 box kapag okay na. Thank you. Or unmute ka na lang para hindi na magflash dun sa recording. Okay, see ya. Thank you so much, Irene. So again, good morning to everybody. So with regards to the chapter, okay. Anandun, this can be found on your normal hemostasis. I don't have my iPad here with me. Pero tingnan natin baka lumang i-re-labas ko din dito. In the coming slides, what chapter are we waiting for? Chapter 37. Can you please confirm what is chapter 37 in your Rolex? Those who are opening your book na para lang sure ako natama yung chapter that we are in. Qualitative disorders. Okay, so one moment. Okay, for those of you who are following, okay, chapter 35. Okay, chapter 35 putayo for the components of your secondary hemostasis, specifically under the coagulation system. So that will be page 631. Right column. Okay, 631 of the sixth edition of your Rodax Hematology 2020. Okay, so I hope we're all on the same page na 631. Chapter 35. Ayun, chapter 35. Okay, so I hope everybody is on the same page already. Okay, so let's get started with our discussion for today. So during our discussion of the primary hemostasis, we started off with discussing the components of your primary hemostasis which are your vascular entema and then your platelet. So we talk about your blood vessels, your endothelium, both the pro-coagulant and anti-coagulant property of your blood vessels. And at the same time, we also did talk about the different platelet function that is important when it comes to your primary hemostasis. Now before we dig into the mechanisms of your secondary hemostasis, let us first talk about the component of your secondary hemostasis which are your coagulation factors. Okay, these are your coagulation factors. So coagulation factors, what is the other name for your coagulation factors? They can also go by the name of coagulation proteins because they are proteins. They are also called your pro-coagulant. Why pro-coagulant? Because they favor the formation of your clot inside the body. And these coagulation factors are mainly produced by our liver. That's why a quick background when it comes to your clinical chemistry 1 and 2, you guys are discussing proteins and you are discussing everything about your liver function. And one of the way on how we can assess the synthetic function of your liver is by measuring your proteins, like your total protein and your albumin. Included in that test, you can also make use of measuring your coagulation factor to assess the liver, the synthetic function of your liver. Why? Why? Because your coagulation factors, your coagulation proteins are most of them except for one. Almost all of your coagulation factors, majority of your coagulation factors are produced by the liver. So later on, I'll tell you what is the exemption when it comes to the list of coagulation factor, which one is not produced by the liver. So those are your coagulation factors. And remember, when it comes to your coagulation factors, there are two forms of coagulation factors that you can see within your body. Those are your zymogens and your cofactor. So I hope by this time you are very much familiar when it comes to zymogen, when it comes to cofactor. So when we say zymogen, these are your enzyme precursor. Enzyme precursor meaning to say they are in their inactive form. If you guys could remember, I always mention that coagulation should happen at the right place at the right time for the right purpose. But these proteins are inside our body. So how do we prevent it from or how is our body maintaining hemostasis without how does our body maintain hemostasis in us that is by maintaining the inactive form of your coagulation factors. So zymogen or your enzyme precursor, these are the inactive form of your cofact coagulation factor. So if you guys could see, there are a list of coagulation factors on your book and most of them are in their inactive form. Aside from that, we also have your cofactors. When it comes to your cofactors, these are, when it comes to your cofactors, when it comes to your activators, di ba may mga activators tayo when it comes to enzymes, our activators can either be a coenzyme or a cofactor. So your coenzyme, what is the difference between a coenzyme and a cofactor? Anyone? Sige, what is the difference between a cofactor and a coenzyme? So nga, so remember ha, a coenzyme is an organic activator when it comes, an organic activator when it comes to your cofactors naman, when it comes to your cofactors, these are inorganic, okay, such as your calcium, your mga electrolytes that you will be discussing as you go along in clinical hematology. So can I see a reason for clear with the cofactors? So your cofactors are needed for your enzymes, for your coagulation factor to either be activated or for them to function in the system. So remember there is an active site in an allosteric site. So your cofactors will, your cofactors will help your zymogens be activated or will help in their function, in the coagulation, okay? So when it comes