"Sana With Rash"

"Sana With Rash"

1. PHYSIOLOGY OF COAGULATION

   • DIFFERENCE BETWEEN PLATELETS AND CLOTTING FACTORS DEFICIENCY

2. TYPES OF BLEEDING DISORDERS

   • classified into problems with:
     • Primary hemostasis
       • formation of weak platelet plug
     • Secondary hemostasis
       • a strong fibrin clot through activation of intrinsic/extrinsic/common pathways
     • Vascular bleeding disorders
       • Vitamin C deficiency, Septic vasculitis infections, Henoch-Schonlein Purpura
   • INVESTIGATIONS OF BLEEDING DISORDERS
     • Primary Hemostasis
       • Blood Count & Blood Film Examination.
       • Bleeding Time (BT) & Platelet Function Assay (PFA)
     • Secondary Hemostasis
       • Prothrombin Time (PT).
       • Activated Partial Thromboplastin Time (aPPT)
       • Thrombin Time (TT).
     • Blood Count & Film Examination
     • aPPT & PT
   • TREATMENT OF BLEEDING DISORDERS
     • Hemophilia A
       • If MILD give, DDAVP or Arginine vasopressin
         • If SEVERE give, recombinant factor 8 pre operation and post for weeks
     • Hemophilia B
       • Recombinant factor 9
         • Tranexamic acid For operations
     • Liver disease
       • Fresh frozen plasma
         • Vitamin K

3. WHAT IS IDIOPATHIC THROMBOCYTOPENIC PURPURA?

   • Thrombocytopenia is due to the destruction of platelets coated by antibody
   • ITP can lead to excessive bruising and bleeding internally, as well as on and under the skin.
   • Decreased platelet production by megakaryocytes in the bone marrow has been discovered
   • prognosis
     • the condition isn’t serious or life-threatening.
       • acute ITP in children often resolves within 6 months or less without treatment.
         • people can live for many decades with the disease
   • causes
     • Autoimmune diseases
     • certain medications
     • pregnancy
   • CLINICAL PRESENTATION OF ITP
     • Petechiae – pin prick rash
     • Bruising
     • Purpura – purple coloured spots on the skin
     • Bleeding from the nose and gums
     • Black blisters in the mouth
     • Heavy menstrual periods
   • TYPES OF ITP
     • Acute ITP
     • Chronic TP
   • MANAGEMENT OF ITP
     • Front line drug therapy:
       • Corticosteroids
         • IV Immunoglobin
     • Second line drug therapy
       • TPO receptor agonist
         • Rituximab
     • Splenectomy
       • PREPARATION AND COMPLICATIONS OF SPLENECTOMY
         • Purpose
           • Trauma
             • Splenomegaly and Hypersplenism
           • Blood disorders
         • Types
           • Open approach
           • Laparoscopic approach
         • Preparation
         • Complications
   • EPIDEMIOLOGY
     • ITP
       • Acute ITP affect children
         • Chronic ITP affect females ( 20-40 )
     • Bleeding disorders
       • Hemophilia A > Hemophilia B > von Willebrand disease

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