulate megakaryocytopoiesis
IL-3, IL-6, and IL-11
35Specify the size range and percentage of total bone marrow cells represented by megakaryocytes
30 to 160 \mum; < 0.5%
36State the normal range of megakaryocytes found per 10x low-power field in a bone marrow smear
2 to 10
37Identify the three megakaryocyte lineage-committed progenitor stages in order of maturity
BFU-Meg (least mature), CFU-Meg, and LD-CFU-Meg (most mature)
38Identify the specific cell type that all three megakaryocyte progenitor stages resemble morphologically
Lymphocytes
39Identify the type of cell division performed by BFU-Meg and CFU-Meg
Normal mitosis
40Identify the unique process performed by LD-CFU-Meg after it loses its capacity to divide
Endomitosis
41Define the process of endomitosis
Nuclear division only with no cytoplasmic division
42Identify the MK-I stage of megakaryocyte precursors
Megakaryoblast
43Identify the MK-II stage of megakaryocyte precursors
Promegakaryocyte
44Identify the MK-III stage of megakaryocyte precursors
Megakaryocyte
45State the primary morphological feature used to identify the MK-II stage
Appearance of nuclear lobularity
46Identify which precursor stage is the most abundant and is the stage where platelet shedding proceeds
MK-III (megakaryocyte)
47Provide the alternative name (aka) for platelet shedding
Thrombocytopoiesis
48State the estimated number of platelets that one megakaryocyte may shed
2000 to 4000
49Identify the precursor stage characterized by a round nucleus, 2 to 6 nucleoli, and a 3:1 N:C ratio
MK-I
50Identify the precursor stage characterized by an indented nucleus and a 1:2 N:C ratio
MK-II
51Identify the precursor stage characterized by a multilobed nucleus, invisible nucleoli, and a 1:4 N:C ratio
MK-III
52Identify the staining characteristic of the cytoplasm in the MK-I stage
Basophilic
53Identify the staining characteristic of the cytoplasm in the MK-III stage
Azurophilic and granular
54Identify the structural system present in all three precursor stages (MK-I, MK-II, and MK-III)
Demarcation System (DMS)
55Enumerate the three methods mentioned for studying platelet ultrastructure
Scanning and transmission electron microscopy, flow cytometry, and molecular sequencing
56Identify the two types of molecules anchored within the platelet plasma membrane
Glycoproteins and proteoglycans
57Enumerate the two neutral phospholipids found in the outer plasma layer
Phosphatidylcholine and sphingomyelin
58Enumerate the three anionic or polar phospholipids found in the inner cytoplasmic layer
Phosphatidylinositol, phosphatidylethanolamine, and phosphatidylserine
59Identify the phospholipid that flips to the outer surface upon activation to provide a charged surface for coagulation
Phosphatidylserine
60Enumerate the two coagulation pathway complexes that assemble on the phosphatidylserine surface
TENASE complex and PROTHROMBINASE complex
61Identify the substance that makes up the platelet membrane surface and absorbs plasma proteins through endocytosis
Glycocalyx
62Enumerate three plasma proteins absorbed by the glycocalyx
Albumin, fibrinogen, and other plasma proteins
63Identify the ligand for the GP Ia/IIa (Integrin \alpha_{2}eta_{1}) receptor
Collagen
Vitronectin
Laminin
Fibronectin
64Identify the receptor from the immunoglobulin gene family that serves as the key collagen receptor
GP VI
65Identify the substances released when GP VI triggers platelet activation
TXA_{2} and ADP
66Identify the specific site on the GP Ib/IX/V complex where VWF binds
GPIb
67Identify the clinical condition caused by a deficiency of the GP Ib/IX/V complex
Bernard-Soulier syndrome
68Identify the key fibrinogen receptor and the ligands it binds
GP IIb/IIIa (Integrin \alpha_{IIb}eta_{3}); Fibrinogen and VWF
69Identify the clinical condition caused by a deficiency of GP IIb/IIIa
Glanzmann’s thrombasthenia
70Enumerate the two STR receptors that bind Thrombin
PAR 1 and PAR 4
71Enumerate the two STR receptors that bind Adenosine diphosphate (ADP)
P2Y_{1} and P2Y_{12}
72Identify the ligand for the IP receptor and its effect on platelet activation
Prostaglandin I_{2} (PGI_{2}); Inhibits platelet activation
73Identify the low-affinity receptor (CD32) associated with heparin-induced thrombocytopenia (HIT)
Fcamma RIIA
74Identify the integrin found on \alpha-granule membranes that helps platelets bind to endothelial cells and WBCs
P-selectin (CD 62)
75Enumerate the three components of the platelet cytoskeleton
Microtubules, actin microfilaments, and intermediate microfilaments
76Identify the protein that forms microtubules
Tubulin
77Explain the structural role of the thick, circumferential bundle of microtubules
