Presentasi hematologi
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Transcript of Presentasi hematologi
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Presentation
B4
Bleeding
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Key Words
- Children 5 years old
- Peteckie in the Arms, Tungkai and Body
- = fever
- Common Cold- Bleeding out from anus
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Question
- What is the patomekanism of hemolisis?
- What is the patomekanisme of Gejala ?
- What is the diagnosis ?
- What is the medical ?
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Clinical Symptoms- Petechie, echymosis, and hematoma in the skin
- Hematuric
- Melena
- Epistachsis
- Massive bleeding in the pulmonal, brain and intraventikular.
- Local ischemic and necrosis.
- Pallor, hipotensi and tachicardi.
- Acral cyanocis
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P THOMEC NISMTrigger
Systemic inflamatory response
Cytokines
Increased generation of thrombin
The simultaneous suppression of physiology anticoagulation
mechanism
Delayed removal of fibrin
Activation of tissue factor and factor VII
Systemic coagulation
Intravasculardeposition of fibrin
Thrombosit of small
and midsize vessels
Organ failure
Depletion of plateletsand coagulation factor
Bleeding
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Laboratory- Hypofibrinogenemia
- Trombocytopenic
- Prolongation of clotting times, such as thrombin time,
prothrombin time and the activated partial-thromboplastin time.
- The presence of FDPD-dimer test.
- Low plasme of coagulation inhibitors such as antithrombin III
- Examination of a blood film red cell fragmentation
(schistocytes)
- Liver and renal function tests
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Management- Treatment of the underlying disorder.
- Anticoagulation heparin, with dose 15 u/kg/hour by continuous
infusion.
- Platelet concentrate and palsma.
- Concentrate of coagulation inhibitorantithrombin or protein C.
- Concentrate of blood component fresh frozen plasma or
cryoprecipitate
- Plasmin inhibitorsTranexamic acid or aprotonin
- Vit. K and folic acid
- Gabexate Mesylatea synthetic inhibitor of serine protease
(including, thrombin and plasmin)
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ITP(idiophatic Trombositopeni Purpura)
Definition
Merupakan kelainan autoimun dimana autoantibody
dibentuk untuk mengikat trombosit.
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Clinic Manifestation
- bleeding petecki, ekimosis, melena, hematuri.
- Appliance blood in
- wheightTrombositopeni
- Torniquet test positif
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Gambaran darah
- Trombositopeni
- Perifer blood smear
shape of trombosit abnormal, big size.
- Bleeding of time prolonged
- PT and APTT normal
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Patomechanisme
ISPA
celular defence
humoral defence
cardage IgG to virus/bakteri
IgG patch to Trombosit
TROMBOSITOPENI
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Penatalaksanaan
- Can recover by self at children
- Kortikosteroid
- Imunosupresif like vinkristin, infus vinblastin, azatiopirin
and silofosfamid.- splenoktomi represent the definitive therapy to adult
patient ITP.
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Thank U
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B4
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