![]() |
![]() |
![]() |
|
Chapter 8
Bleeding disorders
Overview of hemostasis
Hemostasis is the process through which bleeding is controlled at a site of damaged or disrupted endothelium and is a dynamic interplay between the subendothelium, endothelium, circulating cells, and plasma proteins. Immediately after blood vessel injury, plasma and cellular components are recruited and activated to minimize bleeding and begin tissue repair. The hemostatic process is often divided into 3 phases—the vascular, platelet, and plasma phases; although it is helpful to divide coagulation into these phases for purposes of understanding, in vivo, they are intimately linked and occur in a continuum. The vascular phase is mediated by the release of locally
Approach to the patient with excessive bleeding
Disorders of primary hemostasis
Platelet function disorders Pathophysiology Etiology Clinical presentation Diagnosis Treatment Prognosis and outcomes Gaps in knowledge von Willebrand disease Pathophysiology Etiology Clinical presentation Diagnosis Treatment Gaps in knowledge
Disorders of secondary hemostasis
Hemophilia A and B (FVIII and FIX deficiency) Pathophysiology Etiology Clinical presentation Diagnosis Treatment Prognosis and outcomes Gaps in knowledge Rare factor deficiencies Pathophysiology Etiology Clinical presentation Diagnosis Treatment Prognosis and outcomes Gaps in knowledge
Disorders of fibrinolysis
Pathophysiology Etiology Clinical presentation Diagnosis Treatment Prognosis and outcomes Gaps in knowledge | ||||||||||||||||||||||||||||||||||||||||||||||||||