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27 Cards in this Set

  • Front
  • Back
Which factors are unique to the extrinsic pathway?
VII and Tissue Factor
What is main function of the extrinsic pathway?
Creates the immediate clot in response to vascular injury (and subsequent release of Tissue Factor)
What inhibitor inhibits the TF/VIIa/Xa complex?
Tissue Factor Pathway Inhibitor (TFPI)
What is main function of the intrinsic pathway?
Allows for clot remodeling after extrinsic pathway has been blocked by TFPI (which blocks the TF/VIIa/X complex)
What are the 3 components of the Ten-ase complex?
1. VIIIa

2. Phospholipds (on platets)

3. Ca++
What does the Ten-ase complex do?

What pathway is it a part of?
Cleaves X ---> Xa

Part of intrinsic pathway
What is the prothrombinase complex composed of?
1. Xa

2. Va

3. Phospholipids

4. Ca++
What is the function of the prothrombinase complex?
Cleave prothrombin ---> thrombin
Draw out clotting cascade
(see notes)
What are 5 functions of Thrombin?
1. Cleave Fibronigen ---> Fibrin

2. Stimulate production of TF & Protein C

3. Create VIIIa

4. Create Va

5. Stimulate XI --> XIa
What are the 6 serine protease clotting factors?

Why important?
1. XIIa
2. XIa
3. IXa
4. Xa
5. VIIa
6. Thrombin

Important because prime targets for regulators and anticoagulant drugs
What is the only factor, that if missing, doesn't results in bleeding problem?
XII - because XI can be activated by Thrombin, as well as XII
What does defect in IX cause?

What does defect in VIII cause?
IX = Hemophilia B

VIII = Hemophilia A
What factors does a Prothrombin Time (PT) test?

What pathway does it test?
VII, V, X, Thrombin (II), Fibrinogen

Tests extrinsic pathway
What factors does the activated Partial Thromboplastin Time (aPTT) test?
XII, HMWK, PK, XI, IX, VIII, X, V, Thrombin (II), Fibrinogen
What are the 2 main categories of items that can cause a prolonged aPTT?
1. Deficiencies (either acquired or inherited)

2. Inhibitors (always acquired). Either antibodies or drugs
What are 2 examples of acquired clotting deficiency that cause prolonged aPTT?
1. Vit K deficiency

2. Liver Defect
What step is taken after a prolonged aPPT to see whether problem is a deficiency or inhibitor?
Mix with normal blood.

If becomes normal, must be deficiency. If not, must be inhibitor.
What 4 clotting factors depend on Vitamin K?
Thrombin (II), VII, IX, X

Note: Vit. K required for post-translational modification, not synthesis
What are the 3 primary regulators of coagulation?
1. Tissue Factor Pathway Inhibitor (TFPI)

2. Anti-Thrombin

3. Protein C
Heparin increases the activity of what endogenous regulator of clotting?
Anti-Thrombin
What is the function of protein C/S?
Cleaves and inactivates factors Va and VIIIa, slowing thrombin production

Note: Protein S is a cofactor of Protein C
What activates the production of protein C?
Thrombin (negative feedback loop)
What enzyme degrades clots when they are no longer needed?
Plasmin
Draw out fibrolytic pathway
(see notes)
What are D-Dimers?

What are the useful for?
XIII-crosslinked fragments of polymerized fibrin

useful as a marker for clot production
What is thrombosis?
Over-clotting in vasculature