The document discusses hemodynamic disorders and provides details on key topics like hemostasis, thrombosis, coagulation pathways, fibrinolysis, and anticoagulants. It defines processes such as hemostasis, thrombosis, and explains the roles of platelets, endothelium, thrombin and other factors. Clinical significance of coagulation tests, natural anticoagulants like heparin and warfarin are summarized. Diagrams of coagulation and fibrinolytic pathways further illustrate the formation and breakdown of blood clots.
Coagulation: In medicine, the clotting of blood. The process by which the blood clots to form solid masses, or clots.
More than 30 types of cells and substances in blood affect clotting. The process is initiated by blood platelets. Platelets produce a substance that combines with calcium ions in the blood to form thromboplastin, which in turn converts the protein prothrombin into thrombin in a complex series of reactions. Thrombin, a proteolytic enzyme, converts fibrinogen, a protein substance, into fibrin, an insoluble protein that forms an intricate network of minute threadlike structures called fibrils and causes the blood plasma to gel. The blood cells and plasma are enmeshed in the network of fibrils to form the clot.
DIC is not a disease entity but an event that can accompany various disease processes. It is an “Acquired” Pathological process. Widespread activation of the clotting cascade lead to formation of blood clots in small blood vessels throughout the body causing a compromise of tissue blood flow leading to multiple organ damage MOD. The coagulation process consumes clotting factors and platelets,normal clotting is disrupted and severe bleeding can occur from various sites. Patients with DIC should be treated at hospitals with appropriate critical care units (ICU) with available Subspecialty expertise, such as hematology, blood bank, or surgery. Patients who present to hospitals without those capabilities and who are stable enough for transfer should be referred expeditiously to a hospital that has those resources. Treatment of DIC includes the underlying disorder, supportive treatment and hemostatic Therapy.
Coagulation: In medicine, the clotting of blood. The process by which the blood clots to form solid masses, or clots.
More than 30 types of cells and substances in blood affect clotting. The process is initiated by blood platelets. Platelets produce a substance that combines with calcium ions in the blood to form thromboplastin, which in turn converts the protein prothrombin into thrombin in a complex series of reactions. Thrombin, a proteolytic enzyme, converts fibrinogen, a protein substance, into fibrin, an insoluble protein that forms an intricate network of minute threadlike structures called fibrils and causes the blood plasma to gel. The blood cells and plasma are enmeshed in the network of fibrils to form the clot.
DIC is not a disease entity but an event that can accompany various disease processes. It is an “Acquired” Pathological process. Widespread activation of the clotting cascade lead to formation of blood clots in small blood vessels throughout the body causing a compromise of tissue blood flow leading to multiple organ damage MOD. The coagulation process consumes clotting factors and platelets,normal clotting is disrupted and severe bleeding can occur from various sites. Patients with DIC should be treated at hospitals with appropriate critical care units (ICU) with available Subspecialty expertise, such as hematology, blood bank, or surgery. Patients who present to hospitals without those capabilities and who are stable enough for transfer should be referred expeditiously to a hospital that has those resources. Treatment of DIC includes the underlying disorder, supportive treatment and hemostatic Therapy.
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Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Bleeding Disorders: Causes, Types, and Diagnosis Dr Medical
https://userupload.net/wxvqfbo7ywqu
A bleeding disorder is a condition that affects the way your blood normally clots. The clotting process, also known as coagulation, changes blood from a liquid to a solid. When you’re injured, your blood normally begins to clot to prevent a massive loss of blood. Sometimes, certain conditions prevent blood from clotting properly, which can result in heavy or prolonged bleeding.
Bleeding disorders can cause abnormal bleeding both outside and inside the body. Some disorders can drastically increase the amount of blood leaving your body. Others cause bleeding to occur under the skin or in vital organs, such as the brain.
DIC during Pregnancy is the most dreaded complication and matter to clear the concepts is required.
the slides clear and give a better idea about disseminated intravascular coagulation.
hope you find all your answers to queries in these slides.
disseminated intravascular coagulation is an abnormal blood clot in the blood vessels called dic. causes of this are any infection, cancer, liver disease, abnormal pregnancy, etc. signs and symptoms of this fever, petechiae, purpura, etc .treatment of this id anticoagulant agent like aspirin, plasma transfusion, etc
A presentation about DIC (Disseminated Intravascular Coagulopathy).
Done by 4th year medical students at the University of Science and Technology, Sana'a, Republic of Yemen, in October 2010.
