Zusammenfassung der Ressource
Sana with Rach and
Easy bruising
- Thrombopoiesis
- Process by which mature platelets are
generated within the bone marrow.
- Function
- -Hemostasis -Membrane receptors
-Actin, myosin & thrombosthenin
-Fibrin-stabilizing factor -Growth factors
- Hemostasis means
prevention of blood loss.
- 1-vasoconstriction
- 2-formation of blood clot
- 3-Blood coagulation to
form a blood clot
- mechanism
- bleeding disorder
- investigations
- causes
- thrombocytopenia: below
Below 20,000 cells/ul
- caused by:
- 2-Decreased production:
Aplastic aneamia- megaloblastic
anemia-drugs- infectionHIV-
leukemia
- 1-Decreased survival: immune
thrombocytopenic purpura (ITP)-drug
induced (heparin- quinidine)-Dissiminated
intravascular coagulopathy (DIC)-
thrombotic thrombocytopenic purpura
(TTP)
- DIC:Systemic activation of coagulation
factors – formation of microthrombi
throughout the circulation-consumptive
coagulopathy.
- secondary to many condition:
-Obstetric: MAJOR OB complications;
toxemia, sepsis, abruptio placenta,
retained dead fetus -Infections:
Gm-, meningococcemia, fungi,
Malaria -Many neoplasms; AML,
adenocarcinoma -Massive tissue
injury; trauma, burns, surgery
- Heparin induced thrombocytopenia
- IgG bind to platelet factor 4 on
platelet membrane in a heparin
dependent fashion leading to
platelet activation platelet
aggregation resulting in
thrombosis.
- Vascular Bleeding Disorders
- 1-Congenital defects of the
vessel wall: Ehlers- Danlos
syndrome
- 2-Senile purpura: defect in
the subcutaneous tissue
supporting the bvs
- 3-Scurvy vitamin: C deficiency
- 4-Septic Vasculitis
Infections
:(meningococcaemia,
infective endocarditis,
measles, rickettsia)
- plasma abnormalities
- types
- Idiopathic
thrombocytopenic
purpura (ITP)
- disorder that can lead to easy or excessive
bruising and bleeding. The bleeding results
from unusually low levels of platelets
- types
- pathophysiology
- An autoantibody usually an IgG will be formed in
the spleen and that antibody will be directed
against certain glycoproteins on the platelet
surface (llb/lib, lb/IX) . After the binding of the
antibody to the platelet surface, circulatng
antibody-coated platelet are recognised by the
Fc receptor on splenic macrophages, it will be
ingested and destroyed.
- common risk factors
- -Genetics:Having close relatives who have also
been diagnosed with ITP can sometimes increase
the risk -Gender -Age -Receiving certain
vaccines. Although very rare, some vaccinations
can “trigger” ITP. -Viral infections. Sometimes, after
a bout with the mumps, measles or other viruses,
children can get ITP.
- signs & symptoms
- either internal
or external
bleedin
- bleeding include: Petechiae (< 3mm) Purpura (3-10 mm)
Ecchymoses (> 1 cm) Hematoma Nosebleeds or bleeding from
the gums Blood in urine or stool Any kind of bleeding that's hard
to stop could be a sign of ITP Menstrual bleeding that's
heavier than normal
- Diagnosis
- CBC: low platelet count
- bone marrow biopsy & inspiration: normal
to increased megakaryocytes to
compensate for the platelets loss
- PT& PTT for coagulation
cascades: normal
- peripheral smear
- Complications
- -Menorrhagia
-Intracranial bleeding is
rare -Petechial rash
-Epistaxis -gum bleeding
-Easy bruising
- management
- -Stop using any drug that might inhibit platelet
function- Drugs that suppress your immune
system -Injections to increase your blood
count:injection of immune globulin (IVIG) -Drugs
that boost platelet production
- treatment
- -Steroids + Steroid-sparing agents
-IVIG or Anti Rh (D)- immunoglobulin
-Rituximab -Platelets transfusion
- Treatments for Resistant Disease
- -Other drugs. Azathioprine (Imuran,
Azasan) has been used to treat ITP.
- Removal of the spleen. (splenectomy)
- spleen
- function:- filter for blood as part of the immune system.- Old red blood
cells are recycled in the spleen, and platelets and white blood cells are
stored there. -helps fight certain kinds of bacteria that cause
pneumonia
- recommended that people with asplenia are vaccinated
against Neisseria meningitidis, Haemophilus influenzae, and
Streptococcus pneumoniae. AKA SHiN.