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Role of Vitamin K in coagulation

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Role of Vitamin K in coagulation

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Role of Vitamin K in coagulation

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A 23-year-old woman, gravida 1 para 0, comes to the obstetrician to discuss the possibility of home birth. The patient insists on giving birth to her child at home as an approach to an “all-natural delivery.” The physician reviews her case; he states that while home delivery is possible for the patient to do, he recommends that the baby is brought in following birth to be given vitamin K to prevent fatal bleeding. Which of the following explains the need of vitamin K administration in neonates?  

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Vitamin K helps to regulate the process of blood coagulation by assisting in the conversion of certain coagulation factors into their mature forms. Without vitamin K, our bodies would be unable to control clot formation. Imagine being unable to form blood clots effectively--that would mean that we would lose all of our blood volume from something as simple as a pinprick! To prevent this extreme scenario - vitamin K must be ingested, metabolized, and utilized to create mature coagulation factors.

Now, to understand the regulation of clot formation, we first need to talk briefly about hemostasis, in which hemo refers to the blood, and stasis means to halt or stop. Hemostasis is divided into two phases: primary and secondary hemostasis. Primary hemostasis involves the formation of a platelet plug around the site of an injured blood vessel, and secondary hemostasis reinforces the platelet plug with the creation of a protein mesh called fibrin. To get to fibrin, a set of coagulation factors, each of which are enzymes, need to be activated. These enzymes are activated via a process called proteolysis- which is where a portion of the protein is clipped off. In total, there are twelve coagulation factors numbered factors I-XIII, there’s no factor VI. Most of these factors are produced by liver cells, and it turns out that producing coagulation factors II, VII, IX, and X requires an enzyme that uses vitamin K.

Vitamin K is found in abundance in green leafy foods—things like spinach, kale, and chard which all have high concentrations of vitamin K. It’s a fat-soluble vitamin, along with vitamins A, D, and E, meaning that it can be stored in fat cells instead of being excreted by the kidneys. Vitamin K is also synthesized by bacteria in our gastrointestinal tract as a byproduct of their metabolism, which further contributes to overall intake.

Summary
Vitamin K is a group of structurally similar, fat-soluble vitamins the human body requires for complete synthesis of certain proteins that are prerequisites for blood coagulation that the body needs for controlling binding of calcium in bones and other tissues. The vitamin K-related modification of the proteins allows them to bind calcium ions, which they cannot do otherwise. Without vitamin K, blood coagulation is seriously impaired, and uncontrolled bleeding occurs. Low levels of vitamin K also weaken bones and promote calcification of arteries and other soft tissues.
Sources
  1. "Medical Physiology" Elsevier (2016)
  2. "Physiology" Elsevier (2017)
  3. "Human Anatomy & Physiology" Pearson (2018)
  4. "Principles of Anatomy and Physiology" Wiley (2014)
  5. "The role of vitamins in hemostasis" Thromb Diath Haemorrh (1975)
  6. "Vitamin K--dependent clotting factors" Semin Thromb Hemost  (1977)