to function, your coagulation factors naman, some of them, okay, some of them can be considered, okay, some of them can be considered as serine protease. So these are now the active form of your zymogens. So they are the one now that will leave protein that will activate a particular coagulation factor, so on and so forth. So it's like a domino effect, okay, it's like a domino effect. There is an enzyme, okay, or there is a trigger that will activate your coagulation factor and that coagulation factor will activate the next coagulation factor and then the next and then the next until they are able to activate your thrombin and once your thrombin is activated, your fibrinogen can be converted now to your fibrin and it can form your fibrin clot at the end of your coagulation. That's why later on we will be discussing your coagulation cascade, okay? We will be discussing your coagulation cascade. The reason why I'm telling you, we might either finish the discussion today or if not, we will be focusing on the coagulation cascade next meeting, okay? We will be focusing on the coagulation cascade next meeting. What's important for us to understand today are the properties, the pathway, and also the different coagulation factor so that when we move into the different tests to evaluate and assess your secondary hemostasis, you guys will be able to understand it better, okay? So, aside from your serine proteases, there are also coagulation factors just like what I mentioned a while back that are acting as cofactors so they help accelerate the enzymatic reaction in your coagulation process. So, if you can see, no? Once that you have your wound, why is it that my body can immediately stop the bleeding because that is how fast our primary and secondary hemostasis is reacting so that we'll be able to prevent further bleeding or hemorrhage. And finally, we also have your transglutaminase. So, transglutaminase that are also affecting the coagulation processes, okay? So, are there any questions so far? If non, can I see a raise of hand please? If there are any questions, okay? Thank you so much. So, let's let's talk about your coagulation, coagulation factors or your coagulation protein specifically when it comes to their nomenclature. So, your pro-coagulance were given their name in 1958 by the International Committee for the standardization of the nomenclature of the blood clotting factors, okay? So, aside from clotting factor, aside from coagulation factors, pro-coagulant, they can also go by the name blood clotting factors. So, all of them are one and the same, okay? So, please do remember, ladies and gentlemen, I will be very critical when it comes to this especially during your exam. All of your coagulation factors should be written in Roman numeral. So, take for example, you have your factor one. When you say factor one, it should be in Roman numeral and not in alphanumeric, okay? So, Roman numeral. So, if you answer otherwise, that will be incorrect, okay? So, we have different clotting factors. And by the way, when you answer in your quizzes, in your exam, no need to complete the clotting factor one. No need. Just simply factor one, factor two, factor three, factor four, so one and so for five and then seven. So, all of them can be mentioned such as a short end nalang factor one, factor two. No need na for coagulation factor one. No need na, okay? Am I clear? Can I see a raise of hand if we're clear on the writing of your coagulation factors? Okay? And of course, we were mentioning a while back that most of your clotting factors or your coagulation factors are in their inactive form or what we know as your zymogen, okay? They're in their inactive form. Now, how do we denote, okay? How do we denote an activated form of your your clotting factor? So, a subscript a, okay? A subscript a, small letter a appears behind the numeral to denote that the procoagulation has been activated. So, when we take for example, there's a question, okay? There's a question. What is the what would be the serine protease that will activate your factor one? Factor one is your fibrinogen, okay? And then the choices is as follow. Letter a, factor two, letter b, activated factor two, things like that, okay? So, you will be able to identify which would be the correct answer and always choose the activated one. Of course, depending on the question, but again, please take note that once that your procoagulates are activated, we need to put, okay, your subscript a to denote that it is already activated, okay? Now, when it comes to the zymogen and your serine proteases, I want you to look at this. So, you have your zymogen here, meaning to say these are your inactive or your resting enzymes. So, you have your factor two, factor seven, nine, ten, eleven, twelve, and pre-calacrine, okay? Your pre-calacrine. Now, once activated, this zymogens become now active enzyme as serine proteases. So, these are now your activated factor two, activated factor seven, activated factor nine. So, even though