Bleeding disorders /certified fixed orthodontic courses by Indian dental aca...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Bleeding disorders Causes, Types, and DiagnosisDr Medical
https://userupload.net/v3l4i8jsk7wq
Factor II, V, VII, X, or XII deficiencies are bleeding disorders related to blood clotting problems or abnormal bleeding problems. Von Willebrand's disease isthe most common inherited bleeding disorder. It develops when the blood lacks von Willebrand factor, which helps the blood to clot.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Bleeding Disorders: Causes, Types, and Diagnosis Dr Medical
https://userupload.net/wxvqfbo7ywqu
A bleeding disorder is a condition that affects the way your blood normally clots. The clotting process, also known as coagulation, changes blood from a liquid to a solid. When you’re injured, your blood normally begins to clot to prevent a massive loss of blood. Sometimes, certain conditions prevent blood from clotting properly, which can result in heavy or prolonged bleeding.
Bleeding disorders can cause abnormal bleeding both outside and inside the body. Some disorders can drastically increase the amount of blood leaving your body. Others cause bleeding to occur under the skin or in vital organs, such as the brain.
DIC during Pregnancy is the most dreaded complication and matter to clear the concepts is required.
the slides clear and give a better idea about disseminated intravascular coagulation.
hope you find all your answers to queries in these slides.
disseminated intravascular coagulation is an abnormal blood clot in the blood vessels called dic. causes of this are any infection, cancer, liver disease, abnormal pregnancy, etc. signs and symptoms of this fever, petechiae, purpura, etc .treatment of this id anticoagulant agent like aspirin, plasma transfusion, etc
A presentation about DIC (Disseminated Intravascular Coagulopathy).
Done by 4th year medical students at the University of Science and Technology, Sana'a, Republic of Yemen, in October 2010.
Bleeding disorders /certified fixed orthodontic courses by Indian dental aca...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Bleeding disorders Causes, Types, and DiagnosisDr Medical
https://userupload.net/v3l4i8jsk7wq
Factor II, V, VII, X, or XII deficiencies are bleeding disorders related to blood clotting problems or abnormal bleeding problems. Von Willebrand's disease isthe most common inherited bleeding disorder. It develops when the blood lacks von Willebrand factor, which helps the blood to clot.
UAEU - CMHS - Hematology-Oncology Course - MMH 302 - HONC 320. Education material for medical students - It cover basic principles of hematology and oncology, including CAR-T and gene editing. It can be used for study and review. It illustrates main principles of hematology and oncology.
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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. Feature
Hemostasis
Thrombosis
What is it?
Blood clot
Blood clot
Where is it?
Site of vascular
injury
In an uninjured
vessel
Why is it?
Trauma
(common)
Atherosclerosis
What happens
later?
Stops blood loss Produce
(deserved effect) complications
(Emboli)
2
Dr. Krishna Tadepalli, MD, www.mletips.com
3. Hemostasis
Hemostasis
Events following vascular injury
Events following vascular injury
1. transient vasoconstriction ( by neurogenic
1. transient vasoconstriction ( by neurogenic
mechanisms, Endothelin – vasoconstrictor of
mechanisms, Endothelin – vasoconstrictor of
Endothelial cells), reduce blood loss
Endothelial cells), reduce blood loss
2. Primary Hemostasis formation of Primary
2. Primary Hemostasis formation of Primary
haemostatic plug (( by platelet adhesion, activation
haemostatic plug by platelet adhesion, activation
& Aggregation),
& Aggregation),
3. Secondary Hemostasis Platelets + Fibrin
3. Secondary Hemostasis Platelets + Fibrin
(( from coagulation pathways- either intrinsic or
from coagulation pathways- either intrinsic or
extrinsic), forms secondary haemostatic plug
extrinsic), forms secondary haemostatic plug
3
Dr. Krishna Tadepalli, MD, www.mletips.com
4. Hemostasis
Hemostasis
Role of Endothelium
Role of Endothelium
1. Produce Pro-thrombotic (( Plasminogen
1. Produce Pro-thrombotic Plasminogen
activator inhibitors – PAI, Tissue factor, vWF)
activator inhibitors – PAI, Tissue factor, vWF)
and Anti-thrombotic factors (( Vasodilators –
and Anti-thrombotic factors Vasodilators –
PGI2, NO; tPA, Heparin like molecules &
PGI2, NO; tPA, Heparin like molecules &
