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“6.

Bleeding disorders and


Transfusion Medicine”

by Dr Devesh Mishra
MBBS, MD , AIIMS
Telegram channel Instagram
Rge
< Endothelium
·
D

stabil ↓ G-Anticoagulants ↓


~Heparin"-like mole."N Thrombomodulin(tm)
A I ↓Struct, change
22.
Natural
"h" AT- -
anticoag
-
"Thrombin
I Thrombin
te Canticoagul
inactivate
Synth

[Pro-oag) ⑰
2


protein/s
liver -
2

#, IX to A
inactiv
& ↓ 2
22.

Trans-
mc Hered.
#
tr Leiden
E
thromb mutation

[A U) thmb
+

Young.
Adults.
Alcoholic Liver Disease

22;Gamma ↓

Harboxylation vit. K-
=
depend. ClotFactors

22.
Glutamate
X

2, 7, 9, 10
-
i 20
coagulation path -

22 I
=1165.

i
Intrinsic:aPTT Extrinsic PT
s
=

Har
·

ll I -> tissue-ing

*
-
-

x
·
"vely" charged
H
Glass, si
#
Le tissue
thromboplastin
R

Kaolin
* #a
·

·
PL

Plastic common
sy
-->
-

-vials.= Ea
-

-Cat
Prothrombin
V
7 Thrombina
Y
"Fibre-be
fibrinogenanilisingt
>

401.

FIBRIM
Factor.
Lines
clot-lysis

↓ 22.
~Plasmin
Pla(i)sminogen
Fibrin"->FDP
Itibgra.e -
Bleeding-disorders

Approach
A ↓
Minor Major
↓ -

Petechine/purpura
=

Al
·
Spont. Hematoma
(muscl)
Skin/ Mucosa. ·
Hemarthrosis.
A (Recurr, jointpains
pH-disord -,
Clot-Factor is
2) PH-count (1.5=4.5 lans/mm]

T
*
2] BT [2-gming
-
-

function of pu
Hemophilia
X ↓ ↓
A - B
- &
-
·
AR
XR-Mr
·

· Mc
Hemarthrosis.
·

mptom.
I
I
Lab -

I
-PI-cou=N
-
BT M
=

PT M
-

sated
aPTT4 =
Platelet-disorders
-

↓ -
qualitative BT4
20.
quantitative
22. Fun,
=

defect-=
I
H
Plt-count M N
Plt-count =1,e4
2 =
=

22
PI"functional defect &
BT 4
=

X
Bernard-soulier dis[BSDI
-
1 -

Glanzmann'sthrombosthenia
"YUWD
[T]
Thrombocytopenia
VWE,

I still he


Miimpfu.
quantitative pHdis
Coomb'stest& ana:
Thrombocytopenia
=

b
A ↓ ↓
Immunogenic Non-Immunogenic -> CT-ve

· ge A X -
pH-dest TTP HUS
Eg4-
22

⑭ ADAM-TS-13 ↓ ⑭
M-Ts
DIC -> t t

agentinAbam-TSts
a
· Abn-Agg
↓ Typical
-Pedia Atypical
Adult
Prevent 5 Thrombotic
-

theI
Thromboppenin E.coli [0157:H7]
Noalwing-
=>

·PItcount &
-

Abn-pit-Agy. I
·

completo
shigative
-

clot to
·

cr
=> PI 1; BT4 Flow-t
-
↓ factor Ad
t Pit dest
-

, 4: Srfibrinogent, /
ADAMTS 13

-

·
FDP4 ⑪ ⑭
TTP HUS.
AR >ST AR
-BSD ·

dis.
defect
M P
--
Gpzblsa
Y P2bapIt
⑪11
s
Aggreg
fibrinogene
·enPltesi (are
a

2
② -
WW

-
- -

Weibel -
Palade
Bodies.
ABO inaut
=> MAG- M-Acetyl--Galactosamine
X 9 > Galactose

H-gene
I9
↓ 11

④2 H-substance
it 2 Y⑰ - ↳
2. I

MAG 4 MAG +9 H

X
A 99
If ↑S

RBC =
A
E
AAg
B
*
Bag. AB
e
---
Bag Hag
k

surface

Y
- X Y
anti-A
Serum - anti B anti-A No-ab
- anti-B.
"A, B,
Secretors.-
Al
H-y.
⑬ RBC-sur

Body fuid -> except->Se


·
Serum
·
# Secretors. -> A, B, H-ag>
present, an

Blende 2
1955
A Virate

Blood p
Bombay
22 22.
#
AR = Ih
11
-gene absent
-


-

Blood 9p

Absent
RBC
-> A, B,
H-ag- requiring transf
22
Non-Secretors a X
from
same old Ip
Serum o anti-A, B, H present.
=

ONLY"
A

-Bombay. blood

&
Storage temp Shelf-life
whole Blood Als
↓ 2

⑧ -
components

I 256° ·

I 42
days
2] PRBC ↑

Room-tea. & &

2] telets. · [20 252) >


5-days
-


I
- contagitation
3] FFP
> 12c or ---
1
yr.
-

y Cryoprecipitate lower
-
Blood
Bag Anz
-

A
Additives 21) Glucose/ Dextrose
Nutrition
to RBC
2.

2) A DI 21d. Buffer.
2) Phosphate->
-

pit
-

2] CPD I
XXXX
maintain
Rec
22.
- chelation
3) Citrate= I of cate
o 3] <PD-A -5days.
=>

> ↓
- clot
batt No
42
tetany -

4 SAGM >
days -

ex4) Adenine - ATPsyn -


Stabili
RBCMemb
A
-

life span.
5) Saline
Maintain
=>

RBL
isotonicity
67 Mannitol
I

prevent hemolysis.
Indications BT
of
1) Whole Blood -> Hypovol. Shock Ium,
Anemia.
2) Packed RBC ->

seeafor factor,
trauma
3] FEP ->
e

a
cryoprecipitate # - Hempt.A

&
VNF >VWD

EIll-.d,
- A fibrinogenia

fibrinogen

protocol
Transfusion
↓ 222.

Whole,Blood/PRBC
**
*

· Start transfusion (in> einmin


· Complete transfusion (in s
e
FyrP] mm.Forin
-

the
--
Transfusion Reactions
X I
f

Infections
22.
· MC MCCOD in BT.

extemol y ti c * Al

For
[
2
HIV-1in
-
TRALI * TACO
HCV
Au Transfu Related TransAssoc
=>

HBV
Acute lung in. Overload
->

Cardiac
Malaria
-
Ein "6"
Syphilis, his
·
=>
· cin 12 hrs.
fever -

Tc4
=BN, diuretic
best
BMP
N
q4
BT => > 1 Blood ein 24 his
Massive
-
volume

Al
5L= 10 Blood bags. MBT not alw-

A
complications Art
1

~
KT
Hypothermia, cat
-

feta
are E
↑ catt
=

Metab. Alkalosi's

linersalesas the
A MBT - notalw

AGI bigt
--
4
2+ -

] X
v
- xkt
2

↳Mg2t
ris
DilutionalCoagulopathy
asin the
- Hypothermia
v Metab. Alkalosis.
# Mc-LOD.> in Massive BT
N

Dil.CD

#Fixed component-ratio

PRBC: "Platelets: Ftp
I :1 e I
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v Pathology Books and Notes by Dr Devesh Mishra@


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