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Lecture notes Blood Science (BY327)
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A brief document showing the disorders of haemostasis.
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Haemostasis Disorders: Leukemia, Epistaxis, Excessive bleeding post-op
Platelet disorders are very rare, but acquired ones are common
Thrombophilia- is hereditary, has issues and malfunctions in Protein C
pathway
Protein C anticoagulant pathway: Initiated by thrombin and
thrombomodulin on endothelial cell surface. Thrombin that escapes at site of
vascular injury binds to thrombomodulin (using EPCR). Thrombin loses ability to
clot fibrinogen and also to activate factors V, VIII, XIII, and platelets. It instead
becomes potent activator of protein C.
Thrombosis- A thrombus can block blood flow through a vein or artery. If
detached from vessel wall and lodges in lungs or organs, it can be life
threatening (strokes/ heart attacks). The coagulation system depends on a
balance between natural procoagulants and anticoagulant factors.
Risk factors: Vascular wall injury, circulatory stasis, hypercoagulable state
(all part of Virchow’s triad). Also- genetic factors, circumstantial, lupus
anticoagulant / antiphospholipid syndrome.
Tests- D-Dimer assay: presence of D-Dimers in plasma show signs of an in-
situ clot. Lupus anticoagulant: DRVVT- shows antibodies with strong
correlation to thrombotic disease, both arterial and venous.
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