Hemorrhagic Diathesis<br />Causes:<br />Increased fragility of vessels<br />Platelet deficiency or dysfunction<br />Derang...
Vessel Wall Abnormalities<br />Common but bleeding is LESS Serious<br />Normal Coagulation test<br />1. Microbial damage t...
3. Drugs – immune complex deposits in vessel wall<br />4. Hemoch-Scheonleinpurpura –  	unknown systemic hypersensitivity 	...
R/T THROMBOCYTOPENIA<br />Decrease production<br />Aplastic anemia<br />Leukemias<br />Megalobalstic anemia<br />Decrease ...
Sequestration – seen in marked splenomegaly<br />Dilutional – blood stored > 24hours has less viable platelets<br />R/T TH...
Idiopathic Immune Thrombocytopenic Purpura ( Autoimmune )<br />1. Acute<br />Self-limited Hgicdisease<br />Resolve w/in 6m...
2. Chronic<br />Adults women < 40y/o<br />Associated with<br />Collagen Vascular Disease<br />CLL<br />HIV<br />Repeated e...
Deposition of Ig fragments in Amyloidosis<br />
Thrombotic Microangipathies<br />I.  Thrombotic Thrombocytopenic Purpura<br />	1. Fever<br />	2. Thrombocytopenia<br />	3....
II. Hemolytic –Uremic Syndrome<br />	1. MicroangiopathicHemolytic anemia<br />	2. Thrombocytopenia<br />	3. Prominence of ...
Widespread formation of hyaline thrombi  in microcircualtion<br />Platelet consumption & Intravascular thrombi<br />Microa...
Plasmin Act.<br />Proteolysis of clotting facotrs<br />
Bleeding
Upcoming SlideShare
Loading in …5
×

Bleeding

717 views

Published on

Published in: Health & Medicine, Technology
0 Comments
2 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
717
On SlideShare
0
From Embeds
0
Number of Embeds
4
Actions
Shares
0
Downloads
27
Comments
0
Likes
2
Embeds 0
No embeds

No notes for slide

Bleeding

  1. 1. Hemorrhagic Diathesis<br />Causes:<br />Increased fragility of vessels<br />Platelet deficiency or dysfunction<br />Derangement of coagulation<br />
  2. 2. Vessel Wall Abnormalities<br />Common but bleeding is LESS Serious<br />Normal Coagulation test<br />1. Microbial damage to Microvasculature or DIC<br />2. Scurvy – Impaired formation of collagen needed for vessel wall support<br />
  3. 3. 3. Drugs – immune complex deposits in vessel wall<br />4. Hemoch-Scheonleinpurpura – unknown systemic hypersensitivity disease involve vessels throughout the body & glomerularmesangium<br />5. Amyloid Infiltration of blood vessels – weakens the wall <br />Vessel Wall Abnormalities<br />
  4. 4. R/T THROMBOCYTOPENIA<br />Decrease production<br />Aplastic anemia<br />Leukemias<br />Megalobalstic anemia<br />Decrease platelet survival<br />Immune – mediated<br />Non-immune – mechanical <br />
  5. 5. Sequestration – seen in marked splenomegaly<br />Dilutional – blood stored > 24hours has less viable platelets<br />R/T THROMBOCYTOPENIA<br />
  6. 6. Idiopathic Immune Thrombocytopenic Purpura ( Autoimmune )<br />1. Acute<br />Self-limited Hgicdisease<br />Resolve w/in 6mos.<br />Children after Viral infxn 2 week later  Sudden petechiae, purpura<br />Risk for cerebral bleed<br />Severe cases Tx w/ corticosteroids<br />
  7. 7. 2. Chronic<br />Adults women < 40y/o<br />Associated with<br />Collagen Vascular Disease<br />CLL<br />HIV<br />Repeated episodes of Bleeding<br />Tx Steroids. IgG, Splenectomy in severe cases<br />Idiopathic Immune Thrombocytopenic Purpura ( Autoimmune )<br />
  8. 8.
  9. 9. Deposition of Ig fragments in Amyloidosis<br />
  10. 10.
  11. 11.
  12. 12.
  13. 13. Thrombotic Microangipathies<br />I. Thrombotic Thrombocytopenic Purpura<br /> 1. Fever<br /> 2. Thrombocytopenia<br /> 3. Microangioapthic hemolytic anemia<br /> 4. Transient Neurological damage<br /> 5. Renal Failure<br />Deficiency of ADAMTS 13 enzyme<br />Results to accumulation of VHMW vWF promote widesopread platelet Microaggregation<br />
  14. 14. II. Hemolytic –Uremic Syndrome<br /> 1. MicroangiopathicHemolytic anemia<br /> 2. Thrombocytopenia<br /> 3. Prominence of renal failure<br /> 4. No Neurological damage<br />Hx of Enteric infection E. coli<br />Release of Shiga –like toxin  Absorbed in GIT  Binds and Damage endothelial cells in Glomerulus & other sites  Platelet Activation & Aggregation<br />Thrombotic Microangipathies<br />
  15. 15. Widespread formation of hyaline thrombi in microcircualtion<br />Platelet consumption & Intravascular thrombi<br />Microangiopathic hemolytic anemia<br />Multiple Organ failure<br />Activation of coagualtion cascades is NOT OF PRIMARY IMPORTANCE<br />PT/PTT – usually Normal<br />Thrombotic Microangipathies<br />
  16. 16. Plasmin Act.<br />Proteolysis of clotting facotrs<br />

×