1. The document discusses various bleeding disorders including their causes, symptoms, diagnostic tests, and treatment options. It covers disorders of platelets like ITP and coagulation factors deficiencies like hemophilia A. 2. Evaluation of bleeding disorders involves taking a thorough history and physical exam followed by screening tests like CBC, PT, aPTT. Specific disorders are then diagnosed and treated. 3. Treatment depends on the underlying cause but may include platelet transfusions, coagulation factor replacement, steroids, IVIG, splenectomy, antifibrinolytics, desmopressin, and managing precipitating conditions like infections.

1. Bleeding Disorders By Dr. Sabir M. Ameen

7. Clinical Features of Bleeding Disorders Platelet Coagulation disorders fac disorders Site of bleeding Skin Deep in soft tis. Mucous membranes (joints, musc) Petechiae Yes No Ecchymoses (“bruises”) Small, superficial Large, deep Hemarthrosis / muscle bleeding Extremely rare Common Bleeding after cuts & scratches Yes No Bleeding after surgery or trauma Immediate, Delayed1-2 d usually mild often severe

8. Platelet Coagulation Petechiae, Purpura Hematoma, Joint bl.

9. Petechiae Do not blanch with pressure (cf. angiomas) Not palpable (cf. vasculitis) (typical of platelet disorders)

10. Hemarthrosis

11. Hematoma

12. Petechiae

13. Purpura

14. Ecchymosis

41. Shortening of Achilles tendon

47. Pathogenesis of DIC Coagulation Fibrinolysis Fibrinogen Fibrin Monomers Fibrin Clot (intravascular) Fibrin(ogen) Degradation Products Plasmin Thrombin Plasmin Release of thromboplastic material into circulation Consumption of coagulation factors; presence of FDPs  aPTT  PT  TT  Fibrinogen Presence of plasmin  FDP Intravascular clot  Platelets Schistocytes