Presentasi hematologi

8/13/2019 Presentasi hematologi

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Presentation

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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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Documents

Presentasi hematologi