-Is a pathological process characterized by the widespread activation of the clotting cascade that results in the formation of blood clots in the small blood vessels throughout the body
-Symptoms & Signs :
.shock
.amniotic fluid embolism
.multiorgan failure
.widespread bleeding
-Causes disseminated intravascular coagulation :
.Gram negative septicemia
.Falciparum malaria
.solid tumors and blood cancers (particularly acute promyelocytic leukemia)
.obstetric complications: abruptio placentae, preeclampsia or eclampsia, amniotic fluid embolism
.trauma, burns, hyperthermia, rhabdomyolysis, extensive surgery
.sepsis or severe infection (bacterial infections are the most common): bacterial (Gram-negative and Gram-positive sepsis), viral, fungal, or protozoan infections
.transfusion reactions
.severe allergic or toxic reactions (i.e. snake or viper venom)
.giant hemangiomas (Kasabach-Merritt syndrome)
.large aortic aneurysms
.liver disease
.HELLP syndrome
.thrombotic thrombocytopenic purpura
.emolytic uremic syndrome
..malignant hypertension
+The most helpful and reliable bedside platelet function is (Bleeding time)
+Stored blood is deficient in Factor 8
Heparin-Induced Thrombocytopenia HIT
-It can occur with any form of heparin
-Form of heparin :
.IV unfractionated heparin (more common )
.low molecular weight LMW
+Anticoagulant effect of heparin is based on Potentiation of antithrombin III
+The most useful test in monitoring heparin therapy is Partial thromboplastin time (PTT)
+Important uses of acetylsalicylic acid (aspirin) include :
.Acute rheumatic fever
.Antipyretic
.Transient ischemic attacks
.Mild migraine headache
+Drugs should not be given together Warfarin and aspirin
+Contraindications to the use of streptokinase therapy include (thrombolysis medication in some cases of myocardial infarction ‘heart attack’) :
.Bleeding peptic ulcer
.Infective endocarditis
.Surgery to eye
.pregnancy
.pancreatitis
.active internal bleeding
.stroke
.hypertension
.trauma
.Severe hepatic insufficiency
+Protamine sulfate anti-coagulant (heparin)
BLOOD TRANSFUSION
-Complications of blood transfusion / potential risk :
.Hypothermia
.Hypocalcemia
.Hyperkalemia
.Thrombocytopenia
.Hemolytic reactions
.Anaphylactic reactions
.Hepatitis C
.HIV infection
.Acute congestive heart failure
.Transmission of infection
.Transfusion reaction
.Acidosis
.Impaired hemostasis
.Citrate toxicity
.Impaired oxygen delivery
.Incompatibility
.Non-cardiogenic pulmonary edema
+The most fatal complication of blood transfusion is (Human error)
+Diseases are transmitted through blood transfusion :
.Syphilis
.Malaria
.Hepatitis B and C
.Epstein-Bar virus
.Helicobacter Pylori (are NOT)
+In vascular injury the immediate response that produce hemostasis is (Vasoconstriction)
+Platelets normally have a half life of (7 days)
+In human being, normal red blood cell survival time is approximately (120 days)
+Generalized increased pigmentation may be seen in (skin) :
-Refers to lymph nodes which are abnormal in size, number or consistency and is often used as a synonym for swollen or enlarged lymph nodes
-Types :
.Localized lymphadenopathy (due to localized spot of infection e.g., an infected spot on the scalp will cause lymph nodes in the neck on that same side to swell up)
.Generalized lymphadenopathy (due to a systemic infection of the body e.g., influenza or secondary syphilis)
.Persistent generalized lymphadenopathy (PGL) (persisting for a long time, possibly without an apparent cause)
.Dermatopathic lymphadenopathy (lymphadenopathy associated with skin disease)
-Causes :
.infection (bacterial or viral), or chronic infections (tuberculous lymphadenitis,cat-scratch disease)
.infectious mononucleosis is an acute viral infection caused by Epstein-Barr virus
.autoimmune disease (sarcoidosis)
.malignancy
.toxoplasmosis (parasitic disease such as toxoplasmosis)
.HIV infection
.bites from certain venomous snakes such as the pit viper
.drugs (phenytoin)
**Polycythemia (erythrocytosis)
Is a disease it can due to increase in the number of red blood cells
-Causes :
.Cushing’s syndrome
.Primary hepatoma
.Heavy smoking
.High altitudes
.Hepatoma
.Right to the left shunt
.Hematoma
.Fibroma of uterus
.Massive uterine fibroma
.Renal cell carcinoma
Thrombocytopenia
-Refer to a disorder in which there is a relative decrease of thrombocytes, commonly known as platelets, present in the blood (A normal human platelet count ranges from 150,000 to 450,000 platelets per microliter of blood)
-Causes :
*Decreased production
.Dehydration, Vitamin B12 or folic acid deficiency
.Leukemia or myelodysplastic syndrome or aplastic anemia
.Decreased production of thrombopoietin by the liver in liver failure