Timpul de

Duke : 2- 4
soingerareure.ae
mins
Numoirarea
150K -400K
tb

0Mt @ ☐ rot Trombocitemii pot Fi insot ite ,

Ivy : 4- 10 mins
Trombocitemie > 1mi ,
de nemoraosii
( dysfx )

Trombocitopenie primer afectiuni

Hemostaza primara
mieloprolif
central Periferic trombocitoza esentialoi
policitemia

|
vera

Alungireo . TS Doboindite Distrito

anormaioi
SP'en°me9 secundar

.ae/. . n. . . . /. . . . . . . n
purpura senile postsplenectomie
VQSCUIOPQTII Hipoproiiferare Tbpoiezoi ••--
T distract.ie
"* inef perif anemia Feriprivoi }
capitate post hemoragicoi
Frocgilitoitii
-

inlocuire f. medullar + Biz Bo

Testa ,
Ereditare Teleocngiectoezia
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¥ Imun
Itp moiduva osoasa
ereditara hemoragicoi
Doboindite COX I TTP adult.i
tb Aspirin a
:
Dysfx ale petegii Non
- -

to
Negativ
-

Hus
imun :
copii
Medicament slab + 10-20

Clopidogrel -
rec tb ADP t 20-40
g o. a m , , ,
go.nge.a.em.an.mn, ,
Ereditare Sd Bernard Soulier intens t 40
I Gplb
nature vase studio factor vWF
Afectareoe moiduvei
Defect de produce re
infxnvirale Purpura
Trombocitopenii osoase
cronice trombocitaroi
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Splenomegoclie
metodaaglutinoiriiplachetarecuristocetinoi.a.n.am
.

.. . ..
.ua .
. ÷. .

lipsa agregoirii absentia vWF

Frotiu
singe periferic
absent,Q Cplb Sd Bernard
Trombocitopenie dat
ocgregoiriipiacnetare Soulier
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Face 2
adoiugare
a :
recoltareounticoaginade.eu sg
✓ WF
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' MORFO Qnormocloi tbrnari in Sd Bernard Soulier
{
-

tb interact,iuneo . dintre

Altele tbt endoteliul vase

2 Abs component ultrastrlipsa granule ✗ Moisurare 0cg vWF prin ELISA ( cant ) .

Hipofibrinogenemie Sd plachetecenusii

moisurare act irritate FP plasmatic

* PFA -100 : test in vitro

volloocre predictive -
T

vWF t FPT in rxn de Fata

acuta ,
Sarina ,
foiosire estrogen :
NN

concomitant indicat { i
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moisurare reactant
acuta fibrinogen
0T in infxn acuta poate
Mosca dg Br w
?⃝
 Aderare plachetaroi

coind ?

TS Nu
prelungit nr tb N retract.ie
oheag
Metoda Salzman Hellman modification Teste
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non-specific
tb Fx % tb tb
specificity nespec
care ies nr initial
+ PTI
90%

Foust odtecauze de tbcitopenii

BE
"*
"

Éntrerupere med Cv aspirin a men Studiul Fx piachetare Ac anti -

tb

AINS cel de
put.in 7 2- inainte

Roispuns normal
test
la
scop
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agonist testat
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efectueazoidacoi
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se
testee hemostazei 1° ☐ ysFK Cp lb
sunt N

Doboindite Ereditore + Purpura trombocitopenicoi

Qutoimunoi
60%
Reactive
.

ce Medicamentoasoi Trombocstenioc Glanzmann

+
agregocrea
plocchetaroi
aspirin a
GPZD 3Q Purpura de altoicauzoi
-

1
ADP 2 Epinefrino .

3 A. A 3
roispuns la ristocetinoi normal
colagen
:
 trombino - dis fibrinogen emiQ nipo creditor
Timpul de Prelunogit = aoboinditoi

Consum DIC
F. sensibil la prez heparine ; Fibrinogen -

Timpul de
coagulase '

Qctivoct ( ACT ) NI e standard .

pt monitorizare mirxare cu volum =

plasma N
Cu heparin a
Calea intrinsecoi

Hemostaza secundara
Ttoumestec TT amestec N
utilizoiri
along 't ,
: monitor izare terocpie doze T heparin .

