Hemostasis ●BT,(CT) PT BV Iniury . PTt Neural Damage/contact Contact Blood vessel Coagulation Constriction Aggregation Cascade Primary hemostatic plug Reduced Platelet Activation FIbrin Blood flow formation Platelet study Stable Hemostatic Plug Antibody tests Factor Assay I
Hemostasis BV Injury Platelet Aggregation Platelet Activation Blood Vessel Constriction Coagulation Cascade Stable Hemostatic Plug Fibrin formation Reduced Blood flow Damage/contact. Primary hemostatic plug Neural •CBC-Plt •BT,(CT) •PT •PTT Platelet study Antibody tests Factor Assay Contact
HEMOSTASIS Primary Hemostasis Blood vessel contraction Platelet Plug formation Secondary Hemostasis Activation of Clotting Cascade Deposition Stabilization of Fibrin Tertiary Hemostasis Dissolution of fibrin clot Dependent on Plasminogen Activation
HEMOSTASIS Primary Hemostasis – Blood vessel contraction – Platelet Plug Formation Secondary Hemostasis Activation of Clotting Cascade Deposition & Stabilization of Fibrin Tertiary Hemostasis Dissolution of Fibrin Clot Dependent on Plasminogen Activation
Clinical Approach to Bleeding Disorders Clinical Evaluation(who, when, where, what) Laboratory studies Approach to The Patient
Clinical Approach to Bleeding Disorders Clinical Evaluation(who, when, where, what) 2 Laboratory Studies Approach to The Patient
Tests of hemostasis "Screening tests Bleeding. T-10m. Platelet BV function Prothrombin,- Extrinsic, aPtt- Intrinsic Thrombin T-common path. DIC ° Specific tests: Factor assays - hemophilia Tests of thrombosis- Tt FDp Platelet function studies. Adhesion, Aggregation, Release tests Bone marrow study
Tests of Hemostasis: • Screening tests: – Bleeding.T - 10m. Platelet & BV function – Prothrombin.T – Extrinsic, APTT – Intrinsic – Thrombin.T – common path. (DIC) • Specific tests: – Factor assays – hemophilia. – Tests of thrombosis – TT, FDP, – Platelet function studies: • Adhesion, Aggregation, Release tests. – Bone Marrow study
Bleeding: Clinical Features Local-Vs-General, spontaneous Hematoma/ Joint Bleeds-Coag Skin/Mucosal bleeds-PLT wound/surgical bleeding Immediate-PLT Delayed -Coagulation
Bleeding: Clinical Features • Local - Vs - General, spontaneous . . • Hematoma / Joint Bleeds- Coag • Skin / Mucosal Bleeds – PLT • wound / surgical bleeding – – Immediate - PLT – Delayed - Coagulation