SECONDARY HEMOSTASIS Flashcards
SECONDARY HEMOSTASIS Expected product:
fibrin clot
-involves blood vessel and extravascular tissues
VASOCONSTRICTION
-needs a signal from CNS → muscular/tissue response → constriction of bv
VASOCONSTRICTION
-platelet migrates to the site of injury after adhesion
VASOCONSTRICTION
- Shape changes from normal biconvex to an inactivated form
PLATELET ACTIVATION
-: known activator for platelet
Collagen
-: product of primary hemostasis
Platelet plug
-: activator of coagulation
Tissue factor
Pathways:
clotting in vitro
Intrinsic
exposure of blood to negative surface like glass or plastic
Intrinsic
FXII is activated
Intrinsic
in vivo coagulation
Extrinsic
activator: collagen
Extrinsic
product: fibrin clot
Extrinsic
FVII is activated
Extrinsic
activated by either extrinsic or intrinsic
Common
FX is activated
Common
FII is activated to IIA
Thrombin
All cascade happen to generate thrombin
Thrombin
Only activator known for fibrinogen
Thrombin
Activates fibrinogen to fibrin to fibrin clot
Thrombin
not easily activated unless coagulation factor works altogether or cascade occurs
Thrombin
enzyme to the reaction of fibrinogen, fibrin, to fibrin clot, marking secondary hemostasis
Thrombin
fibrin clot → bv starts to heal → clot retracts, but becomes obstruction to blood flow
Thrombin
most important enzyme to be generated
Thrombin
last enzyme to activate fibrinogen
Thrombin
- Plasmin is activated, works on the fibrin clot, and dissolves it by destroying fibrin
FIBRINOLYSIS
- Clot is being dissolved
FIBRINOLYSIS
plasma proteins (coagulation factors) + TF + Calcium (cofactor; CF IV) → fibrin clot
Coagulation
Role of platelet on Coagulation:
-surface area
-formation of platelet-fibrin clot
surface area
platelet phospholipid or platelet factor 3 (platelet dust)
Fibrin clot → dissolved as BV starts to heal restore normal blood flow
Fibrinolysis
bv starts to heal and clot starts retracting
Fibrinolysis
: needed to retract clot → retraction of fibrin clot
thrombostenin
proteolytic enzyme capable of degrading fibrin, fibrinogen as well as Factor V and VIII
plasmin
Plasminogen is activated as
plasmin
: activator of plsmin
Tissue plasminogen activator
Plasmin is capable of degrading
fibrin, fibrinogen, FV, and FVIII
Plasmin cannot degrade [?], a stabilizing factor
CFXIII
- enhancer of fibrinolysis
Protein C and Protein S
In the circulation:
zymogens/proenzymes
: coagulation protein → thrombin → fibrinogen → clot
Activation
Classification of Coagulation Factors
are the substance upon which enzymes act
Substrates
accelerate the activities of the enzymes that are involved in the cascade.
Cofactors
Cofactors ex
(TF, V, VIII, HMWK)
FVII needs Calcium (CFIV) to activate FX
Cofactors
FX needs to activate FV to FVa
Cofactors
: o serine proteases and transaminase
Enzymes
activated FXII activates the substrate FXI
Enzymes
FI (fibrin) creates a fibrin clot and FXIII secures the clot to make it strong
transaminase
: in order acc to its discovery
Roman numeral
Designated “a”:
activated
Designated “f”:
fragmented factor
Fibrinogen
I
Thrombin substrate
I
2-4 days
I
200-400 mg/dl
I
Prothrombin
II
• Prethrombim
II
Serine protease
II
VII
IX
X
XI
XII
PK
3 - 4 days
II
10 mg/dl
II
Tissue factor
III
• Tissue Thromboplastin
III
Cofactor
III
V
VIII:C
HMWK/HK
Lipoprotein found in most of the body tissues
III
Insoluble
III
none
III
Calcium
IV
Mineral
IV
lonized state
IV
8- 10 mg/dl
IV
Proaccelerin
V
• Labile factor
V
• Accelerator globulin
V
36 hrs
V
Most unstable
V
deteriorates rapidly at RT
V
1 mg/dl
V
X
VWF
Proconvertin
VII
• Stable factor
VII
• Serum Prothrombin Conversion
VII
• Accelerator
VII
• Autoprothrombin I
VII
3-6 hrs
VII
Disappears rapidly from the blood when production is halted (eg. coumarin)
VII
0.05 mg/dl
VII
Antihemophilic factor (AHF)
VIII:C
• Antihemophilic Globulin (AHG)
VIII:C
• Antihemophilic Factor A (AHF-A)
VIII:C
• Platelet cofactor 1
VIII:C
Bound to WWF
VIII:C
0.01 mg/dl
VIII:C
Plasma thromboplastin component (PTC)
IX
• Christmas factor
IX
• Antihemophilic Factor B (AHF-B)
IX
• Platelet cofactor 2
IX
18 - 24 hrs
IX
0.3 mg/dl
IX
Stuart-Prower factor
X
• Stuart factor; Prower factor
X
• Autoprothrombin
X
40 - 60 hrs
X
May be stored up to 2 mons at 4°C
X
Plasma thromboplastin antecedent (PTA)
XI
• Antihemophilic factor C (AHF C)
XI
40 - 70 hrs
XI
Circulates in complex with HMWK
XI
0.5 mg/dl
XI
Hageman factor
XII
• Glass factor
XII
• Contact factor
XII
50 - 70 hrs
XII
Heat stable
XII
can be stored at 4°C for 3 mons
XII
Fibrin stabilizing factor (FSF)
XIII
• Laki-Lorand factor
XIII
• Fibrinase; Fibrinoligase
XIII
• Plasma Transglutaminase
XIII
11 - 14 days
XIII
2 mg/dl
XIII
• Fletcher factor
Prekallikrein (PK)
35 hrs
Prekallikrein (PK)
35-50mcg/ml
Prekallikrein (PK)
• Fitzgerald factor
High Molecular Weight Kininogen (HMWK/HK)
Contact activation cofactor
High Molecular Weight Kininogen (HMWK/HK)
• William factor
High Molecular Weight Kininogen (HMWK/HK)
Falujeac factor
High Molecular Weight Kininogen (HMWK/HK)
9 - 10 hrs
High Molecular Weight Kininogen (HMWK/HK)
5mg/dl
High Molecular Weight Kininogen (HMWK/HK)
Factor VIII carrier
von Willebrand factor
Functions in platelet adhesion
von Willebrand factor
24hrs
von Willebrand factor
Phospholipids, Phosphatidy/serine, PF3
Platelet factor 3
Assembly molecule
Platelet factor 3
Released by platelets
Platelet factor 3
