Hema B

Front 1

Antithrombin 3, Protein C, Protein S

Back 1

Natural anticiagulants that lyse fibrin clots

Front 2

Platelet aggregometry

Back 2

What to request if there is marked prolonged PT, normal platelet count and abnormal CRT

Front 3

Factor Assay

Back 3

What to request if with abnormal PTT, PT

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Petechiae

Back 4

Typical of platelet disorders, do not blanch with pressure, not palpable

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Ecchymoses Purpura

Back 5

Typical of coagulation, bigger, palpable, blanches with pressure

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Platelet Disorder

Back 6

Bleeding at skin, mucous membranes

Front 7

Platelet Disorders

Back 7

There is bleeding after cuts, scratches

Front 8

Platelet Disorders

Back 8

Immediate and mild bleeding after surgery

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Coagulation Factor Disorder

Back 9

Bleeding deep in soft tissur

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Coagulation Factor Disorder

Back 10

Delayed bleeding after surgery/trauma

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Allergic Vascular Purpura

Back 11

No thrombocytopenic purpura with allergic symptoms

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Allergic Vascular purpura

Back 12

Normal PT, PTT, BT, CRT

Front 13

Immune Thrombocytopenic Purpura

Back 13

Occurs 1-4 weeks after exposure to a common viral infection

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Immune Thrombocytopenic Purpura

Back 14

Accelerated destruction of sensitized paltelets by phagovytic cells in the reticuloendithelial system

Front 15

Raise platelet count to >20,000 and prevent ICH

Back 15

Objective of early therapy in ITP

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Immune Thrombocytopenic Purpura

Back 16

Severe thrombocytopenia, normal hemoglobin, WBC, bone marrow aspiration

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Splenectomy

Back 17

Tx for older child (>4 yr) with sever ITP ladting >1 year and symptoms not easily controlled

Front 18

IVIG 0.8-1 g/kg/day

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Treatment in ITP to increase platelet count

Front 19

Chronic Autoimmune Thombocytopenic Purpura

Back 19

Aimed to to maintain platelet count >50,000

Front 20

Rombiplostin and eltromboag

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Tx ITP to stimulate thrombobopoies

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Hemophilia

Back 21

Deficiency of F VIII and IX

Front 22

Hemophilia

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Most common severe inherited bleeding disorder

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Hemophilia A

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Deficiency of F VIII

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Hemophilia B

Back 24

Deficiency of Factor IX

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F VIII and IX, phospholipid and calcium

Back 25

Form tenase or factor X activating complex

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Hemophilia

Back 26

90% have evidence of increased bleeding by 1 yr of age

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Joint-hemarthroses

Back 27

Hallmark of Hemophilia

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Hemophilia

Back 28

Soft tissues-ecchymoses and hematomas, vleeding from inir traumatic lacerations

Front 29

Mild Hemophilia

Back 29

>5% bleeding after severe trauma or surgery

Front 30

Moderate Hemophilia

Back 30

1-5% hemorrhage with mild trauma at intervals ranging from weekly to monthly

Front 31

Severe Hemophilia

Back 31

<1% frequent episodes of bleeding into muscles, joints, skin with minimal or no trauma

Front 32

Emicizumab

Back 32

Humanized monoclonal antibody can bridge activated factor IX and X

Front 33

35-50% Factor Concentrate

Back 33

Given in mild to moderate bleeding in Hemophilia

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100% Factor Concentrate

Back 34

Given in life threatening Hemophilia

Front 35

Desmopressin acetate

Back 35

Given to mild Hemophilia A

Front 36

Acquired Prothrombin Complex Deficiency

Back 36

Postneonatal Vit. K deficiency

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Acquired Prothrombin Complex Deficiency

Back 37

Occuring after the neonstal period in breastfed children

Front 38

Acquired Prothrombin Complex Deficiency

Back 38

Due tk lack of oral ontake of Vit. K, alterations in gut flora due to prolonged intake of broad spectrum antibiotics, liver dse, or malabsorption