that the subscript is behind the number, we do not read it as factor a activated. No, we mentioned it, activated factor a, okay? Are pre-clear people? So, nobody would call it na, factor a activated, walang ganern, okay? So, it is activated factor a, factor two, activated factor seven, activated factor nine, activated factor ten, factor eleven, factor twelve, and also your calacrine. One, activated your pre-calacrine becomes now calacrine. Can I see a raise of hand if we are clear? Hello. Okay, thank you so much. And we also did mention about co-factors, correct? So, these are the different co-factors of your active proteases. So, your activated factor seven needs your TF. Ano yung TF? Talent fee? No. That is your tissue factor that is your clotting factor number three, or factor three. So, later we'll talk about that, okay? Your tissue factor, your activated factor ten, factor five yung kailangan niya, your activated factor nine, it needs your factor eight, okay? Your activated factor twelve and your calacrine needs your M-H-W-K, okay? That is your high molecular weight kininogen. Again, high molecular weight kininogen. If again, you need to get the proper spelling, go to chapter 35, okay, and look for the spelling of your high molecular weight kininogen. And in the exam, no abbreviation, please. The co-factor for your thrombine, we have your thrombomodulin. Your protein C this one, the last two rows that you see here are for your fibrenolysis. So, you have your protein S, your protein Z for your protein C and your tissue factor tissue factor pathway inhibitor and your Z dependent protease inhibitor. Again, these two are for fibrenolysis na, okay? Fibrenolysis, okay? So, let's get started and get to know some of your coagulation factors. So, there are a lot to be on it. And at earliest now, you need to memorize all of them, okay? Sir, what do we need to memorize when it comes to them? Of course, the factor, the preferred name, other names if there's any. When it comes to the pathway later on, we'll be talking about your coagulation factor based on their characteristic, their properties, and then based on their pathway. I'll teach you away on how you can memorize it better than this table, okay? And then for the other information, there are some information here that are important when it comes to your when it comes to your coagulation factor. So, please take note of those as we go along. So, there are four slides all about your coagulation factor. So, let's get started with the first one and that is your factor one. Factor one is the ultimate factor one is the ultimate substrate of your thrombine, okay? Your factor one also known as your fibrenogen is a protein produced by the liver, okay? So, it is the combination with the most concentration in your plasma. So, most concentrated clotting factor in our body. Once activated, I want you to take note guys that this does not become an active enzyme, okay? It is not activated as an enzyme but rather they are activated to become fibring monomer. Fibring monomer that will stabilize, okay? Not stabilize, okay? Fibring monomer that will form a fibring network or a fibring mesh that will help solidify or strengthen your clot during bleeding, okay? Remember that it is synthesized by the liver and it is the ultimate substrate of your thrombine, okay? Your fibrenogen if you guys could remember, we mentioned that your glycocallix absorb albumin, aside from albumin it also absorbs your fibrenogen and store it in your alpha granules, okay? We are storing it in your alpha granules. Now, your fibrenogen can be assessed, okay? The activity of your fibrenogen can be assessed by the two test your PT and your PTT, okay? Later, I explain ko sa inyo itong part nito. I'll be skipping this part because I will focus on that when we go to the evaluation after your prelim exams, okay? So, again always remember that your fibrenogen is an APR. What to mean by APR? It is an acute phase reactant and it is increased in PISO. What is PISO? Pregnancy, inflammation, stress, and presence or intake of oral contraceptives. Again, your fibrenogen is an acute phase reactant. Acute phase reactant meaning to say it increases during infection. That's why it was also mentioned during our discussion in immunology. Remember again that your acute phase reactant in specifically your fibrenogen increases during when? It increases during your it increases during your PISO. Your pregnancy, inflammation, stress, and intake of oral contraceptives. Can I see a reason if everybody was able to get that? Hello? Clear? Okay. Thank you so much. Now, aside from your fibrenogen, we'll just gonna talk about them. And then I'll just input the important details about them. So, your protrombin your protrombin is also known as your pre-trombin. It is your factor two. Once activated, it is known to be your trombin. Trombin na lang. It is known to be your trombin. Sir, take for example you as of the specific coagulation factor. How should we answer? So, let us settle the score