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INTRAVASCULAR
ANTICOAGULANTS
HEPARIN
Negatively charged molecule
Chemically a conjugated polysaccharide
Effectiveness
PLASMIN
OR
FIBRINOLYSIN
profibrinolysin
fibrinolysin
1. Vitamin K deficiency
2. Hemophilias
3. Thrombocytopenia
VITAMIN K DEFICIENCY
Production by gut flora
Absorption affected by antibiotics, GIT & bile
disorders
Special consideration: Infants & neonates
Essential for some clotting factors
synthesized by liver
Glutamic acid residues in clotting factor
precursors & formation of -carboxyglutamate
vitamin K epoxide
reductase complex 1 (VKOR
c1)
HEMOPHILIA
Bleeding disease
Hemophilia A or classic hemophilia
Hemophilia B or Christmas disease
Flip top mutation in genes on X chromosome
Genetic transmission
vWD disease or pseudohemophilia
vWD disease
THROMBOCYTOPENIA
Quantitative decrease in platelets
Platelets and primary haemostasis
50,000 / L leads to bleeding
10,000 / L is usually fatal
Purpuras
Treatment options:
Whole blood transfusion
Spleenectomy
Steroids
Immunosuppressants
THROMBOCYTOPENIA
SYMPTOMS
Bruising
Bleeding
Clotting failure
Petechiae (reddish
purple spots)
Bleeding into skin
Purpura
Oral bleeding
Nosebleeds
Enlarged spleen
Vaginal bleeding
Excessive bleeding
after surgery
Excessive postpartum
bleeding
Gastrointestinal
bleeding
Blood in stool
Black stools
Blood in urine
THROMBO-EMBOLIC
CONDITIONS IN HUMANS
3 major types:
1.
2.
3.
Arterial
Venous
Mural
CAUSES OF THROMBO-EMBOLIC
CONDITIONS
Virchows triad
ENDOTHELIAL
INJURY
THROMBUS
(STASIS)
HYPERCOAGUBILITY
EMBOLUS
A detached intravascular solid, liquid or
gaseous mass that is carried by the blood to
a site distant from its point of origin
Usually thrombotic
Other forms include fat, air or nitrogen
bubbles, bone particles, foreign objects e.g.,
bullet pieces
FEMORAL VENOUS
THROMBOSIS
&
MASSIVE PULMONARY
EMBOLISM
QUESTIONS?