Transcription
Hey guys, it's Médicos is Perfection Alice. Continuing our discussion about bleeding and coagulation disorders, in the previous videos we have discussed hemostasis. Today we have a mnemonic and a poem about hemostasis; you're gonna enjoy it. With that being said, now let's get started. [Music]
As you know, hemostasis has many steps: vasoconstriction, temporary platelet plug, coagulation, and fibrinolysis. Primary hemostasis is the platelet plug play; goal: adhesion, platelet activation, platelet aggregation. Secondary hemostasis is the process of formation of the thrombus by forming fibrin fibers and trapping the red blood cells and stabilizing the fibrin. Fibrinolysis is lysing fibrin, breaking down the clot into fibrin degradation products and breaking down the stabilized fibrin into D-dimer and fibrinogen into fibrin degradation products.
Now let's sing together:
It started with a scratch, but for the process to match,
The cells must first attach, then the cells will hatch.
ADP and thromboxane A2 cool, so they can send this patch,
So that other platelets may catch.
Fibrinogen comes upon it, it's never a mismatch,
Strengthening into fibrin so that platelets may clash,
Strengthening into fiber, and this is the secondary hemostasis, cool.
To destroy this mesh work, you must pay cash.
tPA turns plasminogen into plasmin in a flash,
Fibrin and fibrinogen are thrown in the trash.
On five and eight, protein C and S will latch,
Everything's back to normal, blood's free to splash,
Restoring the normal blood flow.
Now let's go to the mnemonic. Now the mnemonic: the Hindu gods—I got this from Dr. Conrad Fisher. J Brahma is the Lord of creation. J Vishnu is the Lord of preservation. J Shiva is the Lord of destruction.
Now let's apply this to hemostasis, because hemostasis has a lord of creation, a lord of preservation, and a lord of destruction. So, the Lord of creation is the fibrin; fibrin creates the clot because it traps the red blood cell within the fibers, and this is called secondary hemostasis. The Lord of preservation, who preserved the creation: factor 13, by stabilizing fibrin into stabilized fibrin. Then the Lord of destruction: tPA, that converts plasminogen into plasmin, and plasmin destroys the clot and restores the function. Fibrin creates the clot, factor 13 stabilizes the clot, tPA destroys the clot: creation, preservation, destruction.
I'm not criticizing Hinduism; it's just a way to memorize hemostasis, and my purpose in this channel is to make it easier for you to learn. If you have noticed, that's my only purpose.
So, did you like the video? Please subscribe and hit the bell. Follow me on Facebook and Instagram. Get my notes and my 50 haematology cases by going to patreon.com/médicos, and I'll send you my bloody Dropbox links. Thank you for watching. This is Médicos is Perfection, elsewhere medicine makes perfect sense. Please don't forget to be safe, stay happy, and study hard.