now. Sir, will you allow us take for example sir, I don't remember the preferred name but I know that it is factor two. Will you be accepting factor two? Two considerations, okay? If take for example the answer is trombin and you simply answered factor two, that is incorrect. Why? Because factor two is inactive. You should answer factor two A to the activated factor two which is now your trombin. Nagigets tayo. So, no abbreviation. So, always remember that when it comes to the name if you write na konwari factor two, do not write na on the side yung trombin. Because take for example you answered factor two and the preferred name that you put was trombin. I will consider that wrong. So, many of you because you put a lot of answer hoping that I will simply consider one. No, it's not the case. If you put a lot of answer it just means that you really don't know the answer so you just put everything you know. So, during our exam if you put if the question requires your trombin, you can answer either trombin or activated factor two. Only the two or only those two answer. And then for if you guys are answering an azimogen or in inactive form, you can simply answer factor two again roman yung mural and then the name. Take for example pro trombin or pre trombin. Avoid the open and close parenthesis na factor two pro trombin avoid those instances okay. Avoid those instances number one for ease of checking on my end and at the end of the day gets naman na natin na factor two is pro trombin. So, during your exam you can either answer any of those two. Just make sure that you answer the correct form or the correct way when asked in the question. Depending on the question that is being asked. So, are we clear people? Can I see a raise of hand if we're clear? Malinao ba tayo? Para ano during your exam nobody wala sir how do we need how are we going to answer the quiz? Genyan genyan okay. So again ha let's go back for your factor two also na sure pro trombin or your pre trombin. The activated form of your factor two is your trombin. It is at function as a serine protease okay. It is part of the common pathway and it is the key protease of your coagulation pathway. Why do we mention that it is the key coagulation factor or the key protease because without pro trombin, without trombin, your fibrenogen cannot be activated. Even if all of the other coagulation factors are present and are functioning well if you have deficiency or if you lack or if you do not have a functioning pro trombin that can be activated to your trombin, your fibrenogen cannot be converted to fibren okay. So that will be a big it will be a big problem inside your body. Now aside from that remember that your trombin is actually it has a feedback mechanism okay. Once that your trombin, your pro trombin is activated. Your trombin now okay. Your trombin not only activate your fibrenogen it also activates your factor 5, 8, 11 11 and your 13. Sir why okay. Why does it need to activate 5, 8, 11 and 13 okay. So once that your trombin is activated it also help the other pathway activate more coagulation factor and specifically your pro your trombin activates your 5, 8, 11 and your 13 okay. Again ha it's not only your fibrenogen that is activated by your trombin. It also activates your factor 5, 8, 11 and 13 and it also activates your platelet. If you guys can remember when we were talking about your platelet loomy agregometry last meeting we mentioned that your trombin is also an aggregating factor or an aggregating agent for your platelet because they promote your full aggregation and full platelet secretion. Can I see Arisa Vanny for clear? Are we clear with trombin? Medyo delayed ba ako or delayed lang yung response niyo? Hello? Are we clear? Can I see Arisa Vanny for clear? Okay. Am I delayed? Delayed ba ako? Can you type on the chat box? Delayed ba yung ano ko? Delayed? Hindi. No. Okay. So baka nag-review lang guys na next class. Okay. So next we have your tissue factor. Kababayan. Okay. Your tissue factor also known as your factor 3 doesn't have an active form. Okay. Why? Because plotting factor 3 is active already. Your tissue factor or also known as your tissue tromboblastin is a cofactor. Kanina na mention natin siya, di ba? It is a cofactor of what? It is a cofactor of factor 7. Okay. Activated factor 7. Now I also did mention a while back that there is one coagulation factor not produced by our liver. And that is your tissue factor or your tissue tromboblastin. Your tissue tromboblastin is not produced by the liver because it is produced by your tissue. Second, it is not found in your plasma on a normal basis. Why? Because it is found in your tissue. That's why, remember guys, when we were discussing about papilare puncture, we wipe off the first drop of blood to avoid tissue fluid contamination. And in the tissue fluid, are your tissue factor or your tissue tromboblastin as well. So they are usually found in most of our tissues organ and also our blood vessel. So what is the nice thing to know about