hello and welcome to bun medrow we discuss concise medical knowledge that you can fit inside of a bun in this video we're going to be having a look at the origin of the platelets where they come from how they go about their daily business and what could potentially go wrong with the platelets before we understand the disorders of the platelet let's have a look at the normal life cycle of a platelet first so where does it all start well it all starts at the liver with the production of a protein known as thrombopoetin thrombopotent then travels to the bone marrow and it causes hematopoietic stem cells to go down the myeloid root and produce lots and lots of these purple cells known as megakaryocytes the megakaryocytes then swell up burst and release platelets into our circulation these circulating platelets have a shelf life of around 10 days before they are finally broken down by the spleen now if we backtrack and see where things can go wrong we can see that if we don't have enough thrombopolatin we might not have enough platelets because we won't be telling anyone to make them so what could cause a reduction in thrombopotent levels well any damage or insult to the liver could cause an issue with thromboprotein and this includes things like liver cirrhosis where we have a fatty dysfunctional liver or excessive alcohol intake which might lead to liver cirrhosis then we could have an issue with the production factory of our plate that's our bone marrow and things for this include things that infiltrate the bone marrow so things like leukemia or milo dysplasia which is the precursor to leukemia however we haven't met the cell count to be classified as leukemia could have things like a lymphoma where we have a cancer of our lymph nodes and this over spills into the blood and infiltrates our bone marrow we could have things like myeloma where we have a cancer of our plasma cells inside of our bone marrow and finally we could have a scarring of the bone marrow matrix in a condition known as myelofibrosis now to find out a bit more about leukemia and myelodysplasia i would recommend checking out the leukemia video as this goes through exactly the cell lineages and how they arise other things that we might have is things like aplastic anemia where we have an infection and we're born with some kind of bone marrow disorder where all of our stella lineages are not being functional and the last thing is if we don't have the substances to form our platelets and form ourselves including things like b12 and folate then we're not going to be able to form our platelets now the next thing might be an issue with the platelets themselves say for instance if we had an immune attack or antibodies against our platelets in the case of idiopathic or immune thrombocytopenic purpura or itp our platelets tend to get attacked by our own immune system another thing that could happen is iatrogenic where we give a medication to our patients which causes them to develop antibodies in things like heparin juice thrombocytopenia where the administration of heparin actually causes the breakdown of platelets and we'll get into both of these conditions in the coming slides we could also have an intrinsic issue with how the platelets interact with each other so when the platelets are activated they bind to each other using a receptor known as the gp2b3a if the receptor is missing or that receptor is dysfunctional then the platelets cannot bind and this is a condition that we call glandsmen thrombustinia another issue that could happen is our platelets have a very difficult time binding to von willebrand factor using the gpa 1b receptor and this is what we call uh bernard soudier syndrome now these two conditions are rather a fine print so don't worry hugely about these ones the last thing that could happen is that we may have an overactive spleen a very hungry spleen which uh eats a lot of our platelets in something like hypersplenism that concludes the video hope you guys found it useful please feel free to share and subscribe and if you have any comments leave them below and we'll get back to you as soon as possible see you in the next one