W11 P: Molecular background of acquired thrombophilia. Fibrin stabilization and the study of soluble fibrin monomers Flashcards
Name 2 proteases that has the function of a procoagulant
Thrombin
FVIIa
Name 2 cofactors that has the function of a procoagulant
FVa
FVIIIa
What happen if there is hyperactivity in anticoagulants?
Causing thrombophilias
Name 3 procoagulants (except proteases and co-factors)
- Tissue factor (TF)
- Fibrin
- Platelets
What happens if there is a dysfunction in procoagulants?
Coagulopathy
2 types of coagulopathy
- congenital (hemophilias)
- acquired
What happen if there is hyperactivity in procoagulants?
Leading to Thrombophilias
What are the symptoms of thrombophilias?
- congenital
- acquired
Name anticoagulants (6)
- Antithrombin
- Protein C and S
- TF pathway inhibitor
- Fibrinolytic system
- Endothelial cells
Name the enzymes
name the inhibitors
APC resistance is the main pathway of ___
membrane bound FVa inactivation
Consequences of Leiden mutation?
Increase of lifetime of prothrombinase and tenase complexes
-> Thrombophilia
Do Coagulation complexes need phospholipids?
yes!
Name 2 experiments for Detection of APC resistance
-Functional assay of APC resistance (by APTT reagent)
-PCR: detection of FVR506Q point mutation
Activated Partial Thromboplastin Time (APTT)
-> Steps of intrinsic pathways
Example of Therapy of APC resistance
Chronic oral anticoagulation with coumarin-derivatives
An example of Therapy of APC resistance is “Chronic oral anticoagulation with coumarin-derivatives”
-> What is the mechanism for this?
Coumarin
-> inhibited vit K reductaseno vit K cofactor
-> no Gla synthesis
-> no clotting complexes
-> longer clotting time/no thrombosis
Functional assay of APC resistance
-> What does it mean when we have normal Activated Partial Thromboplastin Time (APTT)?
No coagulation factor deficiency in APC resistance
Functional assay of APC resistance
-> What happen if we add APC to normal plasma?
APTT will elongate more than 2x
Functional assay of APC resistance
-> What happen if we add APC to FV Leiden plasma?
APTT will slightly elongate
Prothrombin time (PT)
-> Steps of extrinsic pathway