your tissue factor? Not produced by the liver, not seen in your plasma and it is a cofactor for your factor 7. And it is a main player of the extrinsic pathway. Again, do not get bothered when it comes to the pathway. I'll tell you how you can memorize it easier later. Promise. Mga 5 minutes memorize mo na yun. And then we also have your factor 4. Also known as your ionic calcium or simply your calcium. It's function as a mineral that is important in all of your coagulation pathway. We have three pathways kasi, your common, your extrinsic and your intrinsic pathway. Now your calcium, your ionic calcium is important in each of the pathway. That's why remember when you are using your EDTA, your sodium citrate, your potassium oxide, they all bind to your calcium. They bind to calcium so that they can inhibit the coagulation whatever pathway that may be. Can I see a raise of hand for clear? Hello? Okay, good. Now next moving forward, we also have your factor 5. Your factor 5 is your pro accelerin. So your other name is your labile factor or your accelerator globulin. Your pro accelerin is a cofactor. That's why it will not be activated. It is part of the common pathway. Actually it will be activated pala. It will be activated and again it is part of your common pathway. So again it is released by your alpha cells and there is a disease where deficiency of your pro accelerin would cause your para hemophilia also known as your orange disease. Again, deficiency on your factor 5 will lead to para hemophilia also known as your orange disease. Sir, it's para hemophilia different from hemophilia A, hemophilia B. Yes, there are different types of hemophilia. For pro accelerin kapag konte or may deficiency ka sa pro accelerin. If you have deficiency in factor 5, that will lead to the presence of para hemophilia also known as your orange disease. Okay? So that is for your pro accelerin. From your common pathway, release from your alpha granules leading now a deficiency of your factor 5 will lead to para hemophilia or orange disease. Next, we also have your pro converting factor 7. Sir, you missed one number. That was intentional. Let me just make a quick cheetah. When it come to your factor 6, it was known there was a factor 6 before but later on, they discovered that it is just an activated factor 5. That's why they remove your factor 6. They realized it's just simply your pro accelerin and activated pro accelerin. So, they removed factor 6 and they did not replace it anymore. Dapat dano ang deba. Nung inalist na nila si 6, hindi na nila pinalitat. Okay? So that is for your factor 6. Okay? Let's go to factor 7. Your pro converting. Your pro converting is also not your stable factor. Pro accelerin, label factor, pro converting, stable factor. Pro converting is also known as your room pro thrombin conversion accelerator or your SPCA. Parang gusto ko ilabas sa Pistoloyan. Okay? Mahaba. Room pro thrombin conversion accelerator or your SPCA. Also known as your auto pro thrombin 1. Okay? So, they accelerate the what? They accelerate the conversion of your factor 2 or your pro thrombin. You will discover this later when you go to your extrinsic pathway. Okay? You go to extrinsic pathway. So, your pro converting is considered to be the coagulation factor that has the shortest half life. It has the shortest half life and it is the first factor to decrease during warfare in therapy. Okay? Nakalagay dito sa other information are almost all of them are important. Nakalagay dito, I memorize this table palang men buhay ng buhay na kayo during the exams. Okay? So, it has the shortest half life. It is the first factor to decrease during warfare in therapy. Sir, when do we use warfare in therapy? Warfaring therapy are used when patient has thrombosis tendency. Remember, we discussed your thrombotic disorders, conceptives, they increases the formation of clot inside the body. So, for patients with such condition, they can take in kuma din or kuma rin and also your warfare rin. So, warfare rin are anticoagulants, oral anticoagulants that patients take in to prevent bystander clotting. Okay? When you say bystander, yung tipong wala namang nangyayari. And then trip lang mag clot ng dogumo. Again, that's dangerous because that can lead to occlusion of your blood vessels. Okay? So, that is pro-converting. Can I share this event? Kung malinaw pa tayo, are we still clear? Clear? Okay, good. Next, we go to your antihemophilic factor, ang BESHU-UP ng one-wheeled brand factor. Okay? Why do I say BESHU-UP ng one-wheeled brand factor? Because you guys would always see your antihemophilic factor bound to your one-wheeled brand factor. Sulat mo na, girl. Okay? So, antihemophilic factor also known as your antihemophilic factor A, your antihemophilic factor globulin in your platelet factor one. Okay? It is a co-factor found in your intrinsic pathway. Don't worry about that. It is produced mainly by your liver, your hepatocytes. There are free antihemophilic factor. There are free factor eight. But