Thombomodulin)
Thombomodulin)
2. Balance of these factors determine the end result
2. Balance of these factors determine the end result
(( clot or dissolution of clot)
clot or dissolution of clot)
4
Dr. Krishna Tadepalli, MD, www.mletips.com
6. Coagulation pathway
Coagulation pathway
Role of Platelets
Role of Platelets
Granules α granules( contain clotting factors &
Granules α granules( contain clotting factors &
Growth factors), Dense or δ granules (( ADP, Ca++++,
Growth factors), Dense or δ granules ADP, Ca ,
Neuropeptides, Epinephrine)
Neuropeptides, Epinephrine)
Response to injury bind to sub-endothelial
Response to injury bind to sub-endothelial
ECM (( vWF + Gp -Ib) Adhesion
ECM vWF + Gp -Ib) Adhesion
Expose Phospholipid complexes (helps in intrinsic
Expose Phospholipid complexes (helps in intrinsic
clotting pathway) & release ADP& Ca++++
clotting pathway) & release ADP& Ca
Aggregate with other platelets (( with fibrin by Gp
Aggregate with other platelets with fibrin by Gp
IIb-IIIa on platelet surfaces
IIb-IIIa on platelet surfaces
6
Dr. Krishna Tadepalli, MD, www.mletips.com
8. Aspirin in patients at risk for coronary thrombosis8
It irreversibly acetylates and inactivates cyclooxygenase-1 due to
its ability to block TxA2 synthesis EQ
Dr. Krishna Tadepalli, MD, www.mletips.com
11. Coagulation pathway
Coagulation pathway
Most important step in this pathway
Most important step in this pathway
(either intrinsic or extrinsic) formation of
(either intrinsic or extrinsic) formation of
Thrombin
Thrombin
Thrombin produces it effects through
Thrombin produces it effects through
PARS( Protease activated receptors – 7 GPCR
PARS( Protease activated receptors – 7 GPCR
family)
family)
Major effects of Thrombin
Major effects of Thrombin
Fibrin formation from Fibrinogen
Fibrin formation from Fibrinogen
On Platelets TxA2
On Platelets TxA2
On Endothelial cells NO, tPA, PGI2
On Endothelial cells NO, tPA, PGI2
act also on Lymphocytes, Neutrophils, Monocytes
act also on Lymphocytes, Neutrophils, Monocytes
11
Dr. Krishna Tadepalli, MD, www.mletips.com
13. Anti -- Coagulants
Anti Coagulants
Natural ones
Natural ones
1. Antithrombins( AT-III) inactivate Thrombin;
1. Antithrombins( AT-III) inactivate Thrombin;
Factors IX to XII; bind to heparin like molecule on
Factors IX to XII; bind to heparin like molecule on
endothelium
endothelium
2. Proteins – C & S produced by liver; need Vit. K for
2. Proteins – C & S produced by liver; need Vit. K for
activation; inactivate Factors V, VIII
activation; inactivate Factors V, VIII
Tissue Factor Pathway Inhibitors (TFPI) inhibit
Tissue Factor Pathway Inhibitors (TFPI) inhibit
factors VII, X
factors VII, X
Clinical significance
Clinical significance
Heparin act through AT-III; Monitor PTT (Intrinsic pathway), Antidote is
Heparin act through AT-III; Monitor PTT (Intrinsic pathway), Antidote is
Protamine, can produce HIT (heparin induced thrombocytopenia); can be
Protamine, can produce HIT (heparin induced thrombocytopenia); can be
given in pregnancy (as it can’t cross placenta); need frequent injections
given in pregnancy (as it can’t cross placenta); need frequent injections
Warfarin act through inhibition of Vit K mediated carboxylation of
Warfarin act through inhibition of Vit K mediated carboxylation of
clotting factors (II,VII, IX, X); Extrinsic pathway Monitor PT; Antidote is
13
clotting factors (II,VII, IX, X); Extrinsic pathway Monitor PT; Antidote is
Vit.K contraindicated in pregnancy (teratogenic)
Vit.K1 1;;contraindicated in pregnancy (teratogenic)
Dr. Krishna Tadepalli, MD, www.mletips.com
14. Fibrinolytic pathway
Fibrinolytic pathway
Most important step in this pathway
Most important step in this pathway
formation of Plasmin from Plasminogen
formation of Plasmin from Plasminogen
Tissue Plasminogen activator (tPA) is important in this
Tissue Plasminogen activator (tPA) is important in this
conversion
conversion
Plasmin breaks down excess Fibrin Fibrin split
Plasmin breaks down excess Fibrin Fibrin split
products or Fibrin degradation products (FSP or FDP)
products or Fibrin degradation products (FSP or FDP)
Most important component of FDP D-dimer
Most important component of FDP D-dimer
Clinical significance
Clinical significance
D-dimer positivity (≥200 ng) patient had clot and it is lysed by
D-dimer positivity (≥200 ng) patient had clot and it is lysed by
Plasmin
Plasmin
Conditions where D-dimer is positive DIC, DVT, PE
Conditions where D-dimer is positive DIC, DVT, PE
14
Dr. Krishna Tadepalli, MD, www.mletips.com