THE BLOOD COAGULATION CHART

Extrinsic Coagulation Pathway

Intrinsic Coagulation Pathway

(tissue trauma)

vk

(Protein C+S)

Platelet Factor III

pathway inhibitor

Phospholipids (PL)

PT

Factor III; tissue thromboplastin

Calcium

Factor IV

Factor V
PT & PTT

Proaccelerin; labile factor,

Acglobulin (Ac-G)

Factor VII
PT

Serum prothrombin conversion

accelerator (SPCA); proconvertin;
stable factor

Factor VIII
PTT

Antithemophilic factor (AHF);

antithemophilic globulin (AHG)
antithemophilic factor A

Factor IX
PTT

PT?

Plasma thromboplastin
component (PTC); Christmas factor;
antithemophilic factor B

Factor X

Stuart factor; Stuart-Prower factor

PT & PTT

Plasma thromboplastin antecedent

(PTA); antithemphilic factor C

Factor XII

Hageman factor
Fibrin-stabilizing factor

Prekallikrein

Fletcher factor

High-molecular-
weight kininogen

Fitzgerald factor; HMWK

AT III

q
Prothrombin activator
q

vk

XIII
q

Thrombin

XIIIa
q

Fibrinogen
Alpha-2-antiplasmin
Plasminogen

CBC, PFA

vk Vitamin K Warfarin antagonizes

(AT III ) = Antithrombin III

(PL) = Phospholipids

Plasmin

Fibrin
q

Factor XIII

Heparin
+

Prothrombin

Factor XI
PTT

PTT

Va

Tissue Factor

Lovenox

Factor II

PT

vk

Prothrombin

(Protein C+S)

Factor I

Fibrinogen

Platelets

q
Ca2+

Synonyms

Assayed
By

DDAVP

Clotting
Factor

(PL)

factor

Xa

Ca2+ q

vk

Thrombomodulin

VIII & Von Willebrand

TFPI
tissue factor

VIIIa

Ca2+

XI +HMWK+PK

vk

AT III

XII

q
IXa

AT III

Pathway

XIa

VIIa

Ca2+

VII

Alternate
Activation

XIIa

IX

III

vk

(blood trauma or collagen contact)

Amicar

q
Fibrin Degradation
Products

t-PA

The Evaluation of a Bleeding Patient

PT normal
PTT normal

PT prolonged
PTT normal

PT normal
PTT prolonged

PT prolonged
PTT prolonged

Factor XIII
Deficiency
Antiplasmin
Dediciency

Factor VII
Deficiency

Hemophilia
Von Willebrand Disease
Factor XI Deficiency
Factor XII Deficiency
Fibrinogen Deficiency
Platelet Dysfunction
Antiphospholipid antibody
Heparin

DIC
Liver Disease
Hypofibrinogenemia
Dysfibrogenemia
Factor II Deficiency
Factor V Deficiency
Factor X Deficiency
Vitamin K Deficiency
Dysprothrombinemia
Coumadin/Warfarin
Salicylate toxicity

if ...

PT normal
PTT prolonged

if ...

PT prolonged
PTT prolonged

order:
order:

(Consider giving 2-5 mgs Vitamin K SC

or IV while awaiting results.)

Von Willebrand Factor antigen (VWF);

Von Willebrand Factor activity - Ristocetin cofactor
Factor VIII activity level
Factor IX activity level
Platelet Function Assay PFA-100
Fibrinogen level
Factor XI and XII activity levels
TT (Thrombin Time) - time required for thrombin to convert fibrinogen to
fibrin; NI is < 10 seconds;
D-Dimer - This measures a specific degradation fragment of crosslinked
fibrin NI is less than 0.50 mg/L

Abnormal:

Normal:

DIC, Dysfibrinogenemia, Afibrinogenemia,

Liver Disease, Heparin

Early DIC, Dysprothrombinemia, Liver Disease, Factor II, V

or X Deficiency, Vitamin K Deficiency; Coumadin (Warfarin)

Jeff Mann, D.O.

Wolf Creek Medical
Rev. 1/2011
VAu 1-066-974