anticoagulant system Flashcards
(27 cards)
function of plasmin
breaks down fibrin clots
what activated plasminogen
kallikrein
factors 11/12a (procoag)
tPA
FSP/FDP’s
fibrin degradation products
what do elevated levels of FSP’s indicate
active clotting (fibrins being cut up)
how do we measure serum plasmin levels
indirectly by measuring FSPs because if present means plasmin is working and clots are being broken
protein s
activates C with help of thrombomodulin
protein c
inactivates 5 and 8 a
protein z
inactivates 10a
antithrombin
inactivates thrombin (2a) and 10a
TFPI
inactivates 7a (extrinsic pathway)
thrombomodulin
converts thrombin (2a) into anticoagulant; helps protein S activate C
what does small chain heparin inhibot
10 a
Factor 5 liden disease
- mutant factor 5 but still works in cascade
- doesn’t respond to factor C (inhibition)..unimpeded coag and clots
function of warfarin/coumadin
blocks vit k
what lab test is used to evaluate effect of coumadin
PT time
what is PT time used?
factor 7 has a shorter half life and is more sensitive to the effect of the CURRENT dose
function of heparin
activates antithrombin
function of antithrombin
inactivates thrombin and 10 a (converts pro to thrombin)
type I HIT
non-immune
after 2 days
less fractionated, less likely to happen
type II HIT
immune
day 4-10
binds to PF4 which marks platelets for destruction and secrete their chemical mediators stimulating thrombin leading to aggregation, low platelet count and leads to clots
complications of Type II HIT
venous thromboembolism, skin, systemic (iV)
thrombophilia
tendency to form blood clots inappropriately due to abnormalities in structure, abnormalities in amount circulating and abnormal circulating pro-coagulants
factor 5 mutation
- normal procoagulant but doesn’t respond to protein c
- most common genetically acquired thrombophilia
- autosomal dominant
III, Protein C and S deficiency
autosomal dominant
- homozygotes Coumadin for life
no OC
