Medicine.Bleeding disorders.(dr.sabir)

Bleeding Disorders By Dr. Sabir M. Ameen

History ,[object Object],[object Object],[object Object]

History ,[object Object],[object Object],[object Object],[object Object],[object Object],[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 tis. Mucous membranes (joints, musc) 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)

Screening tests for bleeding disorders ,[object Object],[object Object],[object Object],[object Object],[object Object],[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]

Thrombocytopenia ,[object Object],[object Object],Congenital abnormalities of platelets can be divided into disorders of platelet production and those of platelet function. All are very rare. In general they cause moderate to severe bleeding problems.

Acquired thrombocytopenia ,[object Object],[object Object]

Acquired…cont ,[object Object]

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Causes of acquired platelet dysfunction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Increased consumption of platelets ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment of platelet disorders ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment…cont ,[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],[object Object],[object Object]

Treatment…cont ,[object Object],[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]

management ,[object Object],[object Object]

Hemophilia A ,[object Object],[object Object]

Hemophilia A ,[object Object],[object Object],[object Object],[object Object]

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]

Medicine.Bleeding disorders.(dr.sabir)

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