COAGULATION DISORDERS COAGULATION DISORDERSfont size Ed Friedlander, M.D., Pathologistscalpelbladeyahoo.No texting or chat messages, please.Ordinary e mails are welcome.Cyberfriends The help youre looking for is probably here.This website collects no information.Actilyse%20powd%20for%20infusion%20(vial)%2050%20mg9983b8c0-1d02-4815-b2cb-9faa0009b0e5.GIF' alt='Recombinant Tissue Plasminogen Activator Wiki' title='Recombinant Tissue Plasminogen Activator Wiki' />If you e mail me.This page was last modified January 1, 2.I have no sponsors and do not host paid advertisements.All external links are provided freely.Complete information for BCL2L1 gene Protein Coding, BCL2 Like 1, including function, proteins, disorders, pathways, orthologs, and expression.GeneCards The. COAGULATION DISORDERS Ed Friedlander, M.D., Pathologist scalpelbladeyahoo.No texting or chat messages, please.Ordinary emails are welcome.GENATLAS Biochemistry connective tissue activating peptide III,including platelet basic protein,precursor of beta thromboglobulin and neutrophil.Replacement_therapy.jpg/revision/latest?cb=20130930214635' alt='Recombinant Tissue Plasminogen Activator Wiki' title='Recombinant Tissue Plasminogen Activator Wiki' />I believe my visitors will find helpful.Welcome to Eds Pathology Notes, placed.You need to check the accuracy of any.I cannot diagnose or treat over the web.I cannot comment on the health care you have already.I am good at helping people find.If you need me, send me an.E mail at scalpelbladeyahoo.Your confidentiality is completely respected.No texting or chat messages, please.Ordinary e mails are welcome.I am active in Health.Tap. which provides free medical guidance from your cell phone.There is also a fee site at www.Im still doing my best to answer.Sometimes I get backlogged.E mail crashes, and sometimes my.If youve not heard.I send my most. challenging questions to the medical student pathology.E mail. where you can receive a reply.Numbers in curly braces are from the magnificent.Life videodisk. No medical student should.I am presently adding clickable links to.Let me know about good online.Enjoy. Path a great resource for everyone, from beginning medical students to pathologists with years of experience.Medmark Pathology massive listing of pathology sites.Estimating the Time of Death computer program right on a webpage.Pathology Field Guide recognizing anatomic lesions, no pictures.Freely have you received, freely give.Matthew 1. 0 8. My site receives an enormous amount of traffic, and Im.Pathologys modern founder.Rudolf Virchow M.D., left a legacy.I am a mainstream Christian, a man of science, and a proponent of common sense and common kindness.I am an outspoken.I. talk and write straight, and without apology.Throughout these notes, I am speaking only.Special thanks to my friend and colleague.Charles Wheeler M.D. pathologist and former Kansas City mayor.Thanks also. to the real Patch.Adams M. D., who wrote me encouragement when we were both beginning our unusual medical careers.If youre a private individual whos.Thank you, Ed, then what Id like best is a contribution to the Episcopalian home for abandoned, neglected, and abused kids in Nevada.Ive spent time there and they are good.Write Thanks. Ed on your check.My home page. More of my notes.My medical students.Especially if youre looking for.Medline, which will.You owe it to yourself to learn to.Not only will you find some information.Alternative complementary medicine has made real progress since my generally unfavorable 1.If you are interested in complementary medicine, then I would urge you to visit my new.Alternative Medicine page.If you are looking for something on complementary.Association of Naturopathic Physicians.And for your enjoyment.I cannot examine every claim that my correspondents.Sometimes the independent thinkers.You also know that extraordinary claims require.When a discovery proves to.When a. decades old claim by a persecuted genius.If you ask me about.I will simply invite you to.Who knows Perhaps.Our world is full of people who have found peace, fulfillment, and friendship by suspending their own reasoning and.Ive learned that they leave the movements when, and only when, they discover they have been maliciously deceived.In the meantime, nothing that I can say or do will.I am a decent human being.I no longer answer my crank mail.This site is my hobby, and I do not accept donations, though I appreciate those who have offered to help.During the eighteen years my site has been online, its proved to be.It is so well known.Im not worried about borrowers.I never refuse requests from colleagues for permission to.So, fellow teachers.Dont sell it for a profit, dont use it for a bad purpose.William Carey as my institution.Drop me a note about.And special. thanks to everyone whos helped and encouraged me, and especially the.William Carey. for making it still possible, and my teaching assistants over the years.Whatever youre looking for on the web, I hope you find it, here or elsewhere.Health and friendshipBIBLIOGRAPHY FURTHER READINGMore of Eds Notes 2.TTP case. 0. 