Chapter 059 Bleeding and Thrombosis (Part 2) potx

... 059. Bleeding and Thrombosis (Part 2) Coagulation is initiated by tissue factor (TF) exposure, which, with factor (F)VIIa, activates FIX and FX, which in turn, with FVIII and FV as cofactors, ... (Fig. 59 -2). Thrombin also activates factor XIII (fibrin-stabilizing factor) to factor XIIIa, which covalently cross-links and thereby stabilizes the fibrin clot. Figure 5...

Ngày tải lên: 07/07/2014, 01:20

... Chapter 059. Bleeding and Thrombosis (Part 4) Approach to the Patient: Bleeding and Thrombosis Clinical Presentation Disorders of hemostasis ... contributed to the bleeding or thrombotic state. In addition, the history can give clues as to the etiology by determining (1) the bleeding (mucosal and/ or joint) or thrombosis (arterial and/ or venous) ... trauma/s...

Ngày tải lên: 07/07/2014, 01:20

... Chapter 059. Bleeding and Thrombosis (Part 1) Harrison's Internal Medicine > Chapter 59. Bleeding and Thrombosis Bleeding and Thrombosis: Introduction The ... procoagulant and anticoagulant forces. The procoagulant forces include platelet adhesion and aggregation and fibrin clot formation; anticoagulant forces include the natural inhibitors of...

Ngày tải lên: 07/07/2014, 01:20

... Chapter 059. Bleeding and Thrombosis (Part 3) Sites of action of the four major physiologic antithrombotic pathways: ... (PAIs), specifically PAI1 and PAI2, inhibit the physiologic plasminogen activators; and (2) α 2 antiplasmin inhibits plasmin. PAI1 is the primary inhibitor of tPA and uPA in plasma. α 2 antiplasmin ... sensitive markers of blood clot formation, a...

Ngày tải lên: 07/07/2014, 01:20

... Chapter 059. Bleeding and Thrombosis (Part 5) Epistaxis is a common symptom, particularly in children and in dry climates, and may not reflect an underlying bleeding disorder. ... hereditary hemorrhagic telangiectasia and in boys with vWD. Clues that epistaxis is a symptom of an underlying bleeding disorder include lack of seasonal variation and bleeding that...

Ngày tải lên: 07/07/2014, 01:20

... factor pathway inhibitor. Chapter 059. Bleeding and Thrombosis (Part 6) Underlying Systemic Diseases that Cause or Exacerbate a Bleeding Tendency Acquired bleeding disorders are commonly ... obesity, and genetic predispositions. Factors that increase risks for venous and both venous and arterial thromboses are shown in Table 59-3. Age Antiphospholipid antibody...

Ngày tải lên: 07/07/2014, 01:20

... to the threshold for thrombosis and result in deep venous thrombosis (DVT). Note: The magnitude and duration of risk portrayed in the figure is meant for example only and may not precisely ... Venous thrombosis: A multicausal disease. Lancet 353:1167, 1999.] Laboratory Evaluation Careful history taking and clinical examination are essential components in the assessment of...

Ngày tải lên: 07/07/2014, 01:20

... abnormalities is shown in Table 59-4. Chapter 059. Bleeding and Thrombosis (Part 8) Screening Assays The most commonly used screening tests are the PT, aPTT, and platelet count. The PT assesses ... reagents to clotting factor deficiencies and to inhibitors such as heparin and lupus anticoagulants. Thus, aPTT results will vary from one laboratory to another, and the...

Ngày tải lên: 07/07/2014, 01:20

... medications, and the association between minor defects in aggregation or secretion in these assays and bleeding risk is not clearly established Acknowledgment Robert I. Handin, MD, contributed this chapter ... pregnancy, and medications affect levels of many coagulation factors and their inhibitors. Antithrombin is decreased by heparin and in the setting of acute thrombos...

Ngày tải lên: 07/07/2014, 01:20

... Chapter 026. Confusion and Delirium (Part 2) Epidemiology Delirium is a common disease, but its reported incidence ... inpatients, and the diagnosis is especially problematic in the ICU environment where cognitive dysfunction is often difficult to appreciate in the setting of serious systemic illness and sedation. ... benign prognosis. Delirium has now been clearly associ...

Ngày tải lên: 06/07/2014, 13:20