Lecture: Secondary Hemostasis Flashcards
Describes the activation of a series of coagulation proteins in the plasma, mostly serine proteases, to form a fibrin clot
Secondary Hemostasis
These proteins circulate as inactive _ that become activated during the process of coagulation
Zymogens (proenzymes)
Enzyme that converts fibrinogen to a localized fibrin clot
Thrombin
The gradual digestion and removal of the fibrin clot as healing occurs.
Fibrinolysis
The purpose of coagulation system is _
To generate the key thrombin enzyme and produce fibrin
Inactive precursors of coagulation factors; serves as substrates for previous enzymatic reaction in the coagulation cascade
Coagulation Factors / Zymogens / Enzyme Precursors
How many clotting factors does the coagulation system have?
14
What Roman numeral is not included in the naming of the coagulation system?
VI
Activated enzymatic factors; cleaves peptide bonds; no biologic activity
Serine proteases
All coagulation factors are serine proteases upon activation except _ and _
Factor XIII
Fibrinogen
Clotting Factor _ is the only transaminase
XIII
What coagulation factors are included in the serine proteases group?
Clotting Factors:
II
VII
IX
X
XI
XII
Clotting factors included in the procoagulant factor group
Clotting Factors:
III / Tissue factor
V
VIII
HMWK
HMWK means _
High-molecular weight kininogen
Transmembrane receptor for factor VIIa
Tissue Factor / Factor III
Factor _ is a cofactor to Xa in the prothrombinase complex in coagulation
Va
Produced primarily by hepatocytes; cofactor to Factor IX to form intrinsic tenase complex
Clotting Factor VIII
During coagulation, _ cleaves Factor VIII from VWF
Thrombin
Binds to activated platelets and forms the intrinsic tenase complex with factor IXa and Ca / phospholipid
Clotting Factor VIIIa
Cofactor to Factor XIIa and prekallikrein in the intrinsic contact factor complex
HMWK
HMWK is a mechanism for activating coagulation in conditions where foreign objects such as _, _ and _
Mechanical heart valves
Bacterial membranes
High levels of inflammation
Thrombin cofactor; activates protein C which inactivates Factor V
Thrombomodulin
Cofactors in the regulation and control of coagulation
Protein S and Z
Only clotting factor in the substrate group
Factor I / Fibrinogen
Clotting factors included in Fibrinogen group
Clotting Factors:
I
V
VIII
XIII
Coagulation (procoagulant portion); low MW portion of CF VIII
Factor VIII: C
Should be carried by VWF to be stable; platelet adhesion; VFW – arise from endothelial cells or megakaryocyte
Factor VIII: VWF
Functions in the immunologic activity of Factor VIII complex
Factor VIIIR: Ag (Related Antigen)
Important in platelet aggregation in Factor VIII complex
Factor VIIIR: RCo (Related Ristocetin)
All coagulation factors are synthesized in the liver except for
Factor III and IV
Serine proteases are also known as _
Serpins
A non-enzymatic cofactor that allows binding of coagulation factors to platelet surface
Calcium
Clotting factors included in the Prothrombin group
Clotting Factors:
II
VII
IX
X
Helps in binding of coagulation factors to calcium; produce functional coagulation factors
Vitamin K gammacarboxylation of glutamic acid
Prothrombin group is inhibited by oral anticoagulant such as:
Coumadin
Warfarin
Clotting Factors included in the Contact group
Clotting Factors:
XI
XII
PK
HMWK
_ transforms pre-K, a glycoprotein that circulates bound to HMWK, into its active form
Factor XIIa
PK stands for _
Pre-kallikrein
Activated PK is known as _
Kallikrein
Kallikrein cleaves HMWK to form
Bradykinin
The contact factor complex activates _
Factor XI
Contact factor complex consists of
HMWK - Pre-K - Factor XIIa
Factor XIa is an activator of _
Factor IX
Contact group reacts to _, _, and _ in vivo
Collagen
Valve prostheses
Bacterial cell membrane
Contact group reacts to _, _ and _ in vitro
Kaolin
Glass Tube
Ellagic acid
Extrinsic Pathway: _ bind to tissue factor in the presence of calcium to form the _
VII and VIIa
VIIa-tissue factor complex
VIIa-tissue factor complex is also known as _
Extrinsic tenase complex
Factors involved in the extrinsic pathway
III and VII (IV - Calcium)
Deficiency of XI is associated with_ in _ of individuals
Bleeding abnormalities
Approximately 50%
Intrinsic pathway is dependent on calcium. True or False?
