sana with a rash&easy bruising

cuases of non itchy rash
1. leprosy
2. measles
3. rubella
4. erysipelas
5. zinc deficiency
platelets
1. thrombopoiesis
  1. hemocytoblast
    1. megakryoblast
      1. promegakaryocyte
        megakaryocyte
        platlets
        fragment into
  2. stimulated by
    1. MGDF
    2. IL-6
    3. GMCSF
2. life span 8-12 days
3. function
  1. hemostasis
    1. involoves
      1. clotting factors
      2. endothelium
        NO, PGI2
        VWF
        makes the extracellular collagen more sticky
    2. prevention of blood loss
      1. when a blood vessel is injured
        1) vascular constriction
        neurogenic reflex
        myogenic conctriction
        2) formation of platelet plug
        primary plug
        3) formation of blood clot
        secondary plug
4. TH2
5. alpha& delta granules
  1. attract more platlets
bleeding disorders
1. platelets
  1. function
    1. bernard soulier disease
      1. defficiency in VWF receptors ( glycoprotein 1B)
    2. glannzman throbasthenia
      1. prevent the formation of ThA
  2. number
    1. thrombocytopenia
      1. increased destruction
        immune thrombocytopenic purpura
        Chronic ITP
        adults
        secondary causes
        HIV
        Epstein-Barr virus
        6 months of more
        Acute ITP
        children
        viral antigens
        less than 6 minths
        diagnosis by exclusion
        Autoimmune disease
        production of IgG against platelet antigens
        signs and symptoms
        easy bruising
        petechiae
        less than 3 mm
        purpura
        1 cm
        ecchymosis
        over 1 cm
        blood in urine and stool
        heavy menstrual flow
        bleeding from the gums and nose
        treament
        pharmalogical
        glucocorticods
        side effects
        hypertension
        facial swelling
        osteoprosis
        folliculities
        IV IgG
        side effects
        vomiting
        kidney failure
        Thrombopoietin receptor agonists
        Rituximab
        Anti-(Rh)D
        surgical
        splenctomy
        causes
        ruptured spleen
        cancer
        blood disorders
        enlarged spleen
        complications
        postsplenctomy sepsis
        infections
        Laparoscopic surgery
        open surgery
        stages
        minor normal life style
        moderate troublesome life style
        severe lifethreatening
        internal bleedings
        disseminated intravascular coagulopathy
        medical emergency
        heparin induced thrombocytopenia
        thrombotic thrombocytopenic purpura
      2. decreased production
        leukemia
        aplastic anemia
        megaloblastic anemia
2. clotting factors
  1. inherited
    1. hemophilia
      1. X linked
      2. B
        factor 9 deficiency
      3. A
        factor 8 deficiency
      4. PTT elevated
    2. Von Willbrand disease
      1. Autosomal dominant
      2. absence of VWF
      3. PTT and bleeding time elevated
  2. acquired
    1. Vit K deficiency
      1. PT & PTT elevated
    2. liver disease
      1. deficiency of clotting factors
3. invstigations
  1. PT
    1. extrinsic & common pathway
      1. 12-14 sec
  2. PTT
    1. intrinsic and common pathway
      1. 24-35 sec
  3. bleeding time
    1. 2-7 minutes
  4. CBC
    1. platelet morphology
    2. platelet count
      1. 150,000- 450,000 cells\mm3
4. blood vessels
  1. septic vasculitis
  2. herles danlos disorder
  3. henoc schonlein syndrome
5. history taking
  1. alchohol
  2. family history
  3. medication
    1. aspirin and NSAIDS

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sana with a rash&easy bruising

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Medienanhänge

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