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Coagulopathy
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- Blood coagulation or clotting is a
much needed body mechanism that protects against excessive
bleeding following an injury or trauma. Coagulation is a
complex process involving many blood-clotting factors
(proteins) operating in a cascade that, if interfered with,
may lead to serious and dangerous bleeding disorders.
- Bleeding problems can range from mild
to severe. Coagulation factors, platelets, and other substances
work together to stop bleeding at the site of an injury.
This is accomplished by the formation of fibrin, the
material that clots are made of.
- Defects in the coagulation system
occur as a result of deficiencies in clotting factors,
missing clotting factors, or changes in platelet function.
These disorders can be inherited, may be due to an
underlying disease, or may be side effects of drugs or
medication.
- Defects in platelets usually are noticed
with the onset of bleeding after an injury. Such defects are
predominantly superficial, i.e., in skin, mucous membranes
such as found in the nose, the lining of gastrointestinal
tract, and urinary tract.
- Bleeding may be observed as
petechiae (<3 mm) or ecchymoses (>3 mm).
- Coagulation system defects lead to
deeper bleeding than platelet defects. There may be bleeding
into joints (hemarthroses), muscle (hematomas), and abdomen.
- Nose bleeds, bleeding gums, Bruising, and heavy
or prolonged menstrual periods may all be signs of bleeding
problems.
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- Deficiencies in factor II, V, VII,
XII
- Myelofibrosis
- Vitamin K Deficiency
- Hemophilia A and B
and Von Willebrand's Disease
- ITP
- TTP
- Congenital Antithrombin III;
protein c and protein s deficiency
- Disseminated intravascular
coagulopathy
- Drugs -- cephalosporins,
penicillins, dipyridamole, alcohol, sulfonamides, Rifampin,
methyldopa, Phenytoin, warfarin, heparin, urokinase, TPA,
NSAIDs (e.g., aspirin), diuretics, allopurinol,
etc.
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