Understanding Coagulation

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Course Objectives
Discuss the advantages of Coagulation.
Explain and Summarize the 13 Primary Coagulation Factors
Summarize the importance of the circulatory system to coagulation
Discuss and understand Hemostasis: The Four Stages of Vessel Repair
Explain and Summarize Primary and Secondary Hemostasis
Course Content
Course Creator: Kirsten Hermens NCMA-P
Total CE Hours: 1 Credit Hour 
Pace Course #: 586-2406-24

Key Terms: 
  • Aggregation
  • Blood
  • Clotting
  • Coagulation Cascade
  • Deep vein thrombosis (DVT)
  • Endothelium
  • Extrinsic
  • Fibrinogen
  • Hemostasis
  • International Normalized Ratio (INR)
  • Intrinsic
  • Partial Thromboplastin Time (PTT)
  • Pulmonary Embolism (PE)
  • Plasma
  • Platelets
  • Prothrombin Time (PT)
  • Thrombocytopenia
  • Tunica Adventitia
  • Tunica Intima
  • Tunica Media
  • Vasoconstriction
  • Vessel
 
Outline:
  • Introduction
  • Key terms
  • What is coagulation
    • Two Pathways
  • 13 Primary Coagulation Factors
    • I – Fibrinogen 
    • II – Prothrombin 
    • III – Tissue Factor or Thromboplastin 
    • IV – Calcium 
    • V – Labile Factor (Proaccelerin) 
    • VI – Does Not Exist, Studied as Factor 5a 
    • VII – Stable Factor or Proconvertin 
    • VIII – Antihemophilic Factor A
    •  IX – Christmas Factor or Antihemophilic Factor B
    •  X – Stuart Prower Factor
    •  XI – Plasma Thromboplastin Antecedent
    • XII – Hageman Factor
    •  XIII – Fibrin Stabilizing Factor 
      • Test Your Knowledge
  • The cardiovascular system
    • Heart
    •  Artery
    • Capillaries
    •  Exchange Network
    • Veins 
      • Test Your Knowledge
  •  Coagulation: Phlebotomy
    • What is it
    •  Anatomy of the vein
      • Test Your Knowledge 
  • What is Hemostasis
    • Hemostasis: The Blood Vessel Repair
    •  4 Stages of Blood Vessel Repair
      • Vascular
      • Platelet
      •  Coagulation Cascade
      •  Fibrinolysis 
        • Test Your Knowledge
  • 4 Stages of Blood Vessel Repair: Primary and Secondary
    • Stage #1: Vascular 
      • Primary Hemostasis
    •  Stage #2: Platelet Plug 
      • Primary Hemostasis
    •  Stage #3: Coagulation Cascade
      • Secondary Hemostasis
    •  Stage #3 Coagulation Cascade 
      • Extrinsic Pathway
    • Stage #3 Coagulation Cascade
      • Intrinsic Pathway
    • Stage #3 Coagulation Cascade 
      • Common Pathway
    •  Stage #4: Fibrinolysis
      • Final stage 
        • Test Your Knowledge
  • Bleeding and Coagulation: Finding The Problem
    • Deficiency versus Abundance
    •  Is it Inherited?
    •  Is it Acquired?
  • Excessive Bleeding Disorders
    • Primary Hemostasis 
    • Factor VIII 
    • Factor IX 
    • Vitamin K Deficiency
  • Coagulation Disorders
    • Thrombocytosis
    •  Factor II
    •  Antiphospholipid Syndrome
    •  Disseminated Intravascular Coagulation or DIC
    •  Factor V
    •  Deficiency in Clotting Proteins 
      • Test Your Knowledge
  • Types of Coagulation Tests
    • Activated Partial Clotting Time (aPTT)
      • About 
      • How to Collect
    • Activated Clotting Time (ACT) 
      • About
      •  How to Collect
    •  Bleeding Time Test (BTT) 
      • About
      •  How to Collect
    •  Complete Blood Count (CBC)
      • About 
      • How to Collect
    •  D-Dimer 
      • About 
      • How to Collect
    •  Factor V Assay 
      • About
      • How to Collect
    • Fibrinogen Degradation Products (FDP)
      • About 
      • How to Collect
    • Platelet Count
      • About
      •  How to Collect
    •  PT or PT/INR
      • About 
      • How to Collect
    •  Thrombin Time 
      • About 
      • How to Collect
    •  von Willebrand Disease 
      • About 
      • How to Collect

