hemorrhagic diathesis & hematological melignancy

1. hemorrhagic diathesis
hematological melignancy

3. 11 IndexIndex HypoHypo
coagulationcoagulation
NormoNormo
coagulationcoagulation
HyperHyper
coagulationcoagulation
Bleeding time (by Lee-Bleeding time (by Lee-
White methods), minWhite methods), min
>>55 5-35-3 << 33
Platelets numberPlatelets number <<180180 180-320180-320 >>320320
Platelet adhesivenessPlatelet adhesiveness <<2323 23-4423-44 >> 4545
Time of plasmaTime of plasma
recalcification, secrecalcification, sec
>>120120 120-60120-60 << 6060
Heparin tolerance test,Heparin tolerance test,
minmin
>>1111 11-811-8 << 88
Prothrombin index, %Prothrombin index, % <<8080 80-10080-100 >>100100
U-factorU-factor <<8080 80-10080-100 >>100100
Procorventin (VII factor),Procorventin (VII factor),
%%
<<8080 80-10080-100 >>100100
Fibrinogen, g/lFibrinogen, g/l <<22 2-42-4 >> 44

4. HEMOPHILIA
THROMBOCYTOPENIA
HEMOBLASTOSIS
ACUTE LEUKEMIA
CHRONIC LEUKEMIA
The main types of diathesis

5.  It is a congenital form of hemorrhagic
diathesis,cherecterised by heriditary deficiency in
blood coagulating factors,which leads to
disruption of formation of thromboplastin and
reduce blood clotting.
 There are three types of hemophilias.
 Hemophilia A
 Hemophilia B
 Hemophilia C

6.  Specific features of hemorrhagic syndrome
 Beginning at birth(prolonged bleeding from the
umblical wound)
 Prevelence of brushing.
 Bleeding when changing primary teeth.
 Bleeding after injury or during surgery.

7. Arhtropathy
Hematomic
bleeding sickness
types
Diagnostic
criteria
Hemophilia

8.  In the blood dicrease or absent of factors 8,9 ,11
 Family_history_of_coagulation_disorders:
positive APTT:abnormal
 Mixing_APTT:corrected
Factor_VIII:C_activity:abnormal

9.  For patients with mild form of factor IX
deficiency with non-life-threatening bleeding, the
treatment of choice is FFP. For the severe form
of hemophelia B or in life- threatening situation,
prothrombin complex concentrates are the
treatment of choice.
 Treatment of hemartroisis.
 Sympatomatic hemostatic therapy.

10.  Thrombocytopenia (or -paenia, or thrombopenia in short) is
the presence of relatively few platelets in blood.
 Generally speaking a normal platelet count ranges from 180,000
and 320,000 per mm3
.
 Signs and symptoms
 Often, low platelet levels do not lead to clinical problems; rather,
they are picked up on a routine full blood count. Occasionally,
there may be bruising, nosebleeds and/or bleeding gums.
 It is vital that a full medical history is elicited, to ensure the low
platelet count is not due to a secondary process. It is also
important to ensure that the other blood cell types red blood cells,
and white blood cells, are not also suppressed.

11. Petechial-
ecchymosic
Diagnostic
criteria
1. Deacrease
of
platelets

12.  Thrombocytopenia = Reduced platelet number
 Causes
Decreased production of platelets
vitamin B12 or folic acid deficiency
Decreased platelet survival
Immunologic or Nonimmunologic etiology
Sequestration- Hypersplenism
ameliorated by splenectomy
Dilutional
Massive transfusions

13.  • History: Isolated bleeding symptoms consistent with
thrombocytopenia without constitutional symptoms
(e.g. significant weight loss, bone pain, night sweats).
 Physical examination: Bleeding symptoms in the absence of
hepatosplenomegaly, lymphadenopathy, or stigmata of
congenital conditions. •
 Complete blood count: Isolated thrombocytopenia (platelet
count <100 x 109/L). Anemia only if due to significant
bleeding—otherwise normal red cell indices, white blood cell
count and differential.
 •Peripheral blood smear: Identified platelets should be
normal to large in size. Red and white blood cell morphology
should be normal.

14. TestTest Abnormality detectedAbnormality detected
Blood count and filmBlood count and film Anaemia, leukaemia, disseminatedAnaemia, leukaemia, disseminated
intravascular coagulationintravascular coagulation
Platelet countPlatelet count ThrombocytopeniaThrombocytopenia
Activated partial thromboplastin timeActivated partial thromboplastin time Deficiency of all coagulation factorsDeficiency of all coagulation factors
except VII, especially follows VIII andexcept VII, especially follows VIII and
IX;IX;
heparinheparin
Prothrombin timeProthrombin time Deficiency of factors I, II, V, VII, andDeficiency of factors I, II, V, VII, and
X;X;
warfarinwarfarin
Thrombin time or fibrinogenThrombin time or fibrinogen Hypofibrinogenaemia orHypofibrinogenaemia or
dysfibrinogenaemia; heparin; fibrindysfibrinogenaemia; heparin; fibrin
degradation productsdegradation products
Bleeding timeBleeding time Test of platelet-vessel wall interactionTest of platelet-vessel wall interaction

15.  Treatment with glucocorticoiods
 Splenectomy
 Cytotoxic drugs
 Plasmapheresis
 Symptomatic hemostatic therapy

16.  hematoma

17.  petechia-spotted
(macula)

23. Classification of leukaemia
•Acute lymphoblastic leukaemia (ALL)
•Chronic lymphoblastic leukaemia (CLL)
•Acute myeloid leukaemia (AML)
•Chronic myeloid leukaemia (CML)

24.  It is a rapid progessive form of leukemia
charecterised by replacement of normal bone
marrow blast immature hematopoitic cells without
diffirinting them into normal mature blood ceells/
 Classification:-
acute myeloid leukemia.
acute lymphoblastic leukemia.
nondifferentiability acute leukemia.

25.  Acute onset of the disease
 Features of syndromes hemoblostosis,acute
hemoblastosis.
 Fever
 Emergence of large number of myeloblasts in
the blood
 Signs of anemic syndrome
 Signs of hemorrgic syndrome

26.  COMPLETE BLOOD COUNT:-
 Appearance of large amounts of lymphoblasts
in blood smear test
 Eretropenia(lack of eretrocytes)
 Reticulocytopenia(reticulocytes dicreases)
 Trombocytopenia
 Disappeare of eosinophils and basophils

27.  Cytotoxic drugs
 Glucocarticoids in large doses
 Bone marrow transplantation.
 Treatment of underlying diseases
anemia
infections

28.  This form of leukemia in which the main
morphological substrate (cancer).growths up
riping and mature cells reaches a certain level of
differentation
 CLASSIFICATION:-
chronic myeloid leukemia
chronic lymphocytic leukemia
Polyucythemia
multiple myeloma

29.  Common features of syndrome hemoblastosis
 Specific features of syndrome of chronic
myelogenous hemoblastosis.
 Specific features of anemic syndrome
 Itching

30.  Cytotoxic drugs
 Treatment of radiation therapy
 Splenectomy
 Bone marrow transplantation
 Treatment of underlying diseases