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Lecture 08 - Platelets in Hemostasis and Thrombosis

Lecture 08 - Platelets in Hemostasis and Thrombosis -...

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Lecture 09 – Thrombocytosis/Thrombocytopenia Clinical Findings: Platelet plug formation defects Fibrin plug formation or stability Petechiae > purpura > ecchymosis o Pin point hemorrhage o Cue to thrombocytopenia or platelet dysfunction Spontaneous mucosal bleeding (platelet count is low) o Bleeding in the month for example Immediate bleeding post-trauma (doesn’t stop bleeding b/c there is low platelet counts) Venipuncture site bleeding Retinal hemorrhages; blood blisters in mouth (swelling in the mouth with blood) o **when platelet count is very low (Often less than 10,000-5,000 lower limits compared to 150,000 normally o Signs = hemorrhages Spontaneous joint or IM bleed o NO MUCOSAL BLEEDING o Spontaneous bleeding = (FVIII, IX, XI, 8,9,11) o Into joints is never seen in platelet defects in hemophilia Delayed bleeding post-trauma Circumcision, delayed umbilical stump bleeds (don’t worry about this) (VIII, IX, XIII) ** no mucosal bleeding Petechial Bleeding: pinpoint needle in the skin, dependent part of the body (legs) Senile Purpura: purpura that are bigger than petechial bleeding small the ecchymosis (low platelet count; on corticosteroids); can be anywhere Scurvy: pinpoint hemorrrages in the skin @ HAIR FOLLICLES – petechial hairy follicular hemorrhages Tests for platelet number and function - Platelet count o You can save people by ruling out pseudo-thrombocytopenia (non-disease; no problems) o Sometimes the platelet can count come out lower - Peripheral blood smear o Check the blood smear the clump will show up in the smear not the count - Bleeding time (forearm) - Platelet aggregation studies - Measurements of vWF quantity/quality - Special tests o Flow cytometry o Secretion studies o Test for specifics disorders (HIT- heparin induced thrmbocytopenia;TTP-thrombotic thrombocytopenia) Thrombocytopenia due to decreased production
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