Problem 6: Coagulation disorders by https://padlet.com/566736vv/lre4vj2gvc3d0qd4 en-us 2022-09-30 11:15:23 UTC 2022-10-03 19:01:55 UTC hello@padlet.com 1. What is the coagulation cascade? 566736vv https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2320895758 2022-09-30 11:25:17 UTC https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2320895758 2. What are coagulation disorders? 566736vv https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2320898101 2022-09-30 11:27:48 UTC https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2320898101 3. What is deep vein thrombosis (DVT)? 566736vv https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2320899931 2022-09-30 11:28:57 UTC https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2320899931 Importance of Vitamin K in clotting 566736vv https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2320901440 2022-09-30 11:30:36 UTC https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2320901440 Virchow's triad 566736vv https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2320902619 2022-09-30 11:31:54 UTC https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2320902619 Coagulation cascade- simplified (lecture) siennaakkermans https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2322551475
  • Tissue damage -> TF is exposed -> binds to factor VII -> forms a complex  
  • The complex activates factor X, IX, V and VIII 
  • Protein C and S (its cofactor) has inhibitory effect on factor V & VIII 
  • Fibrinolysis 
    • breaks down fibrin and fibrinogen 
    • by plasmin
    • ]]>     2022-10-02 11:58:34 UTC https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2322551475     Coagulation cascade siennaakkermans https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2323485217
  • Coagulation cascade = series of steps in response to bleeding caused by tissue injury, where each step activates the next and ultimately produces a blood clot 
  • Last factor: fibrin, made of fibrinogen, makes sure that all the platelets are combined, the little 'net' that holds the platelets together 
  • Pathways 
    • Intrinsic: because of intrinsic factors such as Factor XII 
    • Extrinsic: happens because of extrinsic factors such as cuts, certain proteins, foreign bodies
    • Factor X connects the intrinsic and extrinsic pathways to  each other 

    • ]]>     2022-10-03 10:22:26 UTC https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2323485217     Vitamin K siennaakkermans https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2323486441
  • vitamin K is required to activate certain factors, e.g. VII, II, IX, X 
    • ]]>     2022-10-03 10:23:29 UTC https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2323486441     Case 1: Factor VII deficiency siennaakkermans https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2323501062
    • Case 1: Factor VII deficiency 
      • increased prothrombin time 
      • aPTT is normal 
    • Related parents 
      • Less genetic variation 
      • Higher chance of recessive disorder 
      • In this case: recessive inheritance pattern of Factor VII deficiency 
    • Treatment 
      • Lifelong Factor VII administration 
      • Vitamin K not very helpful in this case 

    ]]>     2022-10-03 10:36:34 UTC https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2323501062     Case 2: DVT siennaakkermans https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2323516514
  • Patient: sedentary behavior, calves swelling up -> ER after 2 days 
  • Diagnosis: DVT in left common iliac vein 
  • Risk factors: Virchow's triad 
    • Women at high risk: contraceptive pill (estrogen) + pregnancy (higher estrogen & varicose veins & obstruction of vena cava by uterus) 
    • Smoking -> atherosclerosis -> clot 
    • Dehydration -> thicker blood -> more prone to clotting 
  • In this case: sedentary behavior -> venous stasis -> clotting
  • Treatment: DOACs (oral anticoagulants), thrombolytics (break down fibrin cap  and platelets) but dangerous because they can lead to pulmonary embolism 
  • Other treatments: catheterization, suction thrombectomy (risks!) 
    • ]]>     2022-10-03 10:49:29 UTC https://padlet.com/566736vv/lre4vj2gvc3d0qd4/wish/2323516514