SANA with Rash and Easy Bruising

Beschreibung

Mindmap am SANA with Rash and Easy Bruising, erstellt von Salma Mk am 10/05/2017.
Salma Mk
Mindmap von Salma Mk, aktualisiert more than 1 year ago
Salma Mk
Erstellt von Salma Mk vor mehr als 9 Jahre
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Zusammenfassung der Ressource

SANA with Rash and Easy Bruising
  1. Platelets
    1. 1 to 4 um in diameter
      1. platelet count =150,000-300,000/mm3
        1. Functions
          1. hemostasis
            1. prevention of blood loss
              1. when a blood vessel is injured
                1. 1) vascular constriction
                  1. 2) Formation of platelet plug
                    1. 3) formation of blood clot
                  2. involves
                    1. endothelium
                      1. platelet
                        1. clotting factors
                      2. formation of platelet plug
                        1. release of vasoconstrictors
                          1. wound repair-growth factor
                            1. facilitates blood coagulation
                            2. Thrombopoiesis
                              1. stimulated by
                                1. Thrombopoietin
                                  1. MGDF
                                    1. Il-6
                                      1. GMCSF
                                    2. life span= 8-12 days
                                      1. eliminated by spleen-macrophages
                                    3. History Taking of Bleeding disorders
                                      1. family history
                                        1. congenital or acquired?
                                        2. alcohol
                                          1. acute
                                            1. TCP
                                              1. BM toxicity
                                              2. chronic
                                                1. liver cirrhosis
                                              3. medication
                                                1. Aspirin and NSAIDS
                                                  1. immunosuppressant
                                                  2. weight loss/ fever?
                                                    1. Blood Investigations
                                                      1. CBC
                                                        1. platelet count
                                                          1. 150,000-450,000/mm3
                                                          2. platelet morphology
                                                            1. schistocytes?
                                                          3. PT
                                                            1. Extrinsic and common pathway
                                                              1. 12-14 sec
                                                            2. PTT
                                                              1. intrinsic and common pathway
                                                                1. 24-35 sec
                                                              2. BT
                                                                1. 2-7 mins
                                                            3. BLEEDING DISORDERS
                                                              1. vessel wall
                                                                1. septic vasculitis
                                                                  1. henoch Schönlein syndrome
                                                                    1. immune complex vasculitis
                                                                    2. herlers danlos disorder
                                                                      1. congenital defect in BV
                                                                    3. Platelets
                                                                      1. number
                                                                        1. thrombocytopenia
                                                                          1. decreased production
                                                                            1. aplastic/megaloblastic anemia
                                                                              1. leukemia
                                                                                1. myelosuppression:chemotherapy/alcohol
                                                                                2. increased destruction
                                                                                  1. Immune thrombocytpenic purpura
                                                                                    1. igG antibodies made by the spleen, attacking platelets at 1b and 11b receptors, causing the destruction of them within the spleen
                                                                                      1. acute ITP
                                                                                        1. children 2-9 years
                                                                                          1. less than 6 months
                                                                                            1. resolves after 6 months by itself
                                                                                            2. follows a viral infection
                                                                                              1. severe cases
                                                                                                1. splenectomy
                                                                                              2. chronic ITP
                                                                                                1. adults;females 20-40 years
                                                                                                  1. 6 months or longer
                                                                                                    1. secondary causes
                                                                                                      1. SLE
                                                                                                        1. HIV
                                                                                                      2. diagnosed by exclusion
                                                                                                        1. number of platelets increased by corticosteroids
                                                                                                    2. thrombotic thrombocytopenic purpura
                                                                                                      1. PENTAD
                                                                                                        1. fever
                                                                                                          1. thrombocytopenia
                                                                                                            1. Microangiopathic hemolytic anemia
                                                                                                              1. renal failure
                                                                                                                1. neuro deficits
                                                                                                                2. deficiency of enzyme that breaks down vWF
                                                                                                                3. Disseminated Intravascular Coagulopathy
                                                                                                                  1. Consumptive coagulopathy
                                                                                                                    1. systemic activation of clotting factor and platelets
                                                                                                                      1. microthrombi formation
                                                                                                                        1. increased bleeding tendency
                                                                                                                      2. MEDICAL EMERGENCY
                                                                                                                      3. Heparin induced thrombocytopenia
                                                                                                                        1. igG binds to platelet factor 4, leading to platelet activation, platelet aggregation and thrombosis formation
                                                                                                                  2. function
                                                                                                                    1. congenital
                                                                                                                      1. glannzman thrombasthenia
                                                                                                                        1. abnormality in glycoprotein 11b/111a
                                                                                                                        2. bernard soulier disease
                                                                                                                          1. no binding between glycoprotein 1b with vWF
                                                                                                                        3. acquired
                                                                                                                          1. ASPIRIN
                                                                                                                            1. prevents thromboxane formation by cox1
                                                                                                                        4. superficial bleeding
                                                                                                                          1. purpura
                                                                                                                            1. pinpoint hemorrhages
                                                                                                                            2. petechiae
                                                                                                                              1. 3-5 mm hemorrhages
                                                                                                                              2. ecchymosis
                                                                                                                                1. large bruises
                                                                                                                            3. Clotting Factors
                                                                                                                              1. inherited
                                                                                                                                1. Hemophilia
                                                                                                                                  1. X linked recessive
                                                                                                                                    1. factor 8 deficiency
                                                                                                                                      1. Hemophilia A
                                                                                                                                      2. factor 9 deficiency
                                                                                                                                        1. Hemophilia B
                                                                                                                                        2. PTT elevated
                                                                                                                                      3. Von willebrand disease
                                                                                                                                        1. Autosomal dominant
                                                                                                                                          1. absence of vWF
                                                                                                                                            1. involved in
                                                                                                                                              1. prevention of degradation of factor 8
                                                                                                                                                1. platelet adhesion to damaged endothelium via 1b
                                                                                                                                                2. PTT and bleeding time elevated
                                                                                                                                          2. acquired
                                                                                                                                            1. vitamin K deficiency
                                                                                                                                              1. PT and PTT increased
                                                                                                                                                1. liver disease
                                                                                                                                                  1. deficiency of all clotting factors
                                                                                                                                                2. clinical presentation
                                                                                                                                                  1. hemearthrosis
                                                                                                                                                    1. bleeding into joints
                                                                                                                                                    2. hematoma
                                                                                                                                                      1. bleeding into soft tissue
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