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What substances are secreted by activated platelets
Thromboxane A2
Alpha granules-Fibrinogen and von willebrand factor
Delta granules secrete Serotonin, ADP, Calcium
List clotting factors and synonyms
Factor 1 fibrinogen
Factor 2 prothrombin
3 tissue factor
4 calcium
5 labile-factor
7 Serum prothrombin conversion accelerator
8 antihemophilic factor A
9 antihemophilic factor B
10 Stuart factor
11 antihemophilic factor C
12 Hageman factor
13 Fibrin-stabilising factor
Prekallikerin
Platelets
Phospholipids
Hemorrhagic disease of the newborn
All newborn infants by about 48 to 72 hours have a transient decrease in vitamin k dependent factors 2,7,910 with a gradual return to normal by the 7th day, but in preterms especially there is sometimes an accentuating and prolonged effect between the 2nd and 7th day of life results in spontaneous and prolonged bleeding
Hemorrhagic complications present in breastfed infants
What are the differential diagnoses
Early onset(0-24hours):
Inherited coagulopathy
Maternal drugs such as Phenytoin and phenobarbital
Vitamin k defeciency
Classic disease(2-7 days) :
Vitamin k defenciency
Breastfeeding hemorrhage
Late onset(1-6months)
Cholestasis-biliary atresia, cystic fibrosis, hepatitis, warfarin ingestion,
Describe the APT test and what is the principle behind it
Used to differentiate whether blood passed in the stools in the newborn on the 2nd or 3rd day is due to swallowed blood syndrome or hemorrhagic disease of the newborn, adult hemoglobin reacts with alkaline to change color to yellow brown whiles fetal hemoglobin does not
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