Difference of Primary and Secondary Hemostasis

PRIMARY HEMOSTASIS
Adhesion, Activation, Secretion,aggregation

Halimbawa po Eto yung INJURED

BLOOD VESSELS

1st hemostatic response : VASOCONSTRICTION initiated by serotonin and thromboxane A2 na

manggagaling sa platelets and endothelial cells.

1st inflammatory response: VASODILATION

SA PRIMARY HEMOSTASIS BLEEDING TIME PO ANG AFFECTED

SECONDARY HEMOSTASIS

STAGE 1: Generation of thromboplastin

Intrinsic Factors: 12,11,9,8 Extrinsic Factors: 3, 7

palatandaan pag APTT ang PT ang problem so Extrinsic ang
Problem, intrinsic siya parang involved palatandaan PET
May silent i sa dulo
APTTi para madali tandaan

Common Factors: 10,5,2,1

Ex: Pag increase ang PT, Normal ang APTT ang problem po ay nasa EXTRINSIC Factors
Pag increase ang PT at APTTang problem ay nasa common factors
Pag Normal ang PT , increase ang APTT ang problem ay nasa INTRINSIC factors

STAGE 2: Conversion of Prothrombin to thrombin

STAGE 3: Conversion of fibrinogen to fibrin clot stabilized by Factor XIII it is activated by thrombin

Remember my Loves:

COAGULATION FACTORS are produced by the LIVER. yan po yung organ na nagpoproduce ng mga
factor factor na yan All factors are being produced by the liver EXCEPT Factor 8

Meaning to say: ALL FACTORS are INCREASE in LIVER DISORDER except FACTOR 8

There are 2 factors that are being ACTIVATED AT COLD TEMPERATURE:

FACTORS VII and XI ( palatandaan my loves.. malamig sa 7-11 kasi aircon! Para madali tandaan)

Factor V and VIII- labile clotting factors: deteriorate when left at room temp.

Normal ang PT at APTT pero present ang bleeding : primary hemostasis ang problem FACTOR XIII
deficiency
Test for Factor XIII deficiency: Duckerts Test/5M Urea Solubility test .

Reptilase time/test not affected by heparin

Factor 12 deficiency is NOT associated in bleeding.. may problem sa coagulation factor pero negative
sa bleeding

Hemophilia A /Classic/Royal disease: Factor 8 ang problem at vwF

Hemophilia B/ Christmas Disease: Factor 9 ang problem at vwF
Antithrombin III- major inhibitor of thrombin/ most important inhibitor

Platelet Disorders:

Quantitative : Thrombocytopenia or thrombocytosis

Qualitative:
a. Hereditary
Kapag ang problem ay platelet adhesion ibig sabihin hindi makapag produce ng vWF na
dapat ay manggagaling sa megakaryocyte at endothelial cells

EX:
vWD Normal ang Epinephrine, Collagen at ADP (ECA para madali tandaan). Abnormal
ang RISTOCETIN
Bernard Soulier deficient sa glycoprotein Ib or gpIb, normal ang ECA abnormal ang
RISTOCETIN at may GIANT PLATELETS

VWF gpIb
WF

Kapag platelet aggregation ang problem

Glanzmanns thrombasthenia- deficient sa gpIIb at IIIa, normal RISTOCETIN abnormal ECA

Kapag platelet secretion storage pool defects

Gray platelet syndrome- alpha granules ang problem , increase BT, moderate
thrombocytopenia

Hermansky-Pudlak problem ay Chromosome 19, autosomal recessive characterized by

tyrosinase (+) albinism
Wiskott- Aldrich Syndrome- Triad of immunodeficiency small platelet, eczema,
thrombocytopenia SET para madali tandaan
Chediak-Higashi Anomaly- Chromosome 13 ang prob. GIANT LYSOSOMAL.. palatandaan
Chediak sound like tadyak, pag tumadyak dapat naka lysoSHOEmal hehe

b. Acquired
Ex: uremia, AML, paraproteinemias, Drugs : aspirin