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Hemodynamic Disorders
Hemodynamic Disorders
 Edema
 Edema
 Hyperemia and Congestion
 Hyperemia and Congestion
 Hemorr...
•• Hemorrhage = Extravasation of blood due to vessel rupture
Hemorrhage = Extravasation of blood due to vessel rupture
••
...
••
••

Hemorrhage
Hemorrhage
Clinical Features = based on rapidity & site
Clinical Features = based on rapidity & site

••...
Petechiae of the
colonic mucosa

Fatal intracerebral
bleed

4

Dr. Krishna Tadepalli, MD, www.mletips.com
•• Clinical significance
Clinical significance
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••
••
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Most common cause of death in pts. With cirrhosis ??
Mo...
•• Clinical significance
Clinical significance
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••
••
••
••

••

Most common cause of death in pts. With cirrhosis ??
Mo...
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3. hemorrhage; hemodynamic disorders

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3. hemorrhage; hemodynamic disorders

  1. 1. Hemodynamic Disorders Hemodynamic Disorders  Edema  Edema  Hyperemia and Congestion  Hyperemia and Congestion  Hemorrhage  Hemorrhage  Hemostasis and Thrombosis  Hemostasis and Thrombosis  Embolism  Embolism  Infarction  Infarction  Shock  Shock 1 Dr. Krishna Tadepalli, MD, www.mletips.com
  2. 2. •• Hemorrhage = Extravasation of blood due to vessel rupture Hemorrhage = Extravasation of blood due to vessel rupture •• –– Causes = Trauma, Atherosclerosis, Inflammation, Neoplasm Causes = Trauma, Atherosclerosis, Inflammation, Neoplasm Hemorrhagic diatheses: hemorrhage from insignificant injury Hemorrhagic diatheses: hemorrhage from insignificant injury (causes = deficiency of platelet //Clotting factors) (causes = deficiency of platelet Clotting factors) •• •• •• Hematoma = Bleeding with tissues Hematoma = Bleeding with tissues Morphologic types Morphologic types Petechiae = 1-2 mm size minute hemorrhages; into skin, mucosa & Petechiae = 1-2 mm size minute hemorrhages; into skin, mucosa & •• serosal surfaces; due to deficiency of platelet //Clotting factors, serosal surfaces; due to deficiency of platelet Clotting factors, Uremia( platelet functional defects) Uremia( platelet functional defects) Purpura = ≥3 mm size hemorrhages, due to causes of Petechiae + Purpura = ≥3 mm size hemorrhages, due to causes of Petechiae + Amylodosis, Vasculitis Amylodosis, Vasculitis •• Ecchymoses = 1-2 cm size hemorrhages, Bruise (subcutaneous), Ecchymoses = 1-2 cm size hemorrhages, Bruise (subcutaneous), Hemopertoneum (peritoneal cavity), Hemoarthrosis (Joint) Hemopertoneum (peritoneal cavity), Hemoarthrosis (Joint) 2 Dr. Krishna Tadepalli, MD, www.mletips.com
  3. 3. •• •• Hemorrhage Hemorrhage Clinical Features = based on rapidity & site Clinical Features = based on rapidity & site •• >20% loss of blood volume  hypovolemic //Hemorrhagic shock >20% loss of blood volume  hypovolemic Hemorrhagic shock •• Even mild bleeds in Brain  critical Even mild bleeds in Brain  critical •• All patients with Hemorrhage eventually develop anemia due to All patients with Hemorrhage eventually develop anemia due to  Iron deficiency  Iron deficiency 3 Dr. Krishna Tadepalli, MD, www.mletips.com
  4. 4. Petechiae of the colonic mucosa Fatal intracerebral bleed 4 Dr. Krishna Tadepalli, MD, www.mletips.com
  5. 5. •• Clinical significance Clinical significance •• •• •• •• •• •• Most common cause of death in pts. With cirrhosis ?? Most common cause of death in pts. With cirrhosis Most common cause of death in aortic dissections & Most common cause of death in aortic dissections & Aneurysms ?? Aneurysms Petechiae in 40 yr old male patient 3 days after fracture of Petechiae in 40 yr old male patient 3 days after fracture of long bones in aatraffic accident= why? long bones in traffic accident= why? Four day old new born has petechiae and purpura and low Four day old new born has petechiae and purpura and low platelet count. Megakaryocytes in bone marrow are platelet count. Megakaryocytes in bone marrow are increased in # = explain the mechanism increased in # = explain the mechanism 34 yr old female complains of menorrhagia ((excess 34 yr old female complains of menorrhagia excess menstrual bleeding ))for the past 4 cycles. Peripheral blood menstrual bleeding for the past 4 cycles. Peripheral blood and marrow finding are matching with findings of the and marrow finding are matching with findings of the above patient (new born)= explain above patient (new born)= explain A 55 yr old male with blood pressure of 220/14o mm.Hg. A 55 yr old male with blood pressure of 220/14o mm.Hg. Develops, severe headache, visual disturbances, vomitings. Develops, severe headache, visual disturbances, vomitings. CT scan confirms intra cerebral bleed. What is the most CT scan confirms intra cerebral bleed. What is the most common cause of death in this patient? 5 common cause of death in this patient? Dr. Krishna Tadepalli, MD, www.mletips.com
  6. 6. •• Clinical significance Clinical significance •• •• •• •• •• •• Most common cause of death in pts. With cirrhosis ?? Most common cause of death in pts. With cirrhosis Most common cause of death in aortic dissections & Most common cause of death in aortic dissections & Aneurysms ?? Aneurysms Petechiae in 40 yr old male patient 3 days after fracture of Petechiae in 40 yr old male patient 3 days after fracture of long bones in aatraffic accident= why? long bones in traffic accident= why? Four day old new born has petechiae and purpura and low Four day old new born has petechiae and purpura and low platelet count. Megakaryocytes in bone marrow are platelet count. Megakaryocytes in bone marrow are increased in # = explain the mechanism increased in # = explain the mechanism 34 yr old female complains of menorrhagia ((excess 34 yr old female complains of menorrhagia excess menstrual bleeding ))for the past 4 cycles. Peripheral blood menstrual bleeding for the past 4 cycles. Peripheral blood and marrow finding are matching with findings of the and marrow finding are matching with findings of the above patient (new born)= explain above patient (new born)= explain A 55 yr old male with blood pressure of 220/14o mm.Hg. A 55 yr old male with blood pressure of 220/14o mm.Hg. Develops, severe headache, visual disturbances, vomitings. Develops, severe headache, visual disturbances, vomitings. CT scan confirms intra cerebral bleed. What is the most CT scan confirms intra cerebral bleed. What is the most common cause of death in this patient? 5 common cause of death in this patient? Dr. Krishna Tadepalli, MD, www.mletips.com

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