Human disease info

A history of bleeding upon trauma or surgery, severe epistaxes, muscle or joint bleeding, or large ecchymoses arouse suspicion of a coagulation dis­order. A family history of only affected males points to one of the hemophilias, whereas the other congenital coagulation disorders are trans­mitted as autosomal recessive traits. The most im­portant screening tests are the prothrombin time and activated partial thromboplastin time (see Table 55-3); the bleeding time is generally normal in plasma coagulation disorders except for von Willebrand’s disease, in which the deficient factor affects platelet function, and therefore primary hemostasis is also impaired. The prothrombin time measures activity of Factors II, VII, IX, and X; the activated partial thromboplastin time meas­ures Factors XII, XI, IX, VIII, and X. Both tests measure Factors V and II and fibrinogen. A history of delayed bleeding or rebleeding suggests Factor XIII deficiency, which requires specific testing of the stability of the fibrin clot (e.g., in 8M urea) for detection. The pattern of abnormalities and the ability of normal plasma or serum to correct them permits more specific identification of factor de­ficiencies or circulatory anticoagulants. Specific factor assays are available for confirmation and quantification of the various deficiencies.

• INHERITED DISORDERS OF BLOOD COAGULATION
• QUALITATIVE PLATELET DISORDERS
• Liver Disease
• Disseminated Intravascular Coagulation
• Acquired Vitamin K Deficiency
• INHERITED DISORDERS OF OTHER COAGULATION FACTORS
• ACQUIRED DISORDERS OF BLOOD COAGULATION
• SCREENING FOR DISORDERS OF BLOOD COAGULATION
• Renal Disease
• ACQUIRED DISORDERS OF PLATELET FUNCTIOII