This document discusses bleeding disorders and disorders of red and white blood cells. It begins by defining various cardiac arrhythmias and then discusses extravasation of blood from vessels into tissues. It outlines the normal control of bleeding through the vascular, platelet, coagulation, and fibrinolytic phases. Disorders are classified as non-thrombocytopenic purpuras, thromobocytopenic purpuras, or disorders of coagulation. Specific inherited and acquired bleeding disorders are described including hemophilia A, hemophilia B, and disorders affecting platelets or coagulation factors. Signs and symptoms of bleeding disorders are also summarized.

1. Bleeding Disorders
&
Disorders of red and
white blood cells.
Aiman A. Ali DDS, PhD.

2. HAEMORRHAGE
Aiman A. Ali DDS, PhD.

3. First Quiz
Define the following:
Bradycardia:
Tachycardia:
Atrial Flutter:
Atrial Fibrillation:
Agonal rhythm:

4. Extravasations of blood out of the vessels to the surrounding
tissues either internally to the deep cavities and
subcutaneously or externally.
Aiman A. Ali DDS, PhD.
Normal control of bleeding
1. Vascular phase
2. Platelet phase & coagulation
3. Metabolic “fibrinolytic”
phase

5. 1- Vascular phase
2- Platelet phase
3- Coagulation
phase
4- Metabolic
“fibrinolytic” phase

6. Classification of bleeding disorders
Non-thrombocytopenic
purpuras
 Vascular wall alterations
 Disorder of platelet function
Thrombocytopenic purpuras
 Primary [idiopathic]
 Secondary
Disorder of coagulation
 Inherited
 Acquired

7. Thrombocytopenic Disorders
 Primary: Idiopathic
 Secondary:
 Systemic diseases (leukemia)
 Radiation
 Bone Metastasis
 Viral or bacterial infections
 Drugs: Alcohol, Gold salts, Estrogens, Thiazide
diuretics
Aiman A. Ali DDS, PhD.

8. Non-Thrombocytopenic Disorders
 Vascular wall alteration:
 Scurvy
 Infections
 Allergy
 Disorders of platelet function:
 Genetics (Bernard-Soulier disease)
 Allergy
 Autoimmune disease
 Von willebrand’s disease
 Uremia
 Drugs: Aspirin, NSAIDs, Alcohol, Beta-Lactam
antibiotics
Aiman A. Ali DDS, PhD.

9. Disorder of coagulation
 Inherited:
 Hemophilia A
 Hemophilia B
 Acquired:
 Liver diseases
 Vitamin deficiency
 Anticoagulation drugs: Heparin, aspirin NSAIDs
 Primary fibrinogenolysis
Aiman A. Ali DDS, PhD.

10. Bernard Soulier Syndrome
Aiman A. Ali, DDS, PhD.
Hereditary. - Giant non-functional platelets.
- Bleeding tendency.

11. 1- Disorders of platelets:
1.1.- Diseases.
Aiman A. Ali DDS, PhD.
1.2.- Drugs:

12. Aiman A. Ali DDS, PhD.
Immune Thrombocytopenia.
Hypersplenism.
1-1 Diseases:
Thrombocytopenia:
- normal platelet count is about 150-350x103/mm3
- thrombocytopenia exists when the platelet count falls below 100X
103/mm3.
Idiopathic thrombocytopenic purpura.
AIDS associated purpura.

13. 1.2.- Drugs:
1- Aspirin and other NSAIDS such as:
diclofenac, Ibuprofen mefenamic
acid
2- Lactam antibiotics: penicillin, cephalosporins
3- General anesthetic agents: Halothane
4- Others: tetracycline, antidepressant, alcohol,
heparin, thiazide & diuretics
Aiman A. Ali DDS, PhD.

14. Signs and Symptoms:
1- Spontaneous gingival bleeding.
2- Purpura.
3- Petechiae.
4- Ecchymosis.
6- Post operative bleeding.
5- Prolonged : epistaxis, spontaneous bleeding
into GIT and anemia
Aiman A. Ali DDS, PhD.

15. Aiman A. Ali DDS, PhD.

16. 2. Coagulation Defects
Aiman A. Ali DDS, PhD.