Non-Hodgkin Lymphoma NHL

-The neoplastic transformation of both the B and T cell linegaes of lymphatic cells

-Causes :

.infectious diorders (HIV,hepatitis C,Epstein-Barr,HTLV-1,H.pylori

.autoimmune diorders

-Symptoms & Signs :

.Is the same as Hodgkin Disease. The difference is that hodgkin disease is localized to cervical and supraclavicular nodes 80-90% of the time,whereas NHL is localized only 10-20% of the time.

**PLATELET DISORDERS

Immune(Idiopathic) Thrombocytopenic Purpura ITP

-Is defined as isolated low platelet count (thrombocytopenia) with normal bone marrow and the absence of other causes of thrombocytopenia

-Causes :

.lymphoma

.CLL

.HIV

.connective tissue disease

.autoimmune condition

-Symptoms & Signs :

.bruises (purpura)

.petechiae (tiny bruises), especially on the extremities

.bleeding from the nostrils and/or gums

.menorrhagia (excessive menstrual bleeding)

-Treatment :

.corticosteroids

.intravenous immunoglobulin

.anti-D immunoglobulin

. immunosuppressive drugs

Von Willebrand Disease vWD

-An increased predisposition to platelet type bleeding from decreased amount of von willebrand factor

-Is the most common hereditary coagulation abnormality described in humans, although it can also be acquired as a result of other medical conditions

-Types of hereditary vWD :

.vWD Type I (M.C type- Asymptomatic)

.vWD Type II

.vWD Type III

-Symptoms :

.bleeding tendency(bruising,nosebleeds and bleeding gums)

.women may experience heavy menstrual periods and blood loss during childbirth.

.severe internal or joint bleeding is uncommon (except for in vWD type III)

-Diagnosed by bleeding time (normal bleeding time 3-8min)

**CAGULOPATHY

Hemophilia A and B

-Hemophilia A (factor 8 deficiency)

-Hemophilia B (factor 9 deficiency)(christmas disease)

-Both hemophilia (A & B) are X-linked recessive diorders resulting in males

-Symptoms :

.prolonged bleeding after circumcision (during surgical procedures or with trauma)

.bruise

.hemarthrosis (M.C),hematoma,GI bleeding

.bleeding in joints (ankle,knee and elbow)

.blood loss in iliopsoas muscle

.life threating bleeding (intracranial-GI bleeding)

-Causes of prolonged PT or PTT :

.prolonged PT (factor 7 deficiency,liver disease,vit K deficiency,warfarin use)

.prolonged PTT (factor 8-9-11-12 deficiencies,heparin use,antiphospholipid anti body)

.prolonged PT and PTT (factor 1-5-10 deficiencies,pathrombin,fibrinogen,vit K deficiency,liver disease,DIC,compined heparin and warfarine ise)

-Labs :

.inc. PTT (2-3)X / normal PT,INR,platelet,vWF

-Treatment :

.DDAVP (desmopressin)

.prophylaxis is recom.

.AVOID (anti-platelet,aspirin)

.desmopressin does not work for hemophilia B

Vitamin K Deficiency

-The deficiency of vit K resulting in dexreased production of factors (2-7-9-10)

-Both the PT and PTT are elevated

-Causes of deficiency vit K :

.dietary deficiency

.malabsorption

.antibiotics that kill the bacteria in the colon that produce vit K

Liver Disease

-Coagulopathy from the decreased production of clotting factors be the liver

-All factors produce in liver EXCEPT (8) and (vWF)

-Factor 8 produced in endothelia cells

-Treatment :

.fresh frozen plasma or cryoprecipitate

+ To stop bleeding in hemophilic baby you have to give (Cryoprecipitate)

Date: 2016-04-22; view: 412