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Hemostasis NEW - Coagulation

1. Haemostasis is the process of blood clotting and involves both primary and secondary haemostasis. Primary involves platelet plug formation and secondary involves the intrinsic and extrinsic pathways culminating in fibrin formation from fibrinogen. 2. Common coagulation disorders include thrombocytopenic purpura, haemophilia A/B and von Willebrand disease. Haemophilia A is a factor VIII deficiency while haemophilia B is a factor IX deficiency. 3. Tests to diagnose coagulation disorders include bleeding time, coagulation time, prothrombin time, and activated partial thromboplastin time. Prolonged results can indicate disorders of platelets, coagulation factors or liver

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Manjurul Rahaman
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15 views2 pages

Hemostasis NEW - Coagulation

1. Haemostasis is the process of blood clotting and involves both primary and secondary haemostasis. Primary involves platelet plug formation and secondary involves the intrinsic and extrinsic pathways culminating in fibrin formation from fibrinogen. 2. Common coagulation disorders include thrombocytopenic purpura, haemophilia A/B and von Willebrand disease. Haemophilia A is a factor VIII deficiency while haemophilia B is a factor IX deficiency. 3. Tests to diagnose coagulation disorders include bleeding time, coagulation time, prothrombin time, and activated partial thromboplastin time. Prolonged results can indicate disorders of platelets, coagulation factors or liver

Uploaded by

Manjurul Rahaman
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Haemostasis

SL BLOOD CLOTTING COMMON NAME SYNTHESIS SITE VIT K


NO. FACTORS DEPENDENT
1 I Fibrinogen Liver No
2 II Prothrombin Liver Yes
3 III Thromboplastin Tissue factor No
4 IV Calcium - -
5 V Proaccelerin Liver No
6 VI
7 VII Proconvertin Liver Yes
8 VIII Liver No
9 IX Christmas factor Liver Yes
10 X Stuart- Power factor Liver Yes
11 XI Liver No
12 XII Hageman factor/ Contact factor Liver No
13 XIII Fibrin stabilizing factor Liver No

Haemostasis:
1. Primary haemostasis:
 Platelet plug formation
 Adhesion
 Activation
 Aggregation
2. Secondary haemostasis:
 Intrinsic Pathway: XII > XI> IX> VIII
 Extrinsic Pathway: Tissue injury > III > VII
 Common pathway: X> II> I (Fibrinogen to Fibrin)
3. Fibrinolysis:
 Thrombi is removed by action of Plasmin
 Plasmin degrades fibrin to Fibrin degradation product (FDP)-
 D-dimer (or D dimer) is a Dimer is a fibrin degradation product (or FDP), a small protein fragment
present in the blood after a blood clot is degraded by fibrinolysis. It is so named because it contains two
D fragments of the fibrin protein joined by a cross-link, hence forming a protein dimer.
Coagulation disorder:
a) Thrombocytopenic purpura
b) Haemophilia
 Haemophilia A: Factor VIII def
 Haemophilia B (Christmas disease): Factor IX def.
c) Von Willebrand disease
d) Disseminated intravascular coagulation (DIC)
Diagnosis:
A. Bleeding Time:
 Ivy’s method:
 Duke method
 Normal Range: 2 to 7 min
 Prolonged bleeding time is due to:
 Thrombocytopenia
 Von Willebrand disease
 Platelet defect
B. Coagulation time:
 Capillary tube method
 Normal range: 3 to 10 Min
 Prolonged clotting time is due to
 Haemophilia A & B
 Von Willebrand disease
 Liver disease etc.
 Do not increase in thrombocytopenia
C. Prothrombin time:
 Measure Activity of Extrinsic coagulation pathway
 Used to monitor Warfarin anticoagulant therapy
 Thromboplastin (Tissue factor) is used in P time reagent
 Citrated platelet poor plasma is used to test P time.
 Normal value of P Time is 10s to 13s


 INR: International Normalized Ratio (INR)
 The INR was devised to standardize the results and to avoid the variations between different
types and batches of manufacturer's tissue factor used in the reagent to perform the test
 Normal range of INR is 0.8 to 1.1
 On warfarin therapy INR range is 2.0 to 3.0
 P Time increases in:
 Liver disease
 Vit K deficiency
 Factor deficiency: VII/ X/ I/ 11 etc.
D. Activated partial thromboplastin time (APTT):
 Measure activity of Intrinsic pathway of coagulation pathway viz: XII/ XI/ IX/ VIII etc
 Kaolin / Ellagic acid is used in reagent that activate factor XII
 Normal range is 21 to 35 sec.
 Increases in haemophilia A/B, Factor deficiency, Liver disease, Vit K def., Anti phospholipid
antibody syndrome, Lupus anticoagulants etc.
 It is used to monitor Heparin therapy.

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