References:
  1. (n.d.). Coagulation of Blood. Britannica. https://www.britannica.com/science/coagulation-of-blood
  2. (n.d.). Blood Clotting Process. News Medical. https://www.news-medical.net/health/Blood-Clotting-Process.aspx
  3. (n.d.). Fibrinogen. Cleveland Clinic. https://my.clevelandclinic.org/health/diagnostics/22791-fibrinogen-test
  4. https://labpedia.net/blood-coagulation-factors-and-their-interpretations/#Proaccelerin_Factor_V
  5. (n.d.). Prothrombin. Cleveland Clinic. https://my.clevelandclinic.org/health/diagnostics/prothrombin-time-test
  6. (n.d.). Thromboplastin. Cleveland Clinic. https://my.clevelandclinic.org/health/diagnostics/25101-partial-thromboplastin-time a
  7. (n.d.). Calcium Blood Test. Cleveland Clinic. https://my.clevelandclinic.org/health/diagnostics/22021-calcium-blood-test
  8. https://www.dovemed.com/health-topics/focused-health-topics/physiology-factor-v-understanding-its-role-blood-coagulation
  9. (n.d.). Test Catalog. Mayo Clinic. https://www.mayocliniclabs.com/test-catalog
  10.  (n.d.). Test Menu. Lab Corp. https://www2.labcorp.com/test-menu/search?query=aP
  11. (n.d.). BTT. Healthline. https://www.healthline.com/health/bleeding-time#procedure
  12.  (n.d.). Thrombin Time. Rochester Edu. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=thrombin_time
  13. (n.d.). Blood Thinners. Very Well Health. https://www.verywellhealth.com/blood-thinners-5212486
  14.  (n.d.). Causes of Clotting Disorders. National Heart Lung Blood Institute. https://www.nhlbi.nih.gov/health/clotting-disorders/causes
  15.  https://ashpublications.org/blood/article/100/3/743/16367/Role-of-factor-XIII-in-fibrin-clot-formation-and
  16.  (n.d.). Clotting Factors Mnemonic. Medicowesome. https://www.medicowesome.com/2011/11/clotting-factors-mnemonic.html
  17. (n.d.). Circulatory and Cardiovascular. Cleveland Clinic. https://my.clevelandclinic.org/health/body/circulatory-and-cardiovascular-system
  18.  (n.d.). Hemostasis. Cleveland Clinic. https://my.clevelandclinic.org/health/symptoms/21999-hemostasis
  19.  (n.d.). PT, PTT, and INR. Very Well Health. https://www.verywellhealth.com/pt-ptt-and-inr-results-3157005
  20.  (n.d.). Causes of Bleeding Disorders. National Heart Lung Blood Institute. https://www.ncbi.nlm.nih.gov/books/NBK541050/
  21. n.d.). Bleeding Disorders. Healthline. https://www.healthline.com/health/bleeding-disorders
  22.  (n.d.). Thrombocytosis. National Heart Lung Blood Institute. https://www.nhlbi.nih.gov/health/thrombocythemia-thrombocytosis
  23.   (n.d.). Factor II Deficiency. Healthline. https://www.healthline.com/health/factor-ii-deficiency
  24. (n.d.). Antiphospholipid Syndrome. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/antiphospholipid-syndrome/symptoms-causes/syc-20355831
  25.  (n.d.). DIC. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21836-disseminated-intravascular-coagulation-dic
  26.  (n.d.). Factor V Leiden. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17896-factor-v-leiden
  27.  (n.d.). Deficiency in Clotting Proteins. Cleveland Clinic. https://my.clevelandclinic.org/services/blood-clotting-disorders-treatment
  28. 17. (n.d.). Deficiency in Antithrombin. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22251-antithrombin-deficiency


 
Photo Credits:
 
P1: Photo: Fibrinogen. (2020, May 23). In Wikipedia. https://en.wikipedia.org/wiki/Fibrinogen#/media/File:PDB_1m1j_EBI.jpg
 
P2: Photo: Prothrombin. (2014, July 20). In Wikipedia. https://en.wikipedia.org/wiki/Thrombin#/media/File:1nl2_opm.png
 
P3: Photo: Thromboplastin. (2010, February 10). In Wikipedia. https://en.wikipedia.org/wiki/Tissue_factor#/media/File:Protein_F3_PDB_1ahw.png
 
P4: Photo: Calcium. (2016, May 8). In Wikipedia. https://en.wikipedia.org/wiki/Calcium#/media/File:Ca(aq)6_improved_image.tif
 
P5: Photo: Proaccelerin. (2009, December 15). In Wikipedia. https://en.wikipedia.org/wiki/Factor_V#/media/File:Protein_F5_PDB_1czs.png
 
P6: Photo: Proconvertin. (2014, July 20). In Wikipedia. https://en.wikipedia.org/wiki/Factor_VII#/media/File:1dan_opm.png
 
P7: Photo: Antihemophilic. (2013, January 21). In Wikipedia. https://en.wikipedia.org/wiki/Factor_VIII_(medication)#/media/File:Fviii_2R7E.png 

P8: Photo: Christmas Factor. (2010, December 14). In Wikipedia. https://en.wikipedia.org/wiki/Factor_IX#/media/File:PDB_1pfx_EBI.jpg 

P9: Photo: Stuart Prower. (2010, February 10). In Wikipedia. https://en.wikipedia.org/wiki/Factor_X#/media/File:Protein_F10_PDB_1c5m.png 

P10: Photo: Plasma Thromboplastin Antecedent. (2010, February 10). In Wikipedia. https://en.wikipedia.org/wiki/Factor_XI#/media/File:Protein_F11_PDB_1xx9.png 

P11: Photo: Hageman Factor. (2022, June 30). National Institutes of Health. https://3d.nih.gov/entries/3DPX-017334 

P12: Photo: Fibrin Stabilizing Factor. (2019, November 11). In Wikipedia. https://en.wikipedia.org/wiki/Factor_XIII#/media/File:Human_factor_XIII_1EVU.png 

P13: Photo: DeStefano V, Rossi E. Testing for inherited thrombophilia and consequences for antithrombotic prophylaxis in patients with venous thromboembolism and their relatives. Thromb Haemost. 2013 Oct;110(4):697-705
 
P14: (2024). Disseminated Intravascular Coagulation (DIC) [Photograph]. Myhematology. https://myhematology.com/platelet-disorders/disseminated-intravascular-coagulation-dic-a-microangiopathy/
 
P15: (11072024). Factor V Leiden Gene: Increased Risk of Blood Clots [Photograph]. Genetic Life Hacks. https://www.geneticlifehacks.com/factor-v-leiden/
 

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