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Medicine 5th year, 10th lecture (Dr. Sabir)

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College of Medicine, Sulaymaniyah
College of Medicine, Sulaymaniyah

The lecture has been given on Apr. 16th, 2011 by Dr. Sabir.

Health & Medicine
1 of 41
Bleeding Disorders By Dr. Sabir M. Ameen
Vasoconstriction
1° Hemostasis
2° Hemostasis
Hemostasis ,[object Object],[object Object],[object Object],[object Object],[object Object],Plt Study Morphology Function Antibody BV Injury Platelet Aggregation Platelet Activation Blood Vessel Constriction Coagulation Cascade Stable Hemostatic Plug Fibrin formation Reduced Blood flow Tissue Factor Primary hemostatic plug Neural
History ,[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
history ,[object Object]
Examination ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Features of Bleeding Disorders Platelet Coagulation disorders fac disorders Site of bleeding Skin Deep in soft tissues Mucous membranes (joints, musc) (epistaxis, gum, vaginal, GI tract) Petechiae Yes No Ecchymoses (“bruises”) Small, superficial Large, deep Hemarthrosis / muscle bleeding Extremely rare Common Bleeding after cuts & scratches Yes No Bleeding after surgery or trauma Immediate, Delayed1-2 d usually mild often severe
Platelet Coagulation Petechiae, Purpura Hematoma, Joint bl.
Petechiae Do not blanch with pressure (cf. angiomas) Not palpable (cf. vasculitis) (typical of platelet disorders)
Hemarthrosis
Hematoma
Petechiae
Purpura
Ecchymosis
Screening tests ,[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of bleeding ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes..cont. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes…cont. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Idiopathic thrombocytopenic purpura(ITP) ,[object Object]
ITP ,[object Object],[object Object],[object Object]
ITP ,[object Object],[object Object],[object Object]
management ,[object Object],[object Object]
management ,[object Object],[object Object]
management ,[object Object],[object Object]
Hemophilia A ,[object Object],[object Object]
Hemophilia A ,[object Object],[object Object],[object Object],[object Object]
Hemophilia A ,[object Object],[object Object],[object Object],[object Object]
Hemophilia A ,[object Object],[object Object]
Shortening of Achilles tendon
Dosing guidelines for hemophilia A ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Von Willebrand’s disease ,[object Object],[object Object]
vW Dis. ,[object Object],[object Object],[object Object],[object Object]
Treatment of von Willebrand Disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Common clinical conditions associated with DIC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathogenesis of DIC Coagulation Fibrinolysis Fibrinogen Fibrin Monomers Fibrin Clot (intravascular) Fibrin(ogen) Degradation Products Plasmin Thrombin Plasmin Release of thromboplastic material into circulation Consumption of coagulation factors; presence of FDPs  aPTT  PT  TT  Fibrinogen Presence of plasmin  FDP Intravascular clot  Platelets Schistocytes
DIC Treatment approaches ,[object Object],[object Object],[object Object],[object Object],[object Object]
Management of Hemostatic Defects in Liver Disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Medicine 5th year, 10th lecture (Dr. Sabir)

  • 1. Bleeding Disorders By Dr. Sabir M. Ameen
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  • 11. Clinical Features of Bleeding Disorders Platelet Coagulation disorders fac disorders Site of bleeding Skin Deep in soft tissues Mucous membranes (joints, musc) (epistaxis, gum, vaginal, GI tract) Petechiae Yes No Ecchymoses (“bruises”) Small, superficial Large, deep Hemarthrosis / muscle bleeding Extremely rare Common Bleeding after cuts & scratches Yes No Bleeding after surgery or trauma Immediate, Delayed1-2 d usually mild often severe
  • 12. Platelet Coagulation Petechiae, Purpura Hematoma, Joint bl.
  • 13. Petechiae Do not blanch with pressure (cf. angiomas) Not palpable (cf. vasculitis) (typical of platelet disorders)
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  • 39. Pathogenesis of DIC Coagulation Fibrinolysis Fibrinogen Fibrin Monomers Fibrin Clot (intravascular) Fibrin(ogen) Degradation Products Plasmin Thrombin Plasmin Release of thromboplastic material into circulation Consumption of coagulation factors; presence of FDPs  aPTT  PT  TT  Fibrinogen Presence of plasmin  FDP Intravascular clot  Platelets Schistocytes
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