1 / 10

Dr. Prakash Saldanha

Dr. Prakash Saldanha. BLEEDING/COAGULATION DISORDERS. BLEEDING/COAGULATION DISORDERS. HEMOSTASIS a) Vascular phase - Vaso constriction b) Platelet phase - Plug c) Plasma phase - Thrombus APPROACH a) Bleeding / Coagulation Spontaneous / Trauma

vickyj
Download Presentation

Dr. Prakash Saldanha

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Dr. Prakash Saldanha BLEEDING/COAGULATION DISORDERS

  2. BLEEDING/COAGULATION DISORDERS HEMOSTASIS a) Vascular phase - Vaso constriction b) Platelet phase - Plug c) Plasma phase - Thrombus APPROACH a) Bleeding / Coagulation Spontaneous / Trauma Superficial / deep Small / large Short / prolonged

  3. BLEEDING/COAGULATION DISORDERS b) Congenital or Acquired Family history Trauma Umbilical bleeding Immunological- Post transfusion Newborn (Vit. K) Congenital anomalies Auto immune- ITP Eczema Drug – Aspirin Skin elasticity Systemic illness Joint HE PEM Absent radius Sepsis HemangiomaLeukemia Liver Failure Renal Failure Vascular – HUS/HSP

  4. BLEEDING/COAGULATION DISORDERS C) Investigations • Platelet count - ( Quality / Quantity ) • CBC, PS (Pancytopenia, Clumps, abnormal cells) • B.T. • C.T • P.T. - ( II, V, VII,X ) – Hepatic • Activated P.T.T. ( Intrinsic) • Special Factor assay VII, XIII, IX Bone marrow Invitro platelet adhesive test Qualitative Clot retraction test

  5. BLEEDING/COAGULATION DISORDERS C. I.T.P Pathogenesis – Auto immune Types - Acute Acute relapsing Chronic Management :- • Supportive Avoid - Physical activity, IM injections, Drugs, Monitor - Neuro observation, platelet count • Drugs - Oral steroids Methyl Prednisolone 30mg/kg/day x 5 IVIG 400 mg/kg/day x 5 Anti Rh – D c) Platelet transfusion

  6. BLEEDING/COAGULATION DISORDERS CHRONIC ITP PULSE THERAPY – Methyl Prednisolone / IVIG (Biweekly) VINCRISTIN CYCLOPHOSPHAMIDE DANAZOL INTERFERON SPLENECTOMY

  7. BLEEDING/COAGULATION DISORDERS D. HAEMOPHILIA A - DECREASE VIII C B - DECREASE IX ‘X’ LINKED RECESSIVE BOYS ARE MORE DEEP BLEEDING - JOINTS DIAGNOSIS - INCREASE PTT / FACTOR ASSAY TREATMENT :- • CRYO PRECIPITATE • FACTOR VIII • DDAVP • PROTHOMBIN COMPLEX CONCENTRATE (HEMOPHILIA B )

  8. BLEEDING/COAGULATION DISORDERS E. VASCULAR HEMOPHILIA 1.UNDERPRODUCTION OF VON WILLIBRAND PROTEIN 2.COMPONENTS – PLATELET ADHESIVE COMPONENT (VIII R ) FACTOR VIII CARRIER PROTEIN (VIII C) TYPES :- I. CLASSICAL AUTOSOMAL DOMINANT BOTH COMPONENTS DECREASED BOTH PLATELET / CLOTTING – ABNORMAL • AUTOSOMAL RECESSIVE ONLY PLATELET COMPONENT DECREASED ONLY BLEEDING ABNORMALITIES NO CLOTTING ABNORMALITY

  9. BLEEDING/COAGULATION DISORDERS TREATMENT:- • CRYO PRECIPITATE • FACTOR VIII REPLACEMENT • DESMOPRESSIN (DDAVP)

More Related