the problem is, okay, they are unstable. Kaya kailangan nilalagit yung kanilang partner, which is your one-wheeled brand factor. Okay? That's why in most of the references, you would see factor one-wheeled brand factor column factor eight. Because they are always bound to each other. Okay? Sana all, na wherever you go, okay, wherever you go, this is parang true love. But did you know, one-wheeled brand factor can function on its own. It's really just factor eight that is so dependent of one-wheeled brand factor. But anyway, this is another story for another time. Remember that, again, your antihemophilic factor when there is a deficiency in your antihemophilic factor that can lead to your hemophilia. Okay? Hemophilia A. This is the socket of the royal blood, the royal, if you guys remember, this is the common example for the low of heredity by Gregor Mendel. Deba? So again, hemophilia A for antihemophilic factor. And remember, sir, what is the blood component cryoprecipitate? This is cryoprecipitate. Hindi say cryo. You remove the Y before, you remove the Y after C. This is cryoprecipitate. Okay? Ano to iyak? Hindi it. Okay? Yung precipitate ng iyak ko, sir. No. Cryoprecipitate is a blood component reached in factor 8. Again, reached in factor 8. You'll discuss this more in your blood bank with push your blood bank. Ay, huwag napalata yung magchikahan ang gano. Because it's recorded. Okay? And this is for everyone. Okay? So whether sir Vico or sir Nathan, you will be discussing cryoprecipitate in the coming days. Ay, next we also have your plasma trombo-plastin component. Your plasma trombo-plastin component is your factor 9. This is my favorite factor 9. Factor 9, this is Christmas factor. Ayad. Christmas factor. This is also known as platelet cofactor. Platelet cofactor 2 and your antihemophilic factor B. It is also included in your intrinsic pathway and deficiency of this coagulation factor will lead to hemophilia B. Okay? So we have 3 hemophilia. Para hemophilia that is factor 5. Factor 8 hemophilia A. Factor 9 hemophilia B. Okay? Also remember the other name, antihemophilic factor globally and your Christmas factor for your factor 8 and your factor 9, respectively. Now can I see a reason of panic? We're clear on this particular table and if we can move on to the next slide. Clear tayo. Okay? So much. I guess I will not be able to finish because I only have 15 minutes, 18 minutes but I think I'll be able to at least discuss according to their properties. Okay? According to their properties and then my promise about how you guys could memorize the pathway according to number easily. Okay? Easily nalaga. Habang mga may pagkatapos-pagkatapos ng class memorize mo nang siya. Okay? So we also have your factor 10. Your factor 10 is your Stuart Prower factor. It is really prower, not power. Okay? Stuart Prower factor also known as Stuart factor, Prower factor or your Auto Protrombin 3. Okay? Auto Protrombin 3. A while back we mentioned about your Auto Protrombin 1. Okay? Your Auto Protrombin 1 that is your pro converting. Okay? For your Auto Protrombin 3 that is your Prower factor. Okay? It is a Serious Protease and it is filed in your common pathway. Okay? Next we also have your factor 11. This is your Plasma Trombo Plastin. Okay? Anticident. Okay? Remember that. Plasma Trombo Plastin Anticident as opposed to factor 9. O di ba magka? Maligaw lang yung one mo girl boy di ba? Lutang ka na. Plasma Trombo Plastin component that is 9. Plasma Trombo Plastin Anticident that is 11. Okay? And this is known as to be your antihemophilic factor C. Antihemophilic factor C. Ah, so ibig sabihin sir, eto naman yung para sa hemophilia C. Hindi hemophilia C ang tawag that is your Rosenthal Syndrome. So deficiency in your factor 11 that would lead to Rosenthal Syndrome. So it is activated by your contact factor complex at your Trombin. So sir, what is my contact factor complex? Your contact factor complex are your pre-calicrine, your high molecular weight kininogen and your factor 12. Ayan. So later explain ko naman yung taplong yun. Again ha, for those of you nagnunotes, what is the contact factor complex? Contact factor complex is 12 high molecular weight kininogen and then your pre-calicrine. So yung mga walang number number sila halos yung mga contact factor plus number 12. Nagiget yung HMWK pre-K, HMWK high molecular weight kininogen pre-K, your pre-calicrine and then your 12, all of them are together that is your contact factor complex. And then your Trombin also activates your factor 11. Now we also have your factor 12 also known as your Hage man factor. Hage man factor is your glass factor or your contact factor. They are they are included in your intrinsic pathway and then deficiency can lead to negative bleeding. Deficiency of this remember this guys know when it comes to your contact factors your pre-K, HMWK or your Hage man factor or your factor 12. Kahit may deficiency sila normal pa rin yung plotting sa ating katawan. Mamaya, pagdating natin doon sa mga susunod natin