Dr.

Amna Yaseen
 Thromboplastin

Fibrin stabilizing factor

 A bleeding disorder is a condition that affects the way
your blood normally clots. The clotting process, also
known as coagulation, changes blood from a liquid to
a solid.
 When you’re injured, your blood normally begins to
clot to prevent a massive loss of blood. Sometimes,
certain conditions prevent blood from clotting
properly, which can result in heavy or prolonged
bleeding.
 Bleeding disorders can cause abnormal bleeding both
outside and inside the body.
 Some disorders can drastically increase the amount of
blood leaving your body.
 Others cause bleeding to occur under the skin or in
vital organs, such as the brain.
 Bleeding disorders often develop when the blood
can’t clot properly. For blood to clot, your body needs
blood proteins called clotting factors and blood cells
called platelets.
 Normally, platelets clump together to form a plug at
the site of a damaged or injured blood vessel. The
clotting factors then come together to form a fibrin
clot. This keeps the platelets in place and prevents
blood from flowing out of the blood vessel.
CONDITIONS CAUSING EXCESSIVE
BLEEDING IN HUMAN BEINGS

 Bleeding caused by
1. Deficiency of clotting
factors
2. Hemophilia
3. Thrombocytopenia
 Mainly of prothrombin, factor
VII, factor IX & factor X
deficiency
 Clotting factors are mainly
synthesized in liver
 Vit. K is necessary for their
synthesis
1. Liver disease
Any liver disease can cause
deficiency of clotting factors
leading to excessive bleeding
 e.g. Hepatitis, Cirrhosis
 Necessary for synthesis of clotting factors
 Synthesized in GIT by bacteria

1. In GI disease vitamin K deficiency may occur due to

poor absorption of fats.
2. However, in GIT disease, vitamin K deficiency often
occurs as a result of poor absorption of fats from
the GIT tract.
3. The reason is that vitamin K is fat soluble and
ordinarily is absorbed in to the blood along with
the fats.
 One of the most prevalent causes of vitamin
K deficiency is failure of the liver to secrete
bile in to the gastrointestinal tract.

 Obstruction of bile duct and liver diseases.

 Lack of bile prevents adequate fat digestion

and absorption and therefore depresses
vitamin K absorption as well.
2. HEMOPHILIA
 Is a bleeding disease
 85% due to deficiency of factor VIII –
classic hemophilia or hemophilia A
 15% caused by deficiency of factor
IX
 Disease occurs exclusively in males
 Women have hemophilia because at least one
of her two X chromosomes will have the
appropriate genes.
 If one of her X chromosomes is deficient, she
will be a hemophilia carrier, transmitting the
disease of half of her male offspring and
transmitting the carrier state to half of her
female offspring.
 The bleeding trait in hemophilia can have
various degree of severity, depending on the
character of the genetic deficiency.
 Bleeding usually does not occur except after
trauma, but in some patients the degree of
trauma required to cause sever and
prolonged bleeding may be so mild that it is
hardly noticeable.
 For instance bleeding can often last for days
after extraction of a tooth.
 Two active component.
 Large and small component.
 Small-intrinsic pathway for clotting-cause
deficiency of factor VIII, called classic
hemophilia.
 Large –, called von Willebrand’s disease.
 Treatment: injection of purified factor VIII.
 Very low number of platelets in
circulating blood.
 Bleeding usually occurs from very
small vessels or capillaries-causing
small punctate hemorrhages
 Skin displays small, purplish blotches –
thrombocytopenia purpura
 Bleeding may occur – platelet less
than 50,000.
 Thrombocytopenia of unknown
cause – idiopathic thrombocytopenia
 Treatment is to give fresh whole
blood transfusions
 Splenectomy
THROMBUS:
Any abnormal clot formation in
blood vessels
EMBOLI:
Freely flowing clots are called
emboli
The causes of thromboembolic
conditions in the human being are
usually twofold:
1) Roughened endothelial surface of
blood vessel
2) Slow flowing of blood
 T-PA (Tissue plasminogen activator) is
injected to dissolve the clot
 Converts plasminogen to
plasmin, that dissolves the
clot
 Usually in bed ridden patients due to
stasis of blood
 Sometimes growing upto iliac vein & IVC
 Occasionally disengages & travels with
blood to right side of heart & then into
pulmonary arteries causing massive
pulmonary embolism
 T- PA is life saving
 Clotting mechanism becomes activated in
wide spread areas of body
 Results from traumatized or dying tissue
in body – releases large quantity of tissue
factor in body
 Usually occurs in septicemia
 Plugging of arteries leads to deficient
delivery of oxygen – circulatory shock
LEUKOPENIA
 A condition in which bone marrow produces very
few WBCs leaving body unprotected against
bacteria & other invading agents
 Human body lives in symbiosis with many
bacteria
 Within 2 days after bone marrow stops producing
WBCs, these bacteria invade adjacent tissues
 Bacteria start forming ulcers & then invade
through these ulcers to tissues & blood stream
 Death may occur in less than a week in severe
leukopenia

CAUSES:
 Exposure of body to x-rays, gamma rays
 Drugs(chloramphenicol, thiouracil)
 Certain chemicals(containing benzene)
TREATMENT:
 Adequate transfusions
 Antibiotics
The symptoms can vary depending on the
specific type of bleeding disorder. However,
the main signs include:
 unexplained and easy bruising
 heavy menstrual bleeding
 frequent nosebleeds
 excessive bleeding from small cuts or an injury
 bleeding into joints