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Coagulation cascade memorization

Discussion in 'Step I' started by BlondeCookie, 11.27.06.

  1. BlondeCookie

    BlondeCookie Senior Member

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    I'm having a hard time memorizing the steps of the coagulation cascade. Is there a mnemonic or some sort of easy way people are using to memorize all the intrinsic, extrinsic, and common pathways?
     
  2. trudub

    trudub Senior Member

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    I don't think there is. I think you just have to draw out a diagram over and over and try to turn it into a story. What parts of it are you specifically having trouble remembering, I mean are you having trouble remembering what activates what or which require calcium or what?
     
  3. BlondeCookie

    BlondeCookie Senior Member

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    Yes, I am having trouble remembering what activates what, but also having some trouble remembering what each factor is. For example, Factor I = Fibrinogen, Facter II = Prothrombin, Factor III = Tissue Thromboplastin, etc. And another thing, some texts have simpified steps of the extrinsic, intrinsic, and common pathways. While other texts are more comprehensive. So, it's a bit confusing getting it all straight.

    A couple of specific questions.
    1) Both the intrinsic & extrinsic pathway are occuring at the same time correct? For example, a trauma such as a paper cut would set off both pathways simultaneously, right? :confused:
    2) Is the coagulation cascade (ie intrisic, extrinsic, common pathways) a part of primary hemostasis or secondary hemostasis?
     
  4. YouDontKnowJack

    YouDontKnowJack I no something you don't

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    simplify by ditching the roman numerals, and using alphanumerics instead
     
  5. UCLAstudent

    UCLAstudent I'm a luck dragon!

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    1) Yes, they both occur at the same time. However, the designations of "intrinsic" and "extrinsic" pathway are only really useful in a laboratory setting (i.e., determining PTT or PT). In vivo, the two pathways likely interact with each other extensively (for example, 7 can activate 10).
    2) Secondary hemostasis. Primary hemostasis refers to the formation of the platelet plug
     
  6. BlondeCookie

    BlondeCookie Senior Member

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    Very nice explanation. Much thanks UCLAstudent and everyone else! I've got this one down good now.
     
  7. Buckeye(OH)

    Buckeye(OH) 5K+ Member

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    Also don't forget that fibrinolysis is getting fired up at about the same time that the coagulation cascade is being fired up. Its typically taught as sequential, but that isn't entirely true.
     
  8. flipgirl12

    flipgirl12 New Member

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    One thing I use is this mnemonic: picturing a woman crying over a break up, talking about her ex (extrinsic pathway), and how he was a professional hockey player (the number 7 turned upside down looks like a hockey stick). The whole time she is crying, so she is using a tissue (factor). But before her boyfriend played hockey, he also played baseball (10 looks like a bat and a baseball) and golf (9 looks like a golf club).
     
  9. Buckeye(OH)

    Buckeye(OH) 5K+ Member

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    Lord, thats too much work.
     
  10. flipgirl12

    flipgirl12 New Member

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  11. viostorm

    viostorm Senior Member

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    Someone in our class had this pneumonic for intrinsic.

    Factor Eleven (ends in n) goes to Factor Nine (begins with n, ends in e) which by the action Factor Eight (begins in E, ends in T) in the presence of Calcium, converts Factor Ten to Ten-a (begins with T)

    Also, everything with "a" is active. Without a, inactive.

    Someone should send that in to FA.
     
  12. Jon Davis

    Jon Davis I killed the bank.

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  13. peter90036

    peter90036 not out fishing

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    lordy lordy many years reading the same ol stuff, still cant hold it in ....

    couple hours later & caffeine crashed, this i still remember from my mnemonic (which i devised today...the previous one seems to have been erased from the brain)

    1 ex 7 (forgot what the 1 was for...maybe i was thinking 1 factor...)
    ex warf (wife - warf) ex warf (from warfarin has a role in here)

    12 in ptt + 3 (sing it)
    3 for 3 more factors (11,9,8)
    3 for ptt has 3 letters :O
    in = intrinsic

    ...hopefully i remember 12 in ptt so then the other one - pt is ex 7

    the final = 10 5 2 1 (you know... math... )

    two - thrombin

    1 ...f1br1nogen
     
    Last edited: 08.16.08
  14. DrBellelo

    DrBellelo

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    The actual name of the factors you can remember as follows:

    "Foolish People Try Climbing Long Slopes After Christmas Some People Have Fallen "

    I have always found it helpful.
    As far as the cascade goes if you draw it out a bunch of times you won't have any problem remembering it. :)
     
  15. UditNarayan

    UditNarayan

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    if anyone's a visual learner, try to stick to using only one image of the cascade - i chose goljan's picture in his rapid review book. I kept referring to it when I forgot a component of the picture, and by the end, I could draw it out for you. if you're visual, keeping things simple will reduce the number of images you'll need to recall. that worked for me, good luck!
     
  16. Twitch

    Twitch

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    For the common pathway, just think of dollar denominations:

    $10
    $5
    $2
    $1

    W ex PT : Warfarin; Extrinsic Pathway; only one coag factor 7

    Rest in aPTT; Heparin (12,11,9,8)

    [​IMG]:diebanana:
    [​IMG]
     
  17. scpod

    scpod Moderator Emeritus

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    These are notes from our board review that I've attached. So, it might be a little hard to understand. But, we sat there in review and drew it out a few times and everyone in my class pretty much mastered it. Hope you understand the notes.
     

    Attached Files:

  18. absolutjag9

    absolutjag9

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    thanks for the notes! :) those helped!
     
  19. kryptik

    kryptik

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    very nice notes scpod, was having similar problems as the OP and your notes helped a ton! If you have similar notes for other concepts please do share :)
     
  20. perilou

    perilou

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    I know this is a back-from-the-dead thread, but WOW! These notes are amazing.
     