lecture I'll explain this further to you. So remember nagdag ko nalang since nasulat nyo naman your contact factor complex is responsible in your in vitro coagulation they do not participate most of the time when it comes to in vivo coagulation but when it comes to in vitro coagulation they are part of the coagulation cascade meaning to say inside our body their deficiency doesn't really make any difference at all. When it comes to phenotype mola naman nakikitang bleeding whatsoever nasinga the other coagulation factor can compensate for their deficiency unlike the other diseases like your parahemophilia hemophilia A, hemophilia B, rosental syndrome all of those deficiency can lead to excessive bleeding so that is factor 12. And finally we have your factor 13. Your factor 13 is also not your fibrin stabilizing factor remember that it is the last coagulation factor that will stabilize your fibrin network once it is already in place. Your fibrin stabilizing factor comes in many names. It can be known as your low cheloran factor your fibrinase, fibrinoligase your plasma transglutaminase because it is a transglutaminase part of the common pathway and it is function as to stabilize your fibrin clot if you have deficiency ito lang, if you have deficiency in your factor 13 that will result to a poor wound healing because every now and then remember this guys para kang nang tayo ng castilyong buhangin. Castilyong buhangin. You can put up a sand castle but every time it is hit by the wave it will crash na wawala siya. Para ganoong din yung platelet or yung clot natin and yung fibrin network natin every time that your body is able to form that it will still disintegrate and destabilize because we do not have your factor 13 so that's how important it is. During your test PT-PTT it would have a normal coagulation result even if you have deficiency in your factor 13. That's why the test that we use in identifying deficiency in your factor 13 is your 5 molar urea solubility test. Do not worry, I'll again further discuss this when we go to the different test to assess your secondary hemostasis but so far are there any questions or clarifications on can I see a raise of hand if we're clear on this table? Clear? Okay, now let us move on to the last part of the table before I discuss to you the coagulation factor based on properties. Based on property. So we also have your pre-calacrine. So remember your pre-calacrine also known as your calacrine once activated is also known as your Fletcher factor. It is a part of the contact factor complex. You also have your high molecular weight kinina gen, also known as your Fritzgerald factor, Williams factor Flaugia factor contact activation factor di ba dami name? So that is your contact factor complex together with your factor 12. You also have your platid factor 3 which is a phospholipid phosphatidil serine your PF3, if you guys can remember this, it is an molecule. Remember, do you guys remember this? We talk about this during the ultrastructure of your platelet that in your phosphatidil serine that is where all of your coagulation factor assemble. And it is released by your platelet. And finally we also have your von Willembrand factor which is your restositin factor. Restositin co-factor so it functions for platelet adhesion and it is your factor 8 carrier. Why? Because your factor 8 alone free factor 8 is unstable. It needs your von Willembrand factor. So your von Willembrand factor is produced by barious cells in the body such as your endothelial cells your mega-carouside and it can also be stored in your alpha granules specifically in your weiball pallid bodies. Makikitanda tay din ha? Where can you find your von Willembrand factor in your weiball pallid pallid bodies? So your von Willembrand factor can be degraded by your Adam TS13 and remember your von Willembrand factor among blood group O has lower levels of von Willembrand factor compared to other blood groups. And your von Willembrand factor aside from that is also an APR. What is an APR again? Acute phase reacted but this time it's not but rather for pits. What is for pits? Pregnancy Infection not inflammation ha? Infection trauma and stress. Again, pregnancy infection, trauma and stress. Let me just differentiate to you guys. Inflammation is not necessarily infection. Because inflammation can be because of your immune response your infection is because micro-organism entering our body. Now let me tell you sir, bakit na one increase during infection? Remember that one of the things that is produced during phagocytosis are adhesion molecules. Adhesion molecules such as your P-selectin and also your von Willembrand factor. Okay? Your von Willembrand factor. P-so means pregnancy, inflammation, stress and oral contraceptives. Pits naman, P-I-T-S pregnancy, infection trauma and stress. Stress pa rin. Clear tayo, can I say a reason if my lean now, people's we'll have seven minutes. Clear tayo, so I guess I will not be able to finish it. Sa diyang itinadhan na hindi ako