Describe the fibrinolytic pathway and identify areas of interaction with the coagulation pathway (80% of marks).

List two anti-fibrinolytic agents and state their specific mechanism of action (20% of marks).

[Click here to toggle visibility of the answers]

College Answer

The fibrinolytic pathway is a cascade largely made up of proteolytic enzmes and other factors 
synthesized in the liver that circulate in inactive precursor forms. Marks were awarded for 
description of the principal members of the cascade and the pathway relations between them. 
Endothelium is also important in the fibrinolytic pathway.
Regulation of the pathway to localise the site and size of clot as well as delayed onset of action 
of fibrinolysis is central to any description. Regulation of fibrinolysis by the coagulation cascade 
and a description of this area of interaction were expected.
Many candidates provided a reasonable description of the fibrinolytic cascade. Marks were not 
awarded for description of the coagulation cascade that did not have relevance to fibrinolysis. 
Understanding of regulation of fibrinolysis and it’s interaction with coagulation was poorly 
answered. 
Most candidates were able to name two antifibrinolytic agents. Few were able to describe
mechanism of action.