Surgery>>>>>Hemostasis, Surgical Bleeding, and Transfusion
Question 2#

Which is required for platelet adherence to injured endothelium?

A. Thromboxane A2
B. Glycoprotein (GP) IIb/IlIa
C. Adenosine diphosphate (ADP)
D. Von Willebrand factor (vWF)

Correct Answer is D


Platelets do not normally adhere to each other or to the vessel wall but can form a plug that aids in cessation of bleeding when vascular disruption occurs. Injury to the intimal layer in the vascular wall exposes subendothelial collagen to which platelets adhere. This process requires von Willebrand factor (vWF), a protein in the subendothelium that is lacking in patients with von Wille brand disease. vWF binds to glycoprotein (GP) I/IX/V on the platelet membrane. Following adhesion, platelets initiate a release reaction that recruits other platelets from the circulating blood to seal the disrupted vessel. Up to this point, this process is known as primary hemostasis. Platelet aggregation is reversible and is not associated with secretion. Additionally, heparin does not interfere with this reaction and thus hemostasis can occur in the heparinized patient. Adenosine diphosphate (ADP) and serotonin are the principal mediators in platelet aggregation.