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patho 2 coag

What causes disorders of coagulation defects or deficiencies of one or more clotting factors or CV problems leading to thromboembolic disease
Vit K is indispensable in the synthesis and regulation of normal production of coag factors 2,7,9,10,and anticoag factors protein C and S
Two things can cause abnormal formation of factors or deficiency liver disease(hepatitis, cirrhosis, and acute yellow atrophy)and deficiency of vit. K
One of the most prevalent causes of VIT K deficiency failure of the liver to secrete bile > decreased absorption of vit K
pretreatment with vit K for surgery w/ pts w/ liver disease..route and time frame? 4-8 h before surg, injected
Hemophilia A (classic) most common, def. of factor 8(anti-hemphilic factor)X-linked recessive. affects males transmitted by females
Hemophilia B(Christmas disease) deficiency of factor 9, X linked recessive trait clinically indistinguishable from factor 8 def
hemophilia C factor 11 deficiency, autosomal recessive, both males and females, bleeding less severe
Treatment for bleeding Hemophiliac Plasma, cryo, and factor 8
Thrombocytopenia..platelet count? <100K
platelet count <50K increased risk of hemorrhage with minor trauma
platelet count <10-15K spontaneous bleeding occurs (petechiae, ecchymosis, purpuric spots, bleeding from mucous membranes
platelet count <10K severe bleeding-fatal in GI tract, CNS or resp system
causes of decreased platelets massive blood trans(>10units in 24h)or secondary to other cond. Bone marrow rep.or hypoplasia. also HIT
Thrombocytopenia interferes with hemostasis by preventing the formation of the platelet plug but also stopping the coag cascade
Thrombocytopenic purpura small purplish blotches on the skin, bleeding from many venules or capillaries resulting in small hemmorhages,idiopathic or dev after blood trans.
Immune thrombocytopenic pupura(ITP) common in adult females, sx..bleeding, wt loss, h/a, fever---HIV increase risk for the disease
Treatment for ITP fresh whole blood transfusion, predisone, splenectomy
Thrombocythemia (thrombocytosis) platelet ct >400K asymptomatic until count reaches 1 mil w/ intravasc.thrombosis, hemorhage, or other patho cond appear
primary thrombocynthemia myeloproliferative condition w/ splenomegaly, periodic thrombosis or hemorrhage, h/a, and paresthesia
secondary thrombocynthemia freq. seen in lung, colon, and stomach CA
treatment of thrombocynthemia platelet pheresis together w/ myelosuppresive therapy
In sickle cell anemia what causes increased thrombosis? HbS is exposed to low O2, RBC's sickle and crystals form,can't pass through capillaries, cells rupture=>icterus=>^thromb.=>hemolytic anemia=>decreased O2 transport=>dec.[O2]=>more sickle cells form
DIC acquired clinical syndromew/ increased protease activityin the blood caused by unregulated release of thrombin w/ subsequent fibrin formation and accelerated fibrinolysis
DIC results from large amounts of traumatized or dying body tissue that release great quantities of tissue factor into the blood thus activating clotting.
clinical conditions assoc w/ DIC Arterial hypot, hypoxemia, acidemia, stasis of capillary BF
DIC is precipitated by endothelial damage, tissue damage, direct activation of coag. factor X, but most common cause is infection..gram - bact, fungi, protozoa and viruses
Why does DIC cause hemorrhage? The amt of thrombin entering the circulationduring DIC exceeds the ability of the body's antithrombins(prot C and S and AT 3) to regulate it which results in an unrestricted clot formation that uses up all clot. factors=>hemorrhage
clinical manifestations of DIC simultaneous bleeding at least at 3 unrelated sites with microvascular thrombosis=>improper perfusion and organ system dysfunction
thromboembolic disease effects on arterial system forward occlusion, ischemia, necrosis, gangrene
Thromboembolic disease effect on venous system Deep vein thrombosis=>pulmonary thromboembolism
DIC treatment remove underlying cause, restoration of proper coag-fibrinolysis balance(heparin, platelets, other coag factors)and maintenance of organ viability
Major Etiologies of DIC OB complications, trans rxn, infections, leukemia,crush injuries, acute liver disease, IABP, vascular disorders
Created by: jenbirne69