False, it is not dependent on calcium
Factors involved in the intrinsic pathway
VIII, IX, XI, XII, PK, HMWK
Factors involved in the common pathway
Factors I, II, V, X
Extrinsic Tenase Complex involves what factors?
VIIa, Tissue factor / III, PF3, Calcium
Intrinsic Tenase complex involves what factors?
IXa, VIIIa, PF3, Calcium
Prothrombinase complex involves what factors?
Xa, Va, PF3 and Calcium
Extrinsic Tenase complex activates what factors?
IX and X
Intrinsic Tenase complex activates what factors?
X
Prothrombinase complex activates what factors?
Prothrombin (II)
Thrombin binds to _ activates the _ to suppress coagulation
Thrombomodulin
Protein C pathway
Low levels of thrombin enhances what factors?
Factors V and VIII
Primary substrate of thrombin
Fibrinogen
Factor I is also known as _
Fibrinogen
Factor II is also known as _
Prothrombin
Prethrombin
Factor III is also known as _
Tissue Factor
Tissue Thromboplastin
Factor IV is also known as _
Calcium
Factor V is also known as _
Proaccelerin
Labile Factor
Accelerator Globulin (acG)
Factor VII is also known as _
Proconvertin
Stable Factor
Serum Prothrombin Conversion Accelerator (SPCA)
Factor VIII is also known as _
Antihemophilic Factor
Antihemophilic Globulin
Antihemophilic Factor A
Platelet Cofactor I
Factor IX is also known as _
Platelet Thromboplastin Component
Christmas Factor
Antihemophilic Factor B
Platelet Cofactor II
Factor X is also known as _
Stuart-Prower Factor
Stuart Factor
Prower Factor
Autoprothrombin III
Factor XI is also known as _
Plasma Thromboplastin Antecedent
Antihemophilic Factor C
Factor XII is also known as _
Hageman Factor
Glass Factor
Contact Factor
Factor XIII is also known as _
Fibrin-stabilizing Factor
Laki-Lorand Factor
Fibrinase
Plasma Transglutase
Fibrinoligase
Pre-kallikrein (PK) is also known as _
Fletcher Factor
High-Molecular Weight Kininogen (HMWK) is also known as _
Fritzgerald Factor
Contact Activation Factor
Williams Factor
Flaujeac Factor
Primary Regulators of Coagulation
Tissue Factor Pathway Inhibitor
Antithrombin
Protein C
Disease related to deficiency of coagulation regulators
Venous Thromboembolic Disease (VTD)
Principal inhibitor of extrinsic tenase complex and Factor X
TFPI
TFPI is a cofactor for _
Protein S
Reverts thrombin function from procoagulant to anticoagulant
Protein C
Protein C is activated when thrombin binds with _
Thrombomodulin
Protein C is a cofactor to _
Protein S
Activated Protein C and Protein S complex inhibits
Factor V and VIII
Inhibits IIa, IX, X, XI, XII and PK
Antithrombin
_ is the cofactor for antithrombin
Heparin
Platelets helps in coagulation cascade and supplies: _, _ and _
Procoagulant Factors
Calcium
ADP
Platelet is essential as binding site because this where coagulation factors bind for fibrin formation. True or False?
True
Regulates/inhibit coagulation by forming complex with thrombin; does not elicit action
Alpha-2-macroglobulin
Inhibits extrinsic tenase complex; VIIa and TF/III – XIIIa (ITC)
Extrinsic Pathway Inhibitor (EPI)
EPI or Extrinsic Pathway Inhibitor is also known as _
LACI or lipoprotein-associated coagulation inhibitor
Inhibits thrombin, Xa, XIa
Alpha-1-antitrypsin
Inactivates/inhibits kallikrein (activated form of PK)
C1 Inhibitor
