Tissue Factor and Thromboplastin

Tissue Factor (TF) (aka Factor 3 or CD142) is a protein with a key role in coagulation. TF is present in large concentrations in subendothelial tissue of vessels (so by smooth muscle cells and fibroblasts). The endothelium itself can also express TF but only in imflammatory states, same for circulating monocytes.
TF is responsible for triggering the so called extrinsic pathway of coagulation (or TF pathway as its also known). This path is triggered when the vessel is damaged and there is exposure of the underlying TF. It acts as a receptor for Factor 7 which leads to the cleavage of Factor 10 and the activation of the common pathway of coagulation and thrombin activation.

Thromboplastin is the name of a lab reagent and is actually the combination of TF and phospholipids. TF and phospholipids together can trigger coagulation. Partial thromboplastin is just the phospholipids by themselves and can trigger the intrinsic pathway of coagulation (TF not needed to activate intrinsic pathway). So when an 'activated partial thromboplastin time' APTT test is order it is a measure of the intrinsic path of coagulation.

Picture highlighting TF (yellow box), the extrinsic pathway (red box) and common pathway of coagulation (green box). #medicine #coagulation #labs #tissuefactor #bleeding #medicalschool #medicalblog #medED #FOAMed #study

Study methods you should try

BLA BLA BLA BLA secret message hereIts time to go back to school or university (well for some of us). Its amazing how many people stick to their old study methods, Although these may work for some they can be terribly inefficient. This article has some great advice.

Junior doctors and learned helplessness; a rant.

Pete Devesons's speech opposing the motion "This house believes that medicine is the best career in the world", recorded at the #BMJLive Big Debate in London on 23/10/15. Its been a rough ride for Junior Doctors but now lets take action, keep looking up. 

End of the summer, The play that goes wrong!

So tomorrow I'll be hopping on the plane back to Italy to start and hopefully finish my final year of med school. It's been a long road and after receiving this wonderful email just a few days ago I am excited for a future in the NHS and as a Doctor.

So the hopefully if I'm not to busy on the wards and in the library I will be regularly posting on my blog some hopefully interesting and educational stuff this year. My email is isntthtpleasant@gmail.com and I'm keen for any ideas or questions about the blog, also if anyone wants a free tour around Milan, just drop me a line.

On another note, I saw this play in London over the holidays and it is incredible!
http://www.theplaythatgoeswrong.com/london
It's a simple comedy all based around a play about a murder that all goes wrong and its absolutely hilarious, I was laughing from start to finish and it suitable for all ages (I took my summer school kids there).