  21. fatdoctor

    fatdoctor November

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    .
     
    Last edited: 06.22.10
  22. sendwich

    sendwich you rock!

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    how does heparin work? anyone have a succint answer for that? I know that it works in the intrinsic pathway (measured by PTT) and it works with AntiThrombin III to inactivated Factor 5 and 8?
     
  23. rahulb

    rahulb nutritional facelift

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    heparin binds and accelerates the action of antithrombin III -> degradation of activated clotting factors (thrombin)
     
  24. scube

    scube

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    start with extrinsic pathway. sounds like exercise, PT (physical training) which you should probably do 7 days a week. Also must be outside of you coming in like a knife so what will help things out tissue factor. Who does a lot of PT, the military so they are prepared to go to WARfarin.

    INtrensic factor well its the other one, so PTT/heprin. I just remember its the ones around 10 but not 10 in decending order. 12-11-9-8.

    both of them converge at 10 which is how i remember which one is skipped in intrensic pathway. you just have to remember this part although the money example above is sweet so in available bills. 10-5-2-1

    SOme notes. PTT/PT are elevated with use of either anticoag. if you look at the pathway it makes sense to use the ones they use as a judge for the effecacy bc it includes the right blocked factors(makes most sense for warfarin). Von WIllibrans doesn't really play a part in clotting but you can see a variation bc it increases the half life of 8, so you have a defacto 8 def. so PTT is elevated(it is one of the ones around 10 right.)

    I have a minilecture I do on this but cant do as well writing it out. I hope someone takes something away from this. If you have questions ask, if you have an example to improve my lecture post it(the money one is great). I learned this because a Prof. that I hate said it is impossible and pointless to memorize the 3Cs of medicine(krebs,coag,complement) i memorized the first two and it has served me well, even on what i suspect are his questions.
     
  25. scube

    scube

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    it breaks down the following, 9,10,11,12,and 2. which are all in the full intrinsic pathway(intrinsic plus common) which is why using PTT is a better judge of heparin function.

    warfarin, 10, 9, 2, 7. it has seven so bingo it will affect extrinsic pathway more.

    Also both drugs raise both PT, PTT. they both have at least one factor in the common pathway so it must affect both.
     
  26. DoctorMedic

    DoctorMedic

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    bump...that cheat sheet is amazing!
     
  27. drc243

    drc243 New Member

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    I took my boards today and that cheat sheet which i learned lived from dr barone got me atleast four questions right and each question took me all of 30 seconds.
     
  28. braluk

    braluk SDN Surgerynator Moderator Emeritus

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    The way I memorized it was:

    Intrinsic:
    12....11.....9.....8 (skip 10)

    Extrinsic: (I went to War (warfarin check with PT) with my "Ex", who is a "Physical Therapist" (PT)- Of course, Intrinsic are the other choices[PTT/Hep])

    7

    Both converge onto 10 (common pathway begins here). Next is 5. 10 divided by 5 is 2 (Thrombin= which also goes back and activates more 5). 2 cut in half is 1, finishing off with Fibrin (13 activates- u'll just have to memorize that).

    This is kind of silly but in Asian culture, the number 8 is lucky, like winning a Volkswagen (VW) in "A" contest. (VW stabilizes 8, and "A" being hemophilia A, with B the one right after it (9)).

    I guess making up your own little stories will be the best.
     
  29. hferdjal

    hferdjal

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    Holy ****ing ****, those notes are amazing. I'm going to e-mail it to all my friends. And yes, I know. Crypt-posting. But seriously, these notes are that good to justify it IMO.
     
  30. Captopril

    Captopril

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    is our generation seriously too ADD to freaking memorize a simple flow chart? just draw it like 10x and it's in the memory banks. no need to sing songs or hit up random obscure notes
     
  31. lovepath11

    lovepath11

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    :thumbup:Barone Rocks:)......


     
  32. crazymedstudent

    crazymedstudent

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    Factor ate starts with A, so it goes with hemophilia A. Missing Factor 9 would turn your world upside down (9 looks like an upside down B for Hemophilia B).
     
  33. sswang00

    sswang00 MS4

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    Just wanted to bump this up, because that cheat sheet is amazing!

    Other little facts that help me remember this:
    -"PET": PT = extrinsic (includes all the common factors and Factor 7)
    ="PITT": PITT = intrinsic (includes all factors except 7, 13)

    How to remember the factors involved in both: 1 x 2 x 5 = 10 (Factors 1,2,5,10)
     
  34. shwin

    shwin New Member

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    if you ever need anything ever in life let me know and i will do my best to do it for you.

    anything.


    ever.
     
  35. MoscowAbe

    MoscowAbe

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    The easiest thing for me was to use the diagram in FA in such a way that I drew a wall/line to separate the extrinsic from the intrinsic pathway. Than I placed all the relative info pertaining to each pathwy on the respective side of the wall.
     
  36. premedc

    premedc

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    One of the most awesome guides I had ever read. For as long as I can remember I could not figure out a way to organize the stupid coag cascade. Your doc made its memorization seamless. WOW!!!!

    Thanks a bundle.
     
  37. bruinhd

    bruinhd

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    THIS. Awesome advice. I have been doing this forever.
     
  38. ktn699

    ktn699

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    12? no, 11.98. i'm intrinsically a cheapskate...

    the rest should be bruteforceable.
     
  39. VeryImportant

    VeryImportant

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    I found a good video on Youtube if you search Easy Coagulation Cascade. It's just a guy talking while he draws it out.

    http://youtu.be/MPGe-guZMqM
     

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