Prabhakar Singh IV Sem-clinical disorder in blood acid-base & blood clotting

1. TEJASVI NAVADHITAMASTU
“Let our (the teacher and the taught) learning be radiant”
Let our efforts at learning be luminous and filled with joy, and endowed with the force of purpose
Paper XII: CLINICAL AND DIAGNOSTIC BIOCHEMISTRY
Dr. Prabhakar Singh. D.Phil. Biochemistry
Department of Biochemistry, VBSPU, Jaunpur
CLINICAL DISORDER IN BLOOD: ACID-BASE & BLOOD CLOTTING

2. DISORDERS OF ACID-BASE
BALANCE

3. MAJOR CLINICAL CAUSES OF ACID-BASE DISORDERS

4. Acid-base disorders along with the concentrations of
bicarbonate (HCO3–) and carbonic acid (H2CO3) in plasma

5. ACID-BASE DISORDERS WITH PRIMARY CHANGES AND
COMPENSATORY MECHANISMS

8. Blood Clotting

17. ACQUIRED PROTHROMBIN COMPLEX DEFICIENCY
A rare disorder where infants with a deficiency of vitamin K suffer problems with
bleeding. It is believed to occur in breast fed infants where the milk from the mother
lacks sufficient vitamin K. low
Causes
Vitamin K deficiency is common among neonates in the first few days postpartum due
to poor placental transfer of vitamin K and inadequate production of vitamin K-
producing intestinal flora. Its other causes include prolonged use of drugs, such as
the anticoagulant warfarin and antibiotics that destroy normal intestinal bacteria;
decreased flow of bile to the small intestine from obstruction of the bile duct or bile
fistula; malabsorption of vitamin K due to sprue, pellagra, bowel resection, ileitis, or
ulcerative colitis; chronic hepatic disease, with impaired response of hepatic ribosomes
to vitamin K; and cystic fibrosis, with fat malabsorption. Vitamin K deficiency seldom
results from insufficient dietary intake of this vitamin.

18. Signs and symptoms
The cardinal sign of vitamin K deficiency is an abnormal bleeding tendency,
accompanied by prolonged prothrombin time (PT); these signs disappear
with vitamin K administration. Without treatment, bleeding may be severe
and, possibly, fatal.
Diagnosis
Confirming diagnosis A PT that is 25% longer than the normal range of 10 to 20
seconds, measured by the Quick method, confirms the diagnosis of vitamin K
deficiency after other causes of prolonged PT (such as anticoagulant therapy or
hepatic disease) have been ruled out. The International Normalized Ratio
(normal value, 0.8 to 1.2) is the more common method of assessing PT adequacy.
Repetition of testing in 24 hours (and regularly during treatment) monitors the
therapy is effectiveness.

19. HYPOPROTHROMBINEMIA
Hypoprothrombinemia is a rare blood disorder in which a deficiency in
immunoreactive prothrombin (Factor II), produced in the liver, results in an
impaired blood clotting reaction, leading to an increased physiological risk for
spontaneous bleeding.
This condition can be observed in the gastrointestinal system, cranial vault, and
superficial integumentary system, effecting both the male and female
population.
Prothrombin is a critical protein that is involved in the process of hemostasis, as
well as illustrating procoagulant activities.
This condition is characterized as an autosomal recessive inheritance congenital
coagulation disorder affecting 1 per 2,000,000 of the population, worldwide,
but is also attributed as acquired.