Chir cardio -
palm
prezenta heparinei hipofibrinogenemie

#
Teste de screening
Valor i N : 70 -

180s dis fibrinogen er nie

Timpul de thromboplastin .
Timpul de protrombinoi Quick Timpul de reptilazoc
partial ④ CAPTT )
PT 12-15 Sec NTT ; repti Laza in 10C de FZQ

Calea intrinsecoi Calea comuni Calea extrinsecoi + comunoi nu-eafectato.de -

trombinei
,

indepde Fx tb util monitor izocreo tx influent.at de

pt > Iu e
-

Monitor izare terapie

20 -

39s Ounticoocg Cv
antagonist : co anticoagulant coroner Folosireoe Qnticoag
Occenocumocrol INR Folosit
e
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:
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proboi Max
1T€ ptproboi test

war farin 0,
PT normal

fatso alungire
✗ 1hr : ;
degradeare FP QP -1,2

perioada-coiteuaz.poino-prelung.ir
@
anticoagulant
la instalareef

anticoagulant @ Orate
prelungire 1 Tx

Factor i F.
I
Toate def
congenital @ intrinseci 2 Deficit creditor ai
coaeguloirii
2 ,
5,7 , 10
2
Terapia heparin a
coagulase
co -

specific "
3
Anticoagulant i ,
circulars !i 3 Insvr-icien.to nepatocelularoi
ne specific : f 7 cel Mai
: scurf TYZ
4 consum F. de coagulate -
CID
f- 11,12 "
lung T
'
"
/ z
.

5 I sintezoi hepatica in oofectiuni hepatice severe

4 Consum F. de CID
Monitorizareaterapieicu coag
heparin .

No pt monitor .
tk hep
co out
5 Deficit vitamin a K
Doze I hep : monitor izoure
tb pt exclude re tbpenia
indusoi de heparin a-

Doze T se monitor izeazoi

repetend APTT din 6in 6 ore

2- ,
 Tromboelastogroctfia
Mixing studies

{
tromboeiastometrioutilptstabilireaetiolog.IQ
rotative
Valeri T APTT sow PT

APTT along it
-

initial : test de neutralizers a heparinei

plasma pt
timpinchegore
Parametric
'

moisurocti reefectuoore APTT

cineticacneag plasma N

Fermi toute Cheong

Hemostaza secundara
Ocmplitudineo
deficit
,

Oumestec N de factor de
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liza
coagulase
cheag identified re F.

Investigneaza coagulocrea in ansoemblv ; Testee Speciale

at
amestecalungit prez unui
-

inclusion Fx piacnetocroi
coocguloirii
Fibrinolizo -
lupus anticoagulant
test anti Factor ✗ a substantia med

monitor izare teropie Cu heparin Oi cu Gmt LMWH

LMWH nu modified APTT Semnificoctiv

monitor izare terapie LMWH este necesaroi in :

'
IR

2 Socrcinoi

✓Odori test :

Pt Foiroi 0
terocpie anticoagulantOi u mi

Tera pie Cu
heparin oi trombozoi venoocsoi 0,3 -
0,7 Ulml
 Prot F 5
+
Protein a c S -

FP
Anti trombino
trombino . ✓ it K dependent Oi

-
f- 2, FIOQ ,
FIIQ ,
Fao . deficient:O .
Status hiper coagulant tromb02-Q-venooc.SE

deficient.Q doboinditoider-icien.to .
ereditaroi deficient.Q doboindita-der-icien.to .
ereditaroi cronometricoi

deficient:O Status Tb de coitre warfarin a

. hiper coagulant rise . niv Capac anticoagulanta-
Fila tromboernbolicoi
dozare Functional@ :
defect de interact
.
"
Cu PL.ca PS
Test @
.

cromogenicaactivitocteo.pe
dozare

Functionale Imunologice
cantitative Nu detecteze
poate Soi

deficitulcalitativpc-flla.fi/adecoitre
Anticorpi process coagulase tip ) AT in Inhibitor de ( 11

prezent.ca heparin ei oumbeletr :

Activitoiteo Fila }FXa✗ activitate

→
I
AT defect de e liberate a

Protein as cofactor protein @ C peptidei de activate

deficit
genetic sow

Ounomoclie situsului actin

wit k dependentOi a
anti trombino + sintezoi hepatica
Activitate protein C:
grave
,
boii metodo .
Fx imuno
consumer AT 1
Deficit congenital
+ rombozoi CID moisoara Capac proteinei S ' ELISA 35-65-1 din VN
heterozigo.fi
.

venoaso.pro/-StOtaloi
cofactor de Q Servi PC
rise relativ trombozoi ✗ 7
anti trombino deces IQ
REZ-istent.0.la s libero:
homozigot.i rise T

prof
anticoagulant-e
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} se realize QZOI de prima sor t timpdupoi N .

