Coagulation Cascade/Inf. response ?

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north2southOMFS

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Overall how well do you need to know the coagulation cascade? All the different hemostasis/coagulation factors form platelets/endothelial cells/RBC....etc.... I know we need to know the coagulation disorder, that is a gimme, but this minute detailed crap...yuk


I figure you will all say "like the back of your hand"


but i was just asking because I have long forgotten it from when i learned it and it is confusing and if i can, i'd rather spend time doing somehting else.

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know which are in the extrinsic pathway (7 and TF)
know that the hemophilias involve the instrinsic pathway, and therefore the aPPT
know which factors are in the common pathway, and therefore affect both the PT and aPPT
know the steps before and after the pathway (i.e. vWF binding to collagen, defect in vWF will affect both PT and aPPT) (i.e. mechanism of clopidogrel) (i.e. mechanism of tPA)
know which are affected by vitamin K
etc....

no need to memorize the entire pathway in all the detail. there's plenty of detail to know clinically without knowing the exact order and random ass factors involved. i have never seen any question about HMWK, 11, 12, PF3, calcium, karrelin and all that other crap, but of course I'm not saying you won't. Just saying if you're cutting corners then that's what I would cut out.
 
I would focus on knowing the logic concepts in the pathway. First Aid, p350 has a good summary. ie, if you have a Protein C deficiency, would this cause thrombosis, or diathesis? It seems like the coag cascade is pretty important though, imo, because it seems like it would be easy to write test questions for.

Does anyone think that the complement cascade is important to know?
 
carrigallen said:
I would focus on knowing the logic concepts in the pathway. First Aid, p350 has a good summary. ie, if you have a Protein C deficiency, would this cause thrombosis, or diathesis? It seems like the coag cascade is pretty important though, imo, because it seems like it would be easy to write test questions for.

Does anyone think that the complement cascade is important to know?
No way. Do not waste your time with the complement cascade. But knowing the complete clotting cascade is not a bad idea. Otherwise all the little factoids tend to sort of get mixed up in the ol head. Sometimes the long way is the short way ;)
 
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