Bleeding neonate / child

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clinical features and etiology

Text of Bleeding neonate / child

  • 1. Bleeding neonate /childCAUSES AND CLINICALFEATURES

2. HemostasisINJURYCollagen ExposurePlatelet Adhesion and releasereactionPlatelet aggregationVASOCONSTRICTIONSerotonin Platelet PhospolipidThromboxane A2ADPPrimary haemostatic plugStable haemostatic plugTissue FactorCoagulationThrombinFibrinFibrinolysis 3. ETIOLOGY 4. CoagulationDisordersPlateletDysfunctionVascularFibrinolyticdisorders 5. Coagulation DisordersInherited Acquired Hemophilia A and B von Willebrand Disease Factor VII, X, XIII deficiency Afibrinogenemia Liver disease Vitamin K deficiency Warfarin overdose DIC 6. Platelet DysfunctionQuantitative Qualitative Decreased production Increased destruction Inherited Glanzmann thrombasthenia Bernard Soulier syndrome Gray platelet syndrome Wiskott Aldrich syndrome Acquired Medications CRF Cardiopulmonary bypass 7. Thrombocytopenia ITP TORCH Infections Kala azar, DHF, malaria, hepatitis B and C, HIV Medications Valproate, penicillins, heparin, quinine, digoxin Malignancies Leukemia, lymphoma, neuroblastoma Collagen vascular disorders 8. Bone marrow failure syndromes Thrombocytopenia with absent radii Fanconi anemia Immunodeficiency syndromes Wiskott Aldrich syndrome Others Hypersplenism, HUS, NAIT 9. Vascular causes Henoch Schonlein purpura Connective tissue disorder Scurvy Prolonged steroid use Hereditary hemorrhagic telangiectasia 10. CLINICAL FEATURES 11. NEONATES Oozing from umbilical stump Cephalhematoma Bruising, petechiae Bleeding from site for venipuncture orprocedure site Bleeding from scalp Intracranial hemorrhage Bleeding from mucous membranes 12. OTHERS Mucosal bleeds Joint or muscle bleed Bleeding after minor trauma Petechiae and purpurae Ecchymoses Fever with rash Hepatosplenomegaly Significant lymphadenopathy Menorrhagia 13. HISTORY Age of onset Sex Frequency Location / type of bleeding Duration Medications Family history Associated symptoms 14. Examination Pallor Petechiae, ecchymoses, rashes Hepatosplenomegaly Local examination of mouth and nose Lymphadenopathy Features of bone marrow failure Any associated features 15. Platelet vs coagulation disordersPlatelet Disorder Coagulation DisorderSite Skin, mucousmembranesDeep in soft tissues, joint,musclesPetechiae Yes NoEcchymoses Small, superficial Large, deepBleeding after minortraumaYes NoBleeding after surgery Immediate, mild Delayed, severeExamples von Willebrand disease,ITPHemophilia A and B