intent.ie
mutat.ie FS Leiden purpura
s

act irritate :
fulminoms
CID

☐
mutat.ie punctiformoi I Alterare Fx sintezoificat 6 Deficit e ereditare 2 consent
PCR trombone
F" 0,7% population general

|
Qlte 2 muta !ii tvitk warfarin a 3 deficit it is
2 tx Heterozigoti : ✓ warfarin a
cauzatoare.de
APTTPE probe activ .
20 - 60%
rezistent.ci APTT Se debut 4
prelunges.ie 3 consum CID tromboze 10-50 de
distrugereimvno owtoac
✗2 la N ani

zpt cu FV Leiden 4 Tf PS legato in rxn Homozigoti neon

CID
specif } sensib 100% Foezoi acuta
care
singvra
poatedethomol
hetero 5
pierdere PS -

sd nefrotic
 EPA
fibrinogen glucoza
degrad PAI -
I
+
Fibrino
µ
,

Niv T ar terial Oi
Plasminogen Fibrin OIIZQ trombozo
+ :
.
+

UPA inactiv TPA insulin a HBO

It Sd
hemoroegipoer
:
1=120 .

FVQ FVIIIQ
UROKINQZQ
deficient
,0 . este rocroi predispunoind la tromboza Fibrin OIIZQ excessive
+
plasminogen
Streptokinoiza
Fibrina Prezintoi ritm circadian
Functional imunologic trombino

functional Imuno logic

radial immuno diffusion Specific i
Qdocugare streptokinase 2-0 .
spectrofotometrie QC

assay
+ substrat cromogenic Reactant de Fazoi acuta

Det .
Count de
plasminogen Fibrinolizo . T dupoi evenimentetrombotice + in sarcinoi

"'t "°i
Deficient.oi doboindita-terapietromb.to Nu e test de rutinoi in clinic a med

dysfx hepatica
consum
-
CID

rant
Deficient oi ereditaroi ☐ - dimer : by produsi de degroedare
deficit sever : ai Fibrinei
Anti plasmin Q D- dinner trombi
'

conjunctivitis lignosa
. + +

PDF +
Fibrin . produgi degradation
Fib
1 CID 2
Fibrin ' t
conj .
pseudomb prin depozitele de .
TROMBOZQ
renoasoi plasmin @
de Qbs / t
-

depozite massive clearance 3 MI

're
degrade
y ☐ ysfx
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de Fibrin clot
coitre plasminogen Fibrinogen
É
s post
soingerare
Fibrinogen
•
.

°P
semnir-ico.tn
6
intact
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grad t DIC

Timp liza moisooroe Qctivitocteo cronica

de
eucgiobine plasminogen +

Cheong Plasmin "

D- dimeri : Fibrinous -
a form }
TLCE
functional
0. Fost degradation
metodoi de
Cea Mai rapido investigate
spectrofotometrie
PDF : Fibrina Fibrinogen
-

avantaj poate Fi efectuoctoi 5. i pe deojradate

factor ✗ 1, +
leagoi Ap (a fibrina ;

sg heparinizat doboindit
protejoind -0 de fibrinoiiza i
dysfx hepatica Latex Qglutinare
zterapietrombolitico.
" in:3 ZQ VN
CID Ore
Deficit
3 consum Metod0109.ie ELISA
Ap se
leagoi de plasminogen ;
creditor
Valeriu hiperfibrinolizo coentitativ tip I simplified
impiedicoi fibrin -0
legarda
-

la
coilitoctiv -

tipi
specif citrate T
foloses.tederutinoiptmonitorizareo.NU
NI se
-

,
se Face de rutinoi

imunologic terapieitrombolitice

Qc anti -
a
 CID APTT complete
Hipercoagulare ,
PT
, hemogrocmoi ,

D- dimeri ,
PDF
.
Fibrinogen
Acut T D- dimeri ,
PDF

Cocuze ereditore CQUZE doboindite

Prelvngire APTT } PT

1
Sd anti Fosfo lipidic tr
fibrinogen } nr plachete

QC anti PL

trombone ar teriole Exemple practice Cronic T D- dimeric PDF

venoocse

pierderi de Sarina T
fibrinogen + plachete
repetate
Scurtare PT { APTT
PL
Qc topic leocgoi
Ac cuprind Occ Qnticardiolipidici }
cardio lipidic:
det prin

ELISA
rxnincruci.sato.eu
0cg din sifilis
Lupus anticoagulant :

2 teste
screening
+⑤
test mixing
t
1- este de conf , mare
-

dacoi e present :

coagra-moinprelungitedupoier-ectuo.ro
testee de

ului
mixing
-