THE CASCADE

FLOW CHART OF CAGULATION EVENTS


HOMEOSTASIS 3

THE FACTORS AND THE PATH
As stated earlier the process of coagulation may be initiated by intrinsic cause
or by extrinsic causes
The factors involved and there interactions are shown in Fig. 2.1.
The factors are Named and the deficiency management is tabulated in Table 2.1 below.

Intrinsic Path
(Present in Blood)
XII--------------
? HMWK *

XIIa
XI--------------


XIa
IX------------- Extrinsic Path
ca2+ (Outside the blood vessel)
Present in Tissue Protein
IXa------ -------
ca2+ ca2+
Phospholipid VIII Tissue Thromboplastin

X-----------------------
Phospholipid ca2+
V

Xa
Prothrombin---------------


Thrombin
Fibrinogen---------------------> Fibrin

ca2+ XI

Firm clot

* High Molecular weight Kininogen

Fig. 2.1 COAGULATION CASCADE AND FACTORS REQUIRED
BMJ 1997 314 1026


Factors that take part in these mechanisms are named and listed
in Table 2.1.
TABLE 2.1
NOMENCLATURE OF COAGULATION FACTORS
_______________________________________________________________________

FACTOR SYNONYM TREATMENT DEFECIENCY STATES
_______________________________________________________________________
I Fibrinogen FFP,cryoprecipitate platelet
II Prothrombin FFP, Platlets
III Thromboplastin (tissue
factors)
IV Calcium ion
V Proacclerin,labile factor FFP,minimal in platelets
vWF Von Willebrand's factor FFP,cryoprecipitate,full
concentrate
VII Serum prothrombin conversion FFP, Platelets
accelerator, stable factor
VIII Antihemophilic Factor A FFP,cryoprecipitate,factor
VIII concentrate(plasma
derived or recombinant)
*IX Christmas factor FFP,prothrombin complex
concentrate,factor IX
concentrate,platelets
*X Suart-Power factor FFP,Platelets
XI Plasma thromboplastin FFP,minimal in platelets
antecedent
XII Hageman factor FFP, platelets
XIII Fibrin Stabilizing factor
Low Platelets counts Platelets
_______________________________________________________________________
* Vitamin K-dependent factors
FFP Fresh frozen plasma, platelet packs
The mechanism involved in the intrinsic process of coagulation
are initiated by inactive factor XII coming in contact with
factor VII to form a complex which activates factor X.
Then onwards the process follows a common pathway ending with the
production of fibrin.
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