Front 39

Acquired Prothrombin Complex Deficiency

Back 39

Change in sensorium, seizures, prolonged PT, PTT

Front 40

Vitamin K, FFP

Back 40

Treatment for Acquired Prothrombin Complex Deficiency

Front 41

Disseminated Intravascular Coagulopathy

Back 41

Thrombotic Microangiopathy

Front 42

Disseminated Intravascular Coagulopathy

Back 42

Results in consumption of clotting factors, platelets and anticoagulant proteins

Front 43

Disseminated Intravascular Coagulopathy

Back 43

Consequence: widespread deposition of fibrin

Front 44

Disseminated Intravascular Coagulopathy

Back 44

Triggers: hypoxia, acidosis, tissue necrosis, shock, endothelial damage

Front 45

Disseminated Intravascular Coagulopathy

Back 45

Bleeding, petechiae, ecchymoses, tissue necrosis, microangiopathic HA

Front 46

Disseminated Intravascular Coagulopathy

Back 46

Low fibrinogen, prothrombin, Factor V and VII

Front 47

Disseminated Intravascular Coagulopathy

Back 47

Prolonged PT, PTT, TT, low platelets, elevated PD, D-dimer assay

Front 48

Treat underlying trigger

Back 48

Treatment for Disseminated Intravascular Coagulopathy

Front 49

Platelets

Back 49

1st given in Disseminated Intravascular Coagulopathy

Front 50

Activated Protein C concentrate

Back 50

Given for DIC due to sepsis

Front 51

Neonatal Alloimmune Thrombocytopenic Purpura

Back 51

Transient, isolated, severe thrombocytopenia

Front 52

Neonatal Alloimmune Thrombocytopenic Purpura

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Caused by development of maternal antibodies against antigens present on fetal platelets that are shared with the father and recognized as foreign

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Neonatal Alloimmune Thrombocytopenic Purpura

Back 53

Results from placental transfer of maternal alloantibodies

Front 54

Neonatal Alloimmune Thrombocytopenic Purpura

Back 54

Platelet equivalent of Rh disease of the newborn

Front 55

Neonatal Alloimmune Thrombocytopenic Purpura

Back 55

Presence of maternal alloantibodies directed against father's platelets

Front 56

Neonatal Alloimmune Thrombocytopenic Purpura

Back 56

Most common cause is incompatibilitybfor the platelet alloantigen HPA-1a

Front 57

Neonatal Alloimmune Thrombocytopenic Purpura

Back 57

Generalized petechiae and purpura within first few days after delivery

Front 58

Neonatal Alloimmune Thrombocytopenic Purpura

Back 58

Severe thrombocytopenia of <10,000 on the first day of life

Front 59

Neonatal Alloimmune Thrombocytopenic Purpura

Back 59

First pregnancies maybe severely affected and subsequent preganacies are often more severely affected

Front 60

Neonatal Alloimmune Thrombocytopenic Purpura

Back 60

Common hemorrhagic manifestations: petechiae, hematomas, GI bleeding

Front 61

Neonatal Alloimmune Thrombocytopenic Purpura

Back 61

In utero bleeding: hydrocephalus, porencephaly, seizures, fetal loss

Front 62

IVIG prenatally to mother at 2nd trimester

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Treatment for Neonatal Alloimmune Thrombocytopenic Purpura

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Cesarian

Back 63

Delivery for mothers with Neonatal Alloimmune Thrombocytopenic Purpura

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Transfusion with washed irradiated maternal platelet

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Treatment for severe NATP

Front 65

IVIG 1g/kg daily for 2 days or methylprednisolone 2mg/kg/d

Back 65

Temporary measures for Neonatal Alloimmune Thrombocytopenic Purpura

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Neonatal Alloimmune Thrombocytopenic Purpura

Back 66

Resolves after 2-4 months

Front 67

Neonatal Autoimmune Thrombocytopenia

Back 67

Occur in infants of mothers with immune thrombocytopenia as a result of ITP, SLE or autoimmune disorders

Front 68

Neonatal Autoimmune Thrombocytopenia

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Caused by placental transfer of maternal autoantibodies

Front 69

Neonatal Autoimmune Thrombocytopenia

Back 69

Considered when both neonate and mother exhibit signs of thrombocytopenia or infants of ,others with previous history of immune thrombocytopenia

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Prenatal administration of corticosteroids

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Treatment to mothers for Neonatal Autoimmune Thrombocytopenia

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IVIG and corticosteroids after delivery

Back 71

Treatment to infants for Neonatal Autoimmune Thrombocytopenia

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Neonatal Autoimmune Thrombocytopenia

Back 72

Usually resolves in 2-4 months

Front 73

Methylprednisolone 2 mg/kg/d

Back 73

Given in addtion or in lieu of IVIG