intro. to secondary hemostasis Flashcards
Where are the coagulation factors active/inactive and what is their overall purpose?
Coagulation proteins (Factors)
- Blood – inactive state
- Once activated – interact to form fibrin clot
- Purpose – to reinforce the plt plug
Where are the coagulation factors produced?
All factors are produced in the liver
What is the name for factor I?
Fibrinogen
What is the name for factor II?
prothrombin
What is the name for factor III?
Tissue factor or tissue thromboplastin
What is the name for factor IV?
Ionized calcium
What is the name for factor V?
Labile factor or proaccelerin
What is the name for factor VII?
- stable factor (Serum prothrombin conversion accelerator SPCA),
- proconvertin
What is the name for factor VIII?
antihemophilic factor
What is the name for factor IX?
Christmas factor, plasma thromboplastin component, or antihemophilia factor B
What is the name for factor X?
Stuart-Prower factor
What is the name of factor XI?
plasma thromboplastin antecedent
What is the name of factor XII?
hageman factor or contact factor
What is the name of factor XIII?
fibrin stabilizing factor
What is another name for Fitzgerald factor?
high molecular weight kinogen
What is another name for Fletcher factor?
prekalikrein
Which factor is the main substrate?
Fibrinogen
Which factors are cofactors?
- Factor V (labile factor)
- VIII:C (antihemophilic factor (AHF))
Which factors are serine proteases?
Serine proteases – cut peptide bonds
Includes all except XIII (IIa,VIIa, IXa, Xa, XIa, XIIa, prekallikrein)
Which factor is a transaminase?
XIIIa-creates cross-links to stabilize clots
Which factors are contact proteins?
XII – Hageman factor
XI – plasma thromboplastin antecedent
Prekallikrein – Fletcher factor
High-molecular weight kininogen (HMWK) – Fitzgerald factor
Which factors are vitamin k dependent?
2, 7, 9, 10
Which vitamin k dependent factor has the shortest half life?
7 & is most sensitive levels of coumarin therapy
What are the vit. K dep. Inhibitors?
Prot. C & S
what do Vit K deficient patients-have decreased production of ?
functional prothrombin proteins
& inhibitors
what do Coumarin, Coumadin, Warfarin inhibit?
Vit. K reduction yielding inactive factors
what test monitors coumadin therapy?
pt
what are Acquired Vit K deficiencies – common, seen in ?
- post surgical procedures
- high dose antibiotic use
- liver disease
which factors are Fibrinogen or Thrombin sensitive proteins
I
V
VIII:C
XIII
Which group does thrombin act on?
all the factors in the fibrinogen group
- Enhances activity of factors V & VIII:C
- Activates factor XIII
- Converts fibrinogen to fibrin
what are the Procoagulant effects of Thrombin ?
- feedback: Factor V & VIII
- Converts Factor I to soluble fibrin monomer (cleaves fibrinopeptides A & B)
- Activates XIII (cross-links fibrin monomers)
- Induces plt activation & aggregation by promoting —secretion of serotonin & TXA2
what are the Coagulation inhibitor effects of thrombin?
- Binds to Antithrombin (AT), If heparin present AT enhanced 200x ‘s
- Promotes release of t-PA (Tissue Plasminogen Activator)
- Binds to thrombomodulin – activates Protein C (neg. feedback on Va & VIIIa)
how does Thrombin Initiates Tissue Repair?
- Induces chemotaxis
- Stimulates proliferation of smooth muscle & endothelial cells
