cages dot kate my medical school
today or tom brokaw ideally should disorders
so really how to interpret quite deletion studies
but generally get quietly she studies on patients
who have
bleeding bass it seems that there were days it means
they have a tendency to believe
so these are people who undergone a trial mark
always somewhat
other source for their bullying is our patients who may have underlined
historic genetic disorder choir disorders
that may prevent their blood from clotting as well as the normal person so
we will talk about how to evaluate these people
and that how they interpret this studies and kind of what your stepwise approach
should be
let's first talk about the coed deletion cascade
there's a previous video on a quiet mission cascade which you can refer to
condition that detail about it but prefer the
our quotation cascade consistent extrinsic intrinsic and common path
extrinsic portion consists of
factors sat in tissue factor
antiques starting off caloric
sparked by too she get
we need to activation tissue factor impact sat
now intrinsic catholic consist of factors
twelve
levying nine eight
and high molecular weight cutting edge
now all these pathways feeding to factor ten which impeded the common path etc
which involves vibration pro thrombin thrombin and fiber
or actions of pathways measured p_t_
or intrinsic catholic mission p t t the common pathways measure that i know
but i'm not also capture and abnormalities that incurring ecstatic
pathway as well
now this is a brief review of the graduation pathway
as well as the labs that measure each portion of the passport
so how many valley bleeding disorders
so remember that in this discussion will come up patience with underlying cause
further believing it's not just a trauma that's causing bleeding sort of that
week patience with dinosaurs
to remain test to get platelet count api t t p_t_
so clearly cannot on f_ lee assesses
but i don't think it's you have
now
it was when he left his blinking coming car someone is promising to kick meaning
envelope statements
hideously p t t
to measure intrinsic pathway and are p_t_ to measure extrinsic path
let's take an example of a bleeding problem
so here we have a basic widely shin pathway in this case
are p_t_a_s normal are peachy tease normal end up an arsenal
the patient believe
so what can be cautious well enforcement in completing time on kuwait in normal
initial argues to sort team approved in time
and what does the bonding time show well a boom time
measures interaction off platelets with the vessel
super cool and to normal
in the patient's khalidi
then must be interaction above please with itself
so you don't believe in time to measure that interaction
that the boom times pro-law dead difficult one will be from the senate
committee stinger missile tests of obtaining platelets
well that would totally right away you promise an appeal
otherwise you could hold he depleted supporters at this moment within the
platelets
and examples of this could be part of all the brain disease
so but will the proceeds were most commune
genetic
causes a bleeding disorders italy bernard sawyer syndrome
which detect glycoprotein one p
on the plate with
clinton promised the animals also defect and g_p_ glycoprotein to be three a
so usual all things that could occur please read qualitative or low pulitzer
cosby's
normal coed with green increased bleeding tak
let's go to our second scenario
here second scenario are p_t_a_s absolutely normal
or p t t is elevated
and on arsenal
so when we come seeded
he's likely intrinsic awful
so this is a problem in the intrinsic pathway
so remember the factors involved intrinsic pathway include twelve eleven
ninety eight
diseases that can affect these factors include fund will the brain disease
hemophilia indy and have print they're keeping costs
this pattern of co acts
now but will the brain disease
it's the most common inherited bleeding disorder you can get a concurrent factor
a deficiency
to talk about bond will abandon seized previously jefferson area but also could
represent with this pattern of contract the reason why is factory needs to bind
bond will the grand factor to me stable
if factory doesn't it becomes unstable can decrease in circulation
so if there's not adequate amount upon what the brand factor inappropriate
when we look around factor
factory can bite which remains unstable and becomes deficient in the blood
intuition which would really important to note
is that in the bond will the brain disease you knew kulka teeny speak that
needs
bleeding from bill
aural
and the school two young kids you
mucosa
is really important point is from a separate
from undergoing disorder so that's one of the brain disease here for the
n_b_a_'s deficiency in fact risky nine
excellent recessive disorders
in the class deep tissue insuring week
filled the pattern of bleeding will help to friendship in hemophilia in p but
will the brain disease
fund will grant you cooking is
hemophilia deep tissue injury
also heparin therapy can prolong the p t t
cusip of its effects on these factors
election monitor
happened there p with p_t_ team within the hospital
so the country for view of the intrinsic problems
let's move on twenty x an area
when our next scenario we have a p t t that's normal
a_t_t_ that's elevated and all that salvi
his pattern of cole angst
it's consistent with in
extrinsic
sore externship problem could be due to war for an antiquated lation
chronic liver disease vitamin k deficiency
and every cases can be a congenital factor seven deficiency
or part after sending him
looking at that extrinsic pathway and problems
we know that that is involving actions the pathway include factor seventy issue
factor also the contact with
we've got to attack
when you have been type of vitamin deficiency of i think a deficiency
specifically
fetish to seven nineteen ten
or in decrease plot
if u are about indicate
to be projects
kundun
axes biden cake antagonist
many expensive utilization of advocate for corruption these factors
that's why can't you can't take widely
and chronic liver disease if you have the cells
to make these factors in your life dot indicate
you can't create the factors he developed a sequel so all these people
nsw orphanage graduation chronic liver disease and unki deficiency
all up comment he algae
do you like to buy a ticket for the lack of productions factors
it's because the actions of problem
intuition you can for your keys the content of after seven deficiency
and are factors and headed but it really
with one of the next scenario annexed herewith the p_t_a_ tel aviv p t t eight
elevated
and i'd articulately so what's the problem
will complete common pathway problem
if we have these pattern of co acts
and the the compact with com rematch with cold front and back
is measured conversion hybridagent back
if the prom in time is normal
areas where we could be heavy deficiency including pro from bryn infective five
deficiency after ten deficiency wicca liver disease and we could have d_s_c_
otherwise known as the disseminated
intravascular coagulation
lookup dac in our previous biggest accomplishment alot more about it
if you're trying to time he's elevate
than possible cause in quebec region deficiency by thirteen efficiency
and happy
now let's talk about mixing studies
you don't recall that
thing could be a factor deficiency inhibitor
and we'll figure it out few mixing studies annex that
in a mixing study you
makes your patients last month
with that of normal class first some other source
when you mix these two together at the scene at that time the call accent
sophie judith pgp two key cracks
then no
that this is a back to deficiency cousin normal plasma
has provided you the factor to crack cocaine acts
but if they hasn't p t t m_p_t_p_ remain healthy
the newer factor him there
because inhibitor and your patience plasma is still hitting the factors in
the normal class
neck and help you differentiate between deficiency an inhibitor
stupid review call ags
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