STEP 2

1. What is hemostasis?
Hemostasis is the cessation of bleeding after vascular injury.
Hemostasis depends on the interaction between the blood vessel wall,
platelets, and coagulation factors.
Mehta, Atul & Hoffbrand, Victor. At Glance Hematologi 2nd Edition.
2008. EMS : Jakarta.
Hemostasis (haima: Blood + static: stop) is a process for maintaining the
blood that remains in the blood vessels are damaged.
Silvertoon, Human Physiology

2. How is the process of hemostasis?

3. What kind of hemostasis disorder?

hemostasis disorders (abnormal bleeding) may be caused by the following ways:
1. vascular abnormalities
Vascular disorders are a heterogeneous group of state, which is characterized
by easy bruising and spontaneous bleeding from small blood poembuluh.
Underlying abnormality lies in the blood vessel itself or in the perivascular
connective tissue. In these circumstances, normal successful test standard filter.
The period of normal bleeding, other hemostasis test also normal. Vascular
abnormalities, there are two types of hereditary hemorrhagic telangiectasia
hereditary form, and connective tissue disorders. Another kind is the vascular
defect.
2. Thrombocytopenia

Thrombocytopenia was defined as a platelet count less dari100.000 / mm3.

Usually characterized by spontaneous skin purpura, mucosal bleeding and
prolonged bleeding after trauma. Some causes of thrombocytopenia include:
(1) The failure of platelet production .This is a common cause of thrombocytopenia
which is usually also part of a generalized bone marrow failure. Megakarisit
selective suppression can be caused by drug toxicity or viral infection.
(2) Increased destruction of platelets, It is divided into several types namely:
a.Trombositopenia immune, including ITP, due to infection, post-transfusion purpura,
immune thrombocytopenia due to drug-induced,
b.Purpura trombositopeniatrombotik
Disseminated intravascular
c.Koagulasi,
(3) Distribution trombositabnormal,
(4) Loss due to dilution, in the form of massive blood transfusions in patients with
bleeding store.
3. Coagulation Disorders Can Be as hereditary or acquired, which generally interfere
with coagulation factors.
a.Herediter: hemophilia A and hemophilia Bb.
Obtained: vitamin K deficiency and liver disease
4. Impaired platelet function
Divided into two types, namely:
a.Didapat
1) because the anti-platelet drugs such as aspirin,
2) .hiperglobulinemia,
3) .kelainan myeloproliferative and myelodysplastic, and

4) Uremia
Hereditary b.Kelainan
1) Trombastenia,
2) Sinsrom Bernard Soulier,
3) Retention Disease
Immune thrombocytopenic purpura (PTI)
A bleeding disease that is obtained as a result of the destruction of platelets
superfluous, which is characterized by: thrombocytopenia (platelet count
<100,000 / mm3), purpura, peripheral blood picture which is generally normal, and
no cause of thrombocytopenia other reply.
Thrombocytopenia Purpura Secondary (PTS)
Thrombocytopenia is happening due to influence immune, which causes platelet
lifespan is shortened and disorders have a relationship with a normal or increased
number of megakaryocytes and megakaryocyte less smp no marrow tulang.Neonatal thrombocytopenia
Decreased platelet production, increased destruction of platelets, platelets trapped
in the spleen, or a combination of destruction and production, or combined with the
pathogenesis of which is not diketahui.Hemophilia
Diseases / disorders that are hereditary bleeding due to deficiency of clotting factor
VIII or IX.
Hemophilia A: deficiency of factor VIII (anti-hemophilic factor)
Hemophilia B: deficiency of factor IX (Christmas factor) - Von Willebrand Disease
(PVW) chronic bleeding disorder characterized both platelet aggregation and clot
formation is not adequate.
Capita Selecta Hematology, A.V Hoffbrand et al

4. What is the role of blood vessel in hemostasis?

5. How does the