6 - QUALITATIVE CLOT RETRACTION

Clot Retraction

The process of the shrinkage of a formed clot

To make the clot more stable

Clot Retraction

Why shrink the clot?

actin-myosin cytoskeleton

Clot Retraction

Mediated by the contraction of the intracellular _-_ _ of the activated platelets

Fibrinogen, GPIIb, actinomysin/thrombosthenin

Clot Retraction

Key players (3)

Glanzmann thrombasthenia

Clot Retraction

Can be used to diagnose _ _

Improve stability of the formed clot

Clot Retraction

Purpose of clot retraction

Glanzmann Thrombasthenia

Inherited as an autosomal recessive disorder

GP IIb/IIIa

Glanzmann Thrombasthenia

Disorder of platelet aggregation affecting _ _/_ function

abnormal

poor

normal

Glanzmann Thrombasthenia

Results to _ in vitro clot retraction, _ bleeding time, but _ platelet count

consanguinity

Glanzmann Thrombasthenia

Most frequent in populations with a high degree of _

Bleeding after circumcision

Epistaxis

Gingival bleeding

Petechiae

Purpura

Menorrhagia

Gastrointestinal bleeding

Hematuria

Glanzmann Thrombasthenia

Manifestations (8)

Leukemia

Diabetes

After meals

Abnormal Serum Characteristics

Milky (3)

Jaundice

Abnormal Serum Characteristics

Dark Yellow

Multiple myeloma

Abnormal Serum Characteristics

Cloudy

Presence of platelets

Concentration of fibrinogen

Activity of retraction promoting principle in the serum

Nature of the tube surface

Clot retraction involves the interaction of at least 4 factors

contracts

serum

Principle

A normal blood clot _ and in so doing it, expresses _

amount of serum expressed

Principle

The degree of clot retraction can be measured on the _ _ _ _

serum

Principle

As the clot shrinks, _ would be produced

Shrinkage of formed clot

Principle of clot retraction

directly proportional

Principle

Level of clot retraction is _ _ to the amount of serum expressed

castor oil, 1

first drop

HIRSCHBOECK METHOD (CASTOR OIL METHOD)

1. Place a few drops of _ _ into a clean test tube (around _ mL)

2. Perform a skin puncture onto the patient. Discard the _ _ of blood

1

dimpling

HIRSCHBOECK METHOD (CASTOR OIL METHOD)

1. Place a few drops of castor oil into a clean test tube (around 1 mL)

2. Perform a skin puncture onto the patient. Discard the first drop of blood

3. Add _ drop of fresh blood into the test tube with castor oil and start the timer

4. Observe for “_” or extrusion of droplet-like serum on top portion of the blood

5. Stop the timer as soon as “_” of serum is observed

15-45 minutes

HIRSCHBOECK METHOD (CASTOR OIL METHOD)

Normal Value

thrombotic tendency

HIRSCHBOECK METHOD (CASTOR OIL METHOD)

Less than 15 minutes

hemorrhagic tendency

HIRSCHBOECK METHOD (CASTOR OIL METHOD)

After 45 minutes