1. Haematology

2. Haemostasis

3. The involvement of blood vessels, platelets and blood coagulation in haemostasis

4. Vascular bleeding disorders:
.The underlying abnormalities are either in the vessels themselves
perivascular connective tissue.
Each could be
Inherited
Acquired

6. Inherited vascular disorders Hereditary haemorrhagic telangiectasia
autosomal dominant trait.
There are dilated microvascular swellings
appear during childhood and become more numerous in adult life.
These telangiectasia develop in the skin, mucous membranes and internal organs

8. Ehlers-Danlos syndrome
hereditary collagen abnormalities with purpura resulting from defective platelet aggregation hyperextensibility of joints and hyperelastic friable skin

9. Acquired vascular defect
Simple easy bruising Purpura associated with infections Senile purpra Scurvy The Henoch-Schonlein syndrome Steroid purpura

11. b a

12. Henoch –Sconlein syndrome
immune complex (typeIII) hypersensitivity reaction usually found in children often following acute infection The characteristic purpuric rash accompanied by localized edema & itching is often most prominent on the buttocks &extensor surfaces of lower legs & elbows Painful joint swelling, haematuria & abdominal pain may also occur.

13. Thrombocytopenia

16. 3-Abnormal distribution of platelets
*splenomegaly
4-Dilutional loss
*Massive transfusion of stored blood

18. Hereditary disorders Acquired disorders Antiplatelet drugs Uraemia
Thrombasthenia (Glanzmann's disease)
Bernard-Soulier syndrome
Storage pool diseases
Acquired disorders Antiplatelet drugs
Hyperglobulinaemia
Myeloproliferative and myelodysplastic
Disorders
Uraemia
Heparin, dextrans, alcohol and
radiographic contrast

21. Assessment of Coagulation
1.Clinical assessment.
2.Labroratory assessment.

22. Laboratory assessment of Coagulation:
Bleeding time:
Platelet counts:
Prothrombin time (PT):
Partial thromboplastin time (PTT):
Thrombin time (TT):

24. Case
A 5 yr old boy presents with a haemarthrosis of the right knee. Coagulation studies show normal PT ,normal bleeding time,normal TT, prolonged APTT .
Explain the coagulatin defect?

27. The defect is in the intrinsic pathway .
Haemophillia A or
Haemophillia B
Factor assay.

28. Haematoma

29. DIC

30. Lab. Findings: 1 .The platelet count is low.
2. Fibrinogen concentration low.
3 .The thrombin time is prolonged.
4 .High levels of fibrin degradation products such as D -dimers are found in serum and urine.
5. The PT and APTT are prolonged .
 6. bleeding time is prolonged.

31. THANK YOU