Maintains platelet's discoid shape
78Describe the effect of cold on microtubules and the resulting change in platelet shape
Microtubules disassemble in the cold; platelets become round
79Identify the protein that forms microfilaments and its location
Actin; between the microtubules and the membrane
80Describe the state of actin in resting platelets versus when cytoplasmic calcium increases
Globular and amorphous in resting; filamentous and contractile when calcium increases
81Enumerate the two types of intermediate filaments found in the platelet cytoplasm
Desmin and Vimentin
82Identify the specific route through which \alpha-granules and lysosomes' contents flow during platelet activity
SCCS (Surface-Connected Canalicular System)
83Identify the destination of dense granules during platelet activity
Plasma membrane
84Specify the number of \alpha-granules found in each platelet
50 to 80 granules
85Describe the appearance of \alpha-granules in osmium-dye transmission electron microscopy preparations
Stain medium-gray
86Identify the general category of most \alpha-granule contents and the process they participate in
Proteins; secondary hemostasis (called coagulation)
87Identify the specific structure that \alpha-granule membranes fuse with during platelet activation
SCCS
88Enumerate three functions supported by the contents of \alpha-granules in the nearby environment
Participate in platelet adhesion, participate in platelet aggregation, and support plasma coagulation
89Identify two \alpha-granule proteins that specifically inhibit heparin
eta-thromboglobulin and PF-4 (platelet factor-4)
90Enumerate four coagulation-related proteins found in \alpha-granules but not in the cytoplasm
HMWK, PAI-1, Plasminogen, and Protein C inhibitor
91Enumerate three growth factors found in \alpha-granules that support mitosis of vascular fibroblasts and smooth muscle cells
EGF, PDGF, and TGF-eta
92Enumerate seven proteins found in both \alpha-granules and the platelet cytoplasm
Fibrinogen, Fibronectin, Albumin, Immunoglobulins, VWF, Thrombospondin, and Factor V
93Identify the specific protein found on the \alpha-granule membrane
P-selectin
94Enumerate three glycoproteins found on both the \alpha-granule membrane and the plasma membrane
GP IIb/IIIa, GP IV, and GP Ib/IX/V
95Specify the number of dense granules per platelet
2 to 7 dense granules
96Identify the alternative name (a.k.a.) for dense granules
delta granules
97Describe the appearance of dense granules when treated with osmium in transmission electron microscopy
Stain black (opaque)
98Identify the general functional roles of dense granule contents in primary hemostasis
Vasoconstrictors and platelet agonists
99Define the term Agonist in a cellular context
A substance which initiates a response when combined with a receptor
100Identify the function of ADP released from dense granules and the specific receptors it binds
Supports neighboring platelet aggregation by binding to P2Y_{1} and P2Y_{12}
101State the status of the function of ATP found in dense granules
Function unknown
102Identify the role of Serotonin (5-HT) and the structures it binds
Vasoconstrictor that binds endothelial cells and platelet membranes
103Identify the general function of divalent cations like Ca^{2+} and Mg^{2+} in platelets
Support platelet activation and coagulation
104Describe the relative abundance of lysosomes in platelets
Few in number
105Enumerate four enzymes that lysosomes stain positive for
Arylsulfatase, eta-glucuronidase, acid phosphatase, and catalase
106Identify the structures that lysosomes probably digest during in vivo aggregation
Vessel wall matrix components
107Describe the formation of the SCCS (Surface-Connected Canalicular System)
The plasma membrane invades platelet interior
108Describe the state of the glycocalyx within the SCCS compared to the platelet surface
Less developed
109Enumerate three processes for which the SCCS serves as a route
Endocytosis, secretion of \alpha-granule contents, and secretion of lysosome contents
110Identify the "Control Center" of the platelet which is a condensed remnant of the rough endoplasmic reticulum
DTS (Dense Tubular System)
111Identify the primary ion sequestered by the DTS
Calcium
112Enumerate three enzymes in the DTS that support the eicosanoid synthesis pathway to produce thromboxane A_{2}
Phospholipase A_{2}, cyclooxygenase, and thromboxane synthetase
113Identify the enzyme in the DTS that supports the production of IP_{3} and DAG
Phospholipase C
114Identify the alternative name (aka) for Aspirin and its effect on platelet synthesis
Acetylsalicylic acid; blocks the synthesis of Thromboxane A_{2}