Manifestasi Klinis 2
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Transcript of Manifestasi Klinis 2
Site of bleeding
Petechiae
Ecchymoses (bruises)
Hemarthrosis / muscle bleeding
Bleeding after cuts & scratches
Bleeding after surgery or trauma
Platelet disorders
Skin muscous membranes (epistaxis, gum, vaginal, GI tract)
Yes
Small, superficial
Extremely rare
Yes
Immediate, usually mild
Coagulation factor
disordersDeep in soft tissues (joints,
muscles)
No
Large, deep
Common
No
Delayed (1-2 days), often severe
Vascular
Perdarahan vascular , Petechie, Purpura
Aging process senile purpura (Bateman’s
disease)
Infectious Meningococcus Rocky
Mountain’s syndrome typhoid fever
Roseola spot
Immunologic Henoch-Schonlein purpura
↑ fragility capillary infectious, vasculitis
Henoch-Schonlein purpura
20y Male, fever, painful symmetric polyarthritis for a day. During the next two days, edema and palpable purpura developed.
Platelet Disorders - Features:
Mucocutaneous bleeding
Petechiae, Purpura, Ecchymosis.
Spontaneous bleeding after trauma
CNS bleeding
Prolonged bleeding time (BT)
Petechiae
Do not blanch with pressure (cf. angiomas)
Not palpable (cf. vasculitis)
(typical of platelet disorders)
Coagulation disorders:
Deficiencies of Clotting factors
Onset - delayed after trauma
Deep bleeding • Into joints - Hemarthroses • Into deep tissues – Hematoma • large skin bleed – Ecchymoses
Summary
Symptom Platelet Coagulation Petechiae Yes No
Sites Skin & Mucosa
Deep Tissue
Time Immediate Delayed
Ecchymoses/Hematomas
Yes Yes
BLEEDING TIME
Put blood pressure at 40 mmHg First blood drop is wipedNext, blood is tipped off by filter paper every 30 sec
Normal is less than 5 min