makakatapos ng anong ayon. So for you guys para hindi tayo cut short, I don't want to cut short the lecture para malina tayo. We'll meet on Thursday. So yung promise ko na lang sa inyo. Sir, how will we be able to memorize? Okay, wait lang. How are we going to memorize? Iyang ganoon. Okay, how are we going to memorize the coagulation factors? So remember you have three coagulation pathway. Okay, what are those three pathway? You have your intrinsic. Okay. You have your intrinsic. Okay, you have your extrinsic. And then you have your common pathway. Okay. Intrinsic, extrinsic, and your common pathway. Papakita ko sa inyo muna dito. Based on your... Asan ba yung table natin? Ayan. Can you guys see this? Okay. So remember when it comes to your hello, can you see the can you see the what do you call this? Can you see the slide? Can you guys raise your hand? Kung kita. Okay, in your extrinsic pathway that is your color green. Okay. In your extrinsic pathway, there are only three. There are only two coagulation factors involved. Okay. You have seven and three. Magdali lang tandaan, niba? Seven and three. Seven and then three. For your intrinsic pathway, this comes now. This one is a lot more rather complicated. It is more complicated. Mas madami sila. So the factor involved in your intrinsic pathway are the following. Okay. You have your factor. You have your contact factors. Your pre-collect green, your high molecular weight kinina gen, and then your factor 12. Okay. Aside from your factor 12, you also have your factor nine. Okay. Factor nine and then factor eight. Okay. Together with your one-wheeled brand factor. Nine and eight. Okay. Nine, eight lang sa intrinsic. Nine, eight, one-wheeled brand factor together with your contact complex. Tawagan na lang natin silang contact complex para mas ma-easier for the tongue. Now for the common pathway, eto naman yung sa common pathway. One, two, five, ten. Okay. One, two, five, ten. Okay. One, two, five, and ten. So let's try to summarize everything para alam ninyo. What are the common? What are the other? Eto lang pain coagulation factors natin, ha? So how are we going to memorize them simple? Okay. How are we going to memorize them? So when it comes to your intrinsic pathway, you only have two. Okay. Actually hindi naman dalawa lang yan. So you have your eight. Okay. Your eight, nine, again have one-wheeled brand factor. One-wheeled brand factor katama na ninyi eight. One-wheeled brand factor eight, nine, twelve, high molecular weight kininong jen, hm, wk, and your pre-k. I call it your pre-k. Okay? Your pre-k. So that is for your intrinsic pathway. Okay? Eight, nine, twelve, kong gusto mong i-memorize, eight, nine, one-wheeled brand eight, nine, contact group. Okay? Ano yung contact group, high molecular weight kininong jen, pre-calibrate, and your twelve. For the extrinsic pathway, mabilis lang toh kasi dalawa lang yan. Your tissue factor. Okay? Tissue factor and factor seven. Okay? Factor seven. Okay? And then for your common pathway, mabilis lang, one, your fibrino jen, two, five, two times five, ten. Okay? So what are included in your common pathway? One, two, five, ten. In your extrinsic tissue factor seven, in your intrinsic one-wheeled brand eight, nine, twelve, high molecular weight kininong jen, and your pre-calibrate. Are we clear people? Can I see a raise of hand if you guys can memorize this by the end of the class? Later on, when it comes to properties, there are different properties than when it comes to your, when it comes to your, there are different properties of your, what do you call this? There are different properties of your coagulation factor. And there's also a way on how we can memorize it easier. What are the protrombin group? Okay? Example ko sa inyo para makita na ninyo no. What are the protrombin group? This is your two seven nine ten. Okay? How do I memorize it? Two seven, two seven nine ten. Two plus seven is nine. Anong kasanod ni nine ten? Two seven nine ten. So that's how I memorize my protrombin group. What about the other group? For my fibrino jen group that is five eight thirteen. Pinyan natin kung tama ako. Okay ma? One five eight thirteen. Kasi one five five plus eight is thirteen. Ganon na. One five eight thirteen. Yon yung mga ninyo memorize. Okay? But for now ayun nga. Again, what are the common, what are the common factor, common coagulation factors of the common pathway? We have your what? We have your one, two, five ten factors of your extrinsic three and tissue factor. For your intrinsic, we have your eight with one with a brand factor to make it stable. Factor nine ten. Factor nine and then the contact group. Okay? And then the contact group which is your factor twelve high molecular weight kinino jen and your what? Your pre-calic read. So with that, thank you so much for coming. So we will be meeting next Thursday to finish up with your coagulation factor. So if there's any question or clarification please send in the message now. So ayun, please stop the recording and