WK3HEMA2LEC

• Secondary hemostasis


  composed of coagulation factors and platelet phospholipids
• 3 pathways of hemostasis

  intrinsic, extrinsic, common
• coagulation factors

  also known as pro coagulants
• Circulate in inactivte forms EXCEPT factor

  III and IV (normally active)
• Synthesized in the liver except factor

  III, IV and VIII:C
• functions of coagulation factors

  enzymatic, Substrate, Cofactor
• Enzymatic


  Zymogens, Serine Protease
• Co factor

  Factor III, V, VIII and HMWk
• Factor I

  fibrinogen
• Factor II

  Prothrombin
• Factor III

  tissue factor (thromboplastin)
• Factor IV

  Calcium
• Factor V

  Proaccelerin
• Factor VIII

  proconvertin
• Factor VIII:C

  Antihemophilic factor (AHF)
• Factor IX

  Plasma thromboplastin component (PTC)
• Factor X

  Stuart-Prower factor
• Factor XI

  Plasma thromboplastin antecedent (PTA)
• Factor XII

  Hageman factor (contact factor)
• Factor XIII

  Fibrin stabilizing factor
• Prekallikrein


  Fletcher factor
• High Molecular Weight Kininogen (HMWK)

  Fitzgerald factor
• COAGULATION FACTORS

  - Physical Properties

  - Contact Group
• Contact Group

  - Intrinsic accessory pathway

  - Contact phase group

  - Contact with a negative charged surface
• Factors that can be absorbed by a contact with a negative charged surface:

  - Glass

  - Collagen

  - Sub endothelium layer
• Physical Properties

  - Prothrombin Group

  - Fibrinogen Group
• Prothrombin Group

  Calcium and vitamin K dependent (B. fragilis , E.coli)
• calcium bridges

  Gamma carboxylation of glutamic acid at the N-terminal end allows the

  factors to bind calcium and platelet phospholipids
• Prothrombin Group Proteins

  Protein C, S and Z
• Prothrombin Group Factors

  FII, FVII, FIX, FX
• Inhibited by oral anticoagulants

  - Coumadin

  - Warfarin
• Fibrinogen Group


  - most concentrated coagulation factor

  - Calcium dependent

  - Consumed during coagulation

  - Seen only in PLASMA

  - Only factors found in the alpha granules of platelets
• EXTRINSIC PATHWAY

  - Factors: VII, III, Calcium

  - Factors are not found in plasma

  - It can alternatively activate FIX
• FVIIa

  single chained factor
• Extrinsic Tenase Complex

  FVIIa+Calcium+FIIIa Complex
• INSTRINSIC PATHWAY


  - Factors: FXII, XI, IX, VIII, - HMWK, PK, Ca

  - All components are found in plasma

  - It can activate extrinsic pathway which

  produces two chained FVII via FXII (FIX+Kalikrein)

  - Directs activations of FIX

  - Activation of FXII
• Intrinsic Tenase Complex:

  FIX+FVIII+Ca+Phospholipids
• 85x pro coagulant activity


  Another is FX can hydrolyze FVII into two chain
• Kinin system


  - Involves in the chemotaxis and the sensation of pain, mediate inflame

  response, increase vascular permeability, vasodilation

  - Prekalilreinn , Kalikrein , HMWK and Bradykirin
• Fibrinolysis and Complement


  Produces plasmin

  Plasmin: activates C1 and cleaves C3