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Bleeding disorders
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Possible causes of abnormalities in blood clot formation and causes of abnormal bleeding
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Bleeding disordersMonday, 20 September 2021 5:04 PM
Blood clot formation
- All parts interact closely with each other using positive feedback to ensure quick
blood clot
- Any anomality in the 3 process means clot won’t be formed efficiently
o Vessel wall
o Platelets
o Coagulation cascade
- Platelet mediators
o ADP
§ Positive feedback mechanism on platelet activation
o Serotonin
§ Involved in initiating vasoconstriction and enhancing platelet
aggregation
o Thromboxane A2
§ Synthesized when platelets are activated
§ Feedback control over platelets
• More synthesis of thromboxane A2
§ Cyclo-oxygenase
• Forms thromboxane A2
o Forms platelet plug but still fragile
- Other mediators
o Not released by platelets but by endothelial cells
§ Prostacyclin - PGI2
§ Nitrogen oxide
§ Important because in an intact vessel wall
• NO and prostacyclin have platelet inhibiting effect
o Prevents platelets forming unnecessary platelet plugs
o Limits the extent that the platelet l=plug is formed
- Coagulation cascade
o Many chemical reactions – proteolytic reactions
o Convert inactive protein to active protein
§ Proteolysis
o Prothrombin to thrombin
§ Thrombin cleaves fibrinogen
§ Exerts positive feedback – amplification phase
o Lead to the conversion of fibrinogen to fibrin
o Most factors are converted to active enzymes
o Liver
§ Vitamin K
• 2, 7, 9, 10
§ non-vitamin K
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