9. platelet function:   
1- Adhesion — the deposition of platelets on the subendothelial matrix   2 - Aggregation — platelet-platelet cohesion   3- Secretion — the release of platelet granule proteins   4- Procoagulant activity — the enhancement of thrombin generation

10. Platelet secretion :
Platelets secrete a variety of substances from their granules upon cell stimulation:
1-  ADP and serotonin.
2- Fibronectin and thrombospondin. 3-Fibrinogen is released from platelet alpha granules. 4-Thromboxane A2, a prostaglandin metabolite, promotes vasoconstriction and further platelet aggregation. 5-Growth factors, such as platelet-derived growth factor (PDGF), have potent mitogenic effect on smooth muscle cells. The release of PDGF

27. - Iron deficiency anemia
Causes of reactive thrombocytosis:
- Hemorrage
- Surgery
- Trauma
- Iron deficiency anemia
- Splenoctomy
- Infection
- Malignant disease
- Inflamatory disease

28. ‍Cause of Thrombocytopenia:1
1- Decrease Marrow production:
Marrow failure: AA.
Marrow infiltration :leukemia , Myelidysplasia, Fibrosis….
Marrow depression: Iradiation,Chemotherapy
Selective BM depression:ethanol, drugs induced
Nutritional deficiency: megaloblastic anemia.
Hereditary causes: Fanconi”s anemia
congenital megacariocytic hypoplasia.

29. ‍Cause of Thrombocytopenia:2
2- Increased destruction of platelets:
Immune:
ITP , SLE , CLL , NHL , CVD.
Drud-induced: Heparin,Gold, Quinidine, Penicillins, cimetidine, digoxin.
Infection : HIV , Other Viruses , Malaria.
Post Transfusion purpura.
Neonatal purpura (isoimmune).
Non-immune:
DIC , TTP , UHS , Congenital / acquired heart disease, Cardiopulmonary bypass , Kasabach-Merritt syndrome.
Hereditary causes: Fanconi”s anemia
congenital megacariocytic hypoplasia.

30. Endothelial cell Coagulation Properties
Procoagulant Anti-Coagulant
Vasodilation
ADP ase
Heparin Sulfate
Nitric oxide
Prostacyclin
Thrombomodulin
Tissue factor pathway
inhibitor
Tissue Plasminogen
activator
Collagen
Factor VIII
Fibronectin
Integrins
P-endothelial cell
adhesion molecule-1
Selectin-E
Selectin-P
Von Willebrand f.
Vasoconstriction

31. PT Vit K deficiency ,Liver d. DIC , VII ,V , IX deficiency
Screening Hemostasis Assays
CBC ,PBS Thrombocytopenia, Thrombocytosis , Giant P
PT Vit K deficiency ,Liver d. DIC , VII ,V , IX deficiency
and Factor inhibitor.
PTT Heparin , DIC , Lupus anticoagulant , vWD
XI, IX ,V, X, XII, HMWK , PK , factor inhibitor.
TT Heparin, DIC , Hypofibrinogenemia ,
Dysfibrongenemia
Bleedig T Aspirin , Thrombocytopenia , vWD ,
Storage pool disease
Mixing Study Abnormal clotting time corrects w ith a deficiency
dose not correct with an inhibitor.

32. Drugs Affecting Platelet
Strong Inhibitors
Moderate Inhibitors
Weak Inhibitors
Aspirin
Abciximab
(anti gpIIb/IIIa)
Ticlopidine
(anti ADP)
NSAFD
Antibiotics
Penicillins
cepholosporins
nitrofurantoin
Dextran
Fibrinolytics
Heparin
Hetastrach
Alcohol
Hitroglycerin
Nitroprusside

38. Classification of congenital disorders of platelet function
1- Disorders of adhesion:
Von Willebrand disease
bernared-Soulier syndrome
2- Disorders of aggregation:
Congenital afibrinogenemia
Glansmann thrombasthenia
3- Disorders of platelet secretion:
a- Granules abnormality
Storage pool deficiency
Quebec platelet disordes
b- Primary secretion defects
reseptor defects
Gaq deficiency
Phospholipase C-B2 deficiency
Defect in Ca++ mobilization
Defect in protein phosphorylation (pleckstrin)
c- Abnormalities in arachidonic acid pathways