Bleeding Disorders

1. Dr Ambika Jawalkar

2. I. Platelet disorders
II. Coagulation disorders/defective
coagulation mechanism
III. Vascular disorders (Non-
thrombocytopenic purpura)

3.  Thrombocytopenic purpura – deficiency of
platelets
*essential / idiopathic(ITP)
*secondary
 Thrombasthenia – functional disorder of
platelets (defect in adhesion / aggregation)
eg: aspirin, large doses of penicillin, von
Willibrand’s disease

4.  Deficiency of clotting factors
* Hemophilia
 Vitamin K deficiency
 Anticoagulant overdose
 Disseminated intravascular clotting (DIC)

5.  Drug induced damage to capillary wall
 Deficiency of vitamin C – Scurvy
 Allergic purpura
 Infections
 Senile purpura
 Connective tissue diseases

7.  Group of bleeding disorders
 Characteristic features are,
*purple-colored petechial haemorrhages
*bruises in the skin

8. CAUSES:
1. Platelet disorders
Thrombocytopenic purpura – primary,
secondary
Thrombosthenic purpura – vWD
1. Vascular disorders – non-
thrombocytopenic purpura

9. “group of disorders occouring due to
heriditary deficiency of coagulation”
 Characterized by bleeding tendency &
increased clotting time.
 Hemoplilia A – 83% cases
* FactorVIII (Classic Hemophilia)
 Hemophilia B – 15% cases
* Factor IX (Christmas disease)
 Hemophilia C – 2% cases
* Factor XI (PTA deficiency)

14. TESTSTHAT DETECT
DEFECTS INTHP
 Bleeding time
 Capillary fragility test
 Platelet aggregation test
 Platelet adhesiveness test
TESTSTHAT DETECT
DEFECTS IN DHP
 Clotting time
 Prothrombin time
 Prothrombin
consumption time
 Partial thromboplastin
time (PTT)
 Activated partial
thromboplastin time
(aPTT)
 Thrombin time
 Clot retraction time

15.  Time lapse between the skin prick and
arrest of bleeding
 Estimated by Duke’s method & Ivy’s
method
 Normal values
by Duke’s method – 1-6 min.
by Ivy’s method – 3-6 min.
 BT is prolonged in Purpura & normal in
Hemophilia

16.  Time between skin prick & formation of
first fibrin thread
 Estimated by Capillary tube method & Lee-
White method
 Normal values
by capillary tube method is 3-6 min.
by lee-white method is 8-12 min.
 Prolonged in hemophila

17.  Quick’s one stage method
 Commercially available tissue
thromboplastin & CaCl2 is added to
oxalated or citrated plasma – incubated at
37oC
 Normal value is 11-16 sec.
 Extrinsic system is tested here.(no platelets
involved)
 Used to monitor anti-coagulant therapy
 Increased in liver failure, vit K deficiency

18.  Also known as KCCT – Kaolin cephalin
clotting time.
 Detects minute coagulation defects
 Normal is 40 sec.
 Measures intrinsic pathway
 Used to monitor Heparin therapy
 Is prolonged in Hemophilia, vWD

19.  Measures final step in coagulation i.e,
availability of functional fibrinogen
 Normal is 10 sec.
 Is prolonged in hypofibrinogenemia,
dysfibrinogenemia, DIC & hepain therapy.

20.  Measures time needed for contraction of an
undisturbed clot.
 Indicates function & number of platelets
 Normally begins within 2 hours and
completed within 24 hours
 Is retarded in thrombocytopenia
 Clot is small & soft in thromboasthenia