COAGULATION FIBRINOLYSIS

Activators Inhibitors Activators Inhibitors

Coagulation factors Antithrombin F9, 11a, 12a, Plasminogen
Phospholipid F10 Kallikrein-both Antiplasmin
Factors Protein C, S activators of Macroglobulin
Ca TFP I coagulation and
fibrinolysis

Intrinsic Extrinsic
Contact activated-contact negative Injury activated-TF combines activate
charge surface FVII

Intrinsic Extrinsic Common

Prekallikrein TF 10,5,2,1
HMWK 7,3 (1521)
12,11,9,8 (73)

Physical Groupings
PROTHROMBIN FIBRINOGEN CONTACT GROUP
(1972) 15813 1112/1211
2,7,9,10 -1,5,8,13 -11,12
Protein C, S, Z(CSZ) -Thrombin acts on all -HMWK, PK
-Vitamin K dependent these factors
-Synthesized-liver -Synthesize-liver -synthesize in the liver
-SMALL MW 50,000- -LARGE MW 250,000 LARGE 80,000-173,000
100,00 -Except F8, vWF -activated upon contact on
-Domain critical for Ca -endothelial cells and negatively charged
binding megakaryocyte particle
-Heat Stable -All are consumed in the -not consumed in
-Inhibited by Warfarin clotting process coagulation, found in
serum
-ACTIVATE intrinsic and
fibrinolytic system

Test for platelet FUNCTION and NUMBER

1. Platelet Count
2. Clot Retraction Time
3. Tourniquet Test
4. Bleeding Time
Test for Platelet Aggregation PLATELET FUNCTION
1. Turbidimetric Test
2. Ristocetin
Coagulation Testing
1. PT
2. aPTT
3. Thrombin Time
 PLATELET CLOT RETRACTION TOURNIQUET BLEEDING TIME
COUNT TIME TEST
-number -function -Defect on capillary -NUMBER and Function
-quantitative How long for the blood walls -Prior E surgery
smear clot to retract -Thrombocytopenia -Highly operation
-defects quality, -non specific dependent
appearance-giant -1.5 X the upper limit-
platelets-ITP increased possibility for
haemorrhage
-2X the upper limit-
definitive risk for
haemorrhage

Clotting Time PT aPTT Thrombin Time

Screening test- -screening test- -coagulation -availability of
measure all stages- EXTRINSIC disorders-INTRINSIC functional
Intrinsic and Common coagulation SYSTEM fibrinogen
Pathway mechanism including -detects presence of
-Monitor Heparin common pathway circulating
Therapy(limitations in -monitor anticoagulant
procedure-aPTT) 1972(VITAMIN K -monitor HEPARIN
DEPENDENT) treatment
Disad-poor -monitor
reproducibility anticoagulant
-sensitive only to treatment-
extreme factor Coumadin-act on Vit
deficiency K
-insensitive high doses -Screening for
of heparin coagulation disorders
-liver function test

-liver parenchymal
disease
-vit K deficiency