Bleeding Disorders
Coagulopathy
Causes
Coagulopathy results in excessive bleeding and a lack of clotting. the causes are :
Congenital
Hemophilia : congenital disease characterized by coagulopathy; an example of severe lack of blood clotting.
deficiency of clotting factors
Acquired
Anticoagulation with warfarin
Liver failure
Disseminated intravascular coagulation
Rattlesnakes and viper poison
Clinical Manifestations
Idiopathic thrombocytopenic purpura :
Petechiae purpuric spots - ecchymoses - epistaxis - excessive menstruation - Platelet count between 5000 and 20000/ cubic mm.
Hemophilia : A & B
Hereditary bleeding disorder, X - linked - males affected - females carriers
A :- defect or deficiency of coagulation VIII
B :- defect or deficiency of factor IX
recognized in early childhood
haemarthrosis
intracranial harmorrhage due to injury
bleeding after dental extraction
von Willebrand's disease :
deficiency of von Willebrand factor. vWF is necessary for factor VIII activity
Liver disease
vit K deficiency occurs, prolongation of prothrombin time may occur
ecchymoses, bleeding from peptic ulcers, varices
fresh fozen plasma helps
Disseminated intravascular coagulopathy
blood clots inside vessels - all coagulation factors are utilized leading to deficiency
platelet count decreases, fibrinogen level falls
prothrombin time, partial thromboplastin time prolonged
fibrin degradation products (D-dimers) level increased
cryoprecipitate and fresh frozen plasma for treatment, underlying cause corrected.
