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Questions and Answers
Which coagulation factor is primarily produced in the liver?
Which coagulation factor is primarily produced in the liver?
- Factor III
- Factor VII
- Factor II (correct)
- Factor IV
What triggers the intrinsic pathway of the coagulation cascade?
What triggers the intrinsic pathway of the coagulation cascade?
- Interaction with platelets
- Damage to the blood vessel (correct)
- Release of calcium ions
- Exposure of tissue factor
Which of the following statements about Factor III is accurate?
Which of the following statements about Factor III is accurate?
- It functions primarily in the intrinsic pathway.
- It is secreted by platelets.
- It is also known as tissue factor. (correct)
- It is produced only in the liver.
Which test reflects the intrinsic pathway of coagulation?
Which test reflects the intrinsic pathway of coagulation?
What condition commonly causes prolongation of prothrombin time (PT)?
What condition commonly causes prolongation of prothrombin time (PT)?
Which of the following statements about anticoagulant drugs is true?
Which of the following statements about anticoagulant drugs is true?
What is the role of thrombin in the coagulation cascade?
What is the role of thrombin in the coagulation cascade?
What does APTT reflect in terms of coagulation?
What does APTT reflect in terms of coagulation?
Which of the following best describes the term 'embolus'?
Which of the following best describes the term 'embolus'?
Which coagulation factor is essential for the conversion of prothrombin to thrombin?
Which coagulation factor is essential for the conversion of prothrombin to thrombin?
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Study Notes
Coagulation Factors
- Most coagulation factors are produced in the liver
- Factor III (tissue factor) and factor IV (calcium ions) are produced by other cells, including endothelial cells and platelets
Coagulation Cascade
- Occurs at site of injury
- Intrinsic pathway: activated by blood vessel damage and collagen exposure
- Extrinsic pathway: triggered by tissue factor (factor III) release from damaged tissues
- Common pathway: both pathways converge to produce factor Xa, which converts prothrombin (factor II) into thrombin (factor IIa), leading to fibrinogen (factor I) conversion into fibrin
- Factor Xa is responsible for clot formation
Coagulation Tests
- Activated partial thromboplastin time (APTT) reflects the intrinsic pathway and can indicate deficiencies in factors VIII, IX, XI, or XII
- Prothrombin time (PT) reflects the extrinsic pathway and can indicate factor VII deficiency
- Common pathway deficiencies in factors V, X, thrombin, and fibrinogen prolong both APTT and PT
- Thrombin clotting time (TCT) measures the final step of coagulation, converting fibrinogen to fibrin via thrombin action
- Prolonged TCT can be due to deficiencies in fibrinogen and direct or indirect thrombin inhibitors
Classes and Drug Use
- Factor Xa and direct thrombin inhibitors can be taken at home, in contrast to heparin and vitamin K antagonists
- Drugs do not dissolve existing clots, but prevent new clots from forming and stop existing clots from worsening
- Thrombus: a blood clot formed abnormally within blood vessels
- Embolus: a blood clot dislodged from a vessel wall and travels through the bloodstream
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