Page 456 - First Aid for the USMLE Step 1 2020, Thirtieth edition [MedicalBooksVN.com]_Neat

412 SectIon III Hematology and oncology ` hematology and oncology—PhySIology Hematology and oncology ` hematology and oncology—PhySIology

Coagulation and kinin pathways

Collagen, HMWK
basement membrane,
activated platelets Kallikrein ↑ vasodilation
– #
Contact C1-esterase inhibitor Bradykinin ↑ permeability
activation –
(intrinsic) XII XIIa – Kinin cascade ↑ pain
pathway XI XIa
REGULATORY ANTICOAGULANT PROTEINS:
IX IXa - proteins C and S
Tissue factor * VIII
* VIIIa with vWF
Tissue factor VII VIIa – ANTICOAGULANTS:
(extrinsic) * * - heparin
pathway X * Xa - LMWH
– - direct thrombin inhibitors (eg, argatroban, bivalirudin,
* Va V dabigatran)
ANTICOAGULANTS: –
- LMWH (eg, dalteparin, enoxaparin) II * IIa
- heparin Prothrombin Thrombin Plasminogen
- direct Xa inhibitors (eg, apixaban) THROMBOLYTICS:
- fondaparinux - alteplase, reteplase,
I Ia tPA streptokinase, tenecteplase
Fibrinogen Fibrin monomers –
Hemophilia A: deficiency of factor VIII (XR) ANTIFIBRINOLYTICS:
Hemophilia B: deficiency of factor IX (XR) Aggregation Plasmin - aminocaproic acid,
Hemophilia C: deficiency of factor XI (AR) tranexamic acid
Combined
Note: Kallikrein activates bradykinin 2+
ACE inactivates bradykinin pathway Ca XIIIa XIII Fibrinolytic system
#
= C1-esterase inhibitor deficiency hereditary angioedema
* = require Ca , phospholipid; Fibrin degradation
2+
= inhibited by vitamin K antagonist warfarin products (eg, D-dimer)
= cofactor Fibrin mesh stabilizes
= activates but not part of coagulation cascade platelet plug
LMWH = low-molecular-weight heparin

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