59. American Society of Hematology.For the gung ho students.KCUMB StudentsBig Robbins RBC Bleeding.Lectures follow Textbookbr.QUIZBANKINTRODUCTION TO THE BLEEDING DISORDERS HEMORRHAGIC DIATHESES Your lecturer has no interest in presenting one more overview of the clotting cascades, the activation of platelets, or the mysteries of endothelium.Well look today at diseases that affect one or more of these.I promise to keep it.One more time. THE REAL CLOTTING CASCADE i.Vessel severed. Plasma contacts Tissue Factor TF on cell surfaces the procoagulant responseTF binds VIIVIIa.VIIVIIa complex with TF activates IX and XAnd the rest happenslike in your old textbooks.All diseases of inadequate hemostasis have spontaneous bleeding petechiae, purpura, mucous membranes, GI bleeding, hematuria, into joint spaces, or even.Am. J. Ob. Gyn. 2.The range is from lethal.VIII C deficiency, Bernard Souliers, Glanzmanns to non diseases.XII deficiency, many von Willebrands.Three groups. Increased vascular fragility.Platelet deficiency or dysfunction.Problems with the clotting factors. Microsoft Access Combo Box Filter Format . THE WHOLE BUSINESS OF HEMOSTASIS IS FULL OF PITFALLS.Missing von Willebrands disease and missing it is very, very common may.Failing to manage anticoagulation or component therapy meticulously.Missing a slightly prolonged PT before surgery.INR on a stable patient taking warfarin, or not knowing exactly what to do when you DO spot these.TESTING HEMOSTASIS.Platelet count reference range is 1.Above 3. 50,0. 00 is uncommon and may reflect.Platelets rise at ovulation, and fall low at the start of menstruation.Bleeding time checks both quantity and functional quality of platelets.Hard to standardize and not done that often.Before standardization, normal was 2 9 minutes.Ivy Stab with a 3 mm lancet.Normally bleeds 3 6 minutes.Template Use a standard spring loaded razor device that produces a 1.Normally bleeds 6 1.Ivy time since platelet recruitment is slower for this tiny wound.Thrombin time TT checks factor I fibrinogen activity.Its also the way we assess therapeutic range for dabigatran the new oral thrombin inhibitor.Prothrombin time PT checks activities of factors I, II, V, VII, and X If your patient is on warfarin.INR international normalized.ISI, or international sensitivity index your lab.Youll try to maintain your patients on coumarin in various ranges 2.Chest. 1. 08S 2. Point of care testing to get the INR using fingerstick is now widely available it.It takes four days after starting warfarin for INR testing to be meaningful.Heads up If the phlebotomy is difficult, the little bit of tissue factor that gets into the blood before the anticoagulant can do its work is enough to.INR. This explains the occasional person who needs to be called back for a repeat test.See Am. J. Clin. Path.Of course, if the tube has partially clotted poor mixing.Activated partial thromboplastin time a.PTT checks activities of factors I, II, V, VIII, IX, X, XI, XII.It is prolonged when one of these drops below about 3.Its also prolonged by antibodies against phospholipid.Thromboplastin is a commercial product for coagulation testing.The type used for the prothrombin time is a mix.The type used for the partial thromboplastin is the phospholipids.Today, the anti Xa test is the measure of how well heparinized a patient is the ability to inhibit factor Xa which is one way that heparin works.You need to let the lab know what type of heparin the patient is taking.A few novel tests including one based on snake venom.See Am. J. Clin. Path.Clot retraction checks factor I, platelet.Glanzmanns disease.Urea solubility checks factor XIII fibrinoligase, cross links fibrin strands, rendering the clot insoluble.Fibrin degradation products FDP, fibrin split products, FSP, X Y D E increased levels suggest ongoing fibrinolysis by plasmin, particularly in disseminated intravascular coagulation DIC.This old test has been mostly replaced by D dimer.
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