Fibrinogen is the central substrate for clot formation. It is a soluble plasma protein produced by the liver. During the final step of the coagulation cascade, the enzyme thrombin (Factor IIa) cleaves small peptides from fibrinogen molecules. This converts soluble fibrinogen into insoluble fibrin monomers. These monomers then spontaneously polymerize (link together) to form long strands of fibrin. These strands create a mesh that traps platelets and blood cells, forming the initial, soft clot. Later, Factor XIII (fibrin-stabilizing factor) cross-links these strands to make the clot tough and stable. Therefore, fibrinogen's sole purpose is to be the building material for the fibrin clot. Low levels (hypofibrinogenemia) or dysfunctional fibrinogen (dysfibrinogenemia) can lead to bleeding, while high levels are associated with increased thrombotic risk.

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Zambia

• Joseph Soko – 101 pts

• Visual Pathway Lesions
• Positive and Negative Symptoms
• Hallucinations and Delusions
• Antipsychotic Medications
• Emergency: Environmental Emergencies