Disorders Of Hemostasis

Clinical Characteristics of Bleeding Disorders

Feature

Platelet/Vascular Defect

Coagulation Defect

Site

Skin, mucous membranes

Deep in soft tissues (muscles, joints)

Lesions

Petechiae. ecchymoses

Hemarthroses. hematomas

Bleeding

After minor cuts: yes

After minor cuts: unusual

After surgery: immediate, mild

After surgery: delayed, severe

Purpura

• Nonblanching purple red lesions due to extravasation of RBCs into dermis

• Nonpalpable (macular: 3 mm in diameter petechiae: 3 mm ecchymoses)

platelet disorder thrombocytopenia, defect in platelet function thromboemboli: DIC.TTP. cholesterol or fat emboli vascular fragility: amyloidosis. Ehlers-Danlos. scurvy trauma

vasculitis: leukocytodastic, HSP. PAN. RMSF

infectious emboli: meningococcemia, bacterial endocarditis

Figure 5-3 Approach to abnormal hemotuilt

Abnormal Hemostasls

mucocutaneous

soft tissue

bleeding

bleeding

*

| PLATELET DISORDER|

¡COAGULOPATHY I

/ \

/

\

/ noanal

© personal

© personal

i platelet platelet count

& family Hx

& family Hx

count

it

\

J i plateletfunction

congenital

acquired

/ \

(eg. hemophilia,

(eg. meds. liver

thrombocytopenia ®Hx OHx

vWD)

disease, vitamin K

/K V ' *

defic.. DIC)

/ \ congenital acquired

/ \ Xfeg.vWD) (eg, meds.

/ \ \ uremia)

Hx. CBC. smear. BMBx

i \ X

1 production * destruction splenic

(eg. aplastic (eq. ITP. sequestration

anemia) DIC, TTP)

Was this article helpful?

0 0

Post a comment