Sana with rash and easy Bruising

Hemostais
2. The three steps are
  1. 1- vascular constriction
  2. 2- platelet plug
  3. 3- coagulation
Physiology of Coagulation
1. Extrinsic pathway → begins with trauma to the vascular wall & surrounding tissues.
2. Intrinsic pathway → begins in the blood itself.
Bleeding Disorders
1. Vascular bleeding disorders
  1. 1-Congenital defects of the vessel wall Ehlers- Danlos syndrome
  2. 2-Senile purpura: defect in the subcutaneous tissue supporting the bvs
  3. 3-Scurvy vitamin C deficiency
  4. 4- Septic Vasculitis Infections
  5. 5-Henoch-Schonlein Purpura
2. Platelets disorders
  1. Number :Thrombocytopenia (ITP)
    1. Incidence
      1. in adults is approximately 66 cases per 1,000,000 per year
      2. in children is 50 cases per 1,000,000 per year
    2. etiology
      1. immune system mistakenly attacking and destroying platelets
    3. Clinical manifestations
      1. excessive bruising (purpura)
      2. Bleeding from the gums or nose
      3. Blood in urine or stools
      4. petechiae
      5. epistaxis
    4. CHILDHOOD VS ADULT
      1. Chronic ITP (adult)
      2. persists longer than 6 months without a specific cause.
      3. Acute ITP (childern)
      4. young children (2 to 6 years old)
      5. symptoms may follow a viral illness
      6. symptoms usually disappear in less than six months
    5. Management
      1. Treatment in children
        do not require treatment, and thrombocytopenia resolves spontaneously.
      2. Treatment in adults
        Corticosteroids such as prednisone
        cataracts, high blood sugar, increased risk of infections and Osteoporosis
        IVIG
        headache, vomiting and low blood pressure
        Thrombopoietin receptor agonists
        headache, dizziness, nausea or vomiting, and an increased risk of blood clots
      3. Surgical care:
        splenectomy
        serious post-surgical complications, and not having a spleen permanently increases your susceptibility to infection
        the surgical removal of the spleen.
        In ITP, the antibody-coated platelets are often removed from circulation by the spleen.
        Theoretically, if the spleen is removed, the platelets will remain in the blood stream.
        The spleen can also be the site of antibody production. Therefore removing the spleen may reduce the amount of anti-platelet antibodies in addition to removing the antibody-coated platelets.
      4. SIDE EFFECTS
    6. pathogenesis
      1. an abnormal autoantibody, usually immunoglobulin G (IgG) with specificity for one or more platelet membrane glycoproteins, binds to circulating platelet membranes.
        Autoantibody-coated platelets induce Fc receptor-mediated phagocytosis by mononuclear macrophages
        mononuclear macrophages in the red pulp destroy immunoglobulin-coated platelets
  2. Function: Disorders of platelet function
  3. Acquired: Aspirin- uremia (RF)-MPD Inherited : von Willebrand Disease
3. Coagulation disorders
  1. – Congenital: – hemophilia A – Factor VIII (8) _ Intrinsic pathway – Hemophilia B –Christmas disease -Factor IX(9) _ Intrinsic pathway – Von willebrand diseasen
  2. – Acquired : – liver disease
investigation
DEMOGRAPHY
1. Sana , 28-Years Old, Female

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Sana with rash and easy Bruising

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