Bleeding Disorders Final PDF

Preview

Summary

Function: o To arrest bleeding at the site of injury or blood loss by forming a hemostatic plug. o To remove the hemostatic plug when healing is complete. o To maintain blood in a fluid state w/in the vascular system. Normal Hemostasis in terms of: o Clot-free; Liquid state o w/in the blood vessel o...

Description

SUMMARY OF HEMOSTASIS AND LAB EVALUATION NORMAL HEMOSTASIS Function: o To arrest bleeding at the site of injury or blood loss by forming a hemostatic plug. o To remove the hemostatic plug when healing is complete. o To maintain blood in a fluid state w/in the vascular system. Normal Hemostasis in terms of: o Clot-free; Liquid state o w/in the blood vessel o should be in normal flow: AXIAL FLOW LAMINAR FLOW Middle Peripheral Occupied w/ cells Occupied w/ plasma Rapid flow Slow flow 4 Components: 1.) Vascular/endothelium 2.) Platelets 3.) Coagulation 4.) Fibrinolysis

PLATELET AGGREAGATION

SECONDARY HEMOSTASIS COAGULATION CASCADE INTRINSIC PATHWAY EXTRINSIC PATHWAY Initiator: Tissue factor Initiator: Factor XII (endothelium) Utilizing CF: TENET Utilizing CF: VII APTT, PTT Prothrombin time COMMON PATHWAY X,V,II,I APTT,PTT,PT FIBRINOLYTIC SYSTEM Initiator: coagulation system LABORATORY EVALUATION

Bleeding time

Clotting time

Prothrombin time APTT Thrombin time Antithrombin Protein C & S

PRIMARY HEMOSTASIS *Activator: collagen from the endothelium during endothelial injury PLATELET Receptor: GP1b-IX ADHESION Pandikit: vWF (Source of vWF: endothelial cells, weibel palade bodies,

Tissue Factor Pathway Inhibitor D-dimer test

an assess blood vessel but it is usually used to test platelet function assess clotting factors; nonspecific test Prolonged clotting  clotting factor deficiency; pero hindi mo alam yung specific clotting factor deficient kaya you have do the Factor Assay assess Extrinsic & Common Pathway Clotting Factors assess Intrinsic & Common Pathway Clotting Factors indirectly measures Fibrinogen measured to know if you’re prone to thrombosis or not plasma protein; protein C is activated by thrombomodulinthrombin complex with cofactor as forming activated protein C which will inhibit Factor Va and Factor VIIIa secreted by the endothelium, inhibits tissue factor/Factor VII deep vein thrombosis if prolonged

1

DISORDERS OF

megakaryocytes)  – PVTBF (growth factors) Dense – CHAPS (calcium, ATP, ADP) Receptor: GPIIb-IIIa Pandikit/intracellular bridge: Fibrinogen Platelets→Aggregation: GPVa

Page

HEMATOLOGY II HEMOSTASIS

PLATELET SECRETION

Tendencies for thrombosis

PLATELET COUNT DIRECT METHODOLOGIES REESE & ECKER WBC BCB Blood then diluting fluid GUY & LEEKE RBC CV Diluting fluid then blood BECKER & CONCRITE Phase contrast microscopy 1% NH4 Oxalate AUTOMATION 1.) electrical impedance 2.) flow cytometry/ light scatter 3.) radio frequency INDIRECT METHODOLOGIES FONIO Wright stain 14% MgSO4 TOCANTINE Arterial is possible OLEF BCB Normal Platelet count Bleeding time is prolonged even if the function of platelets is normal Thrombocytosis Thrombocytosis Thrombocytopenia Trauma induced bleeding Spontaneous Bleeding due to platelet problems

150,000 – 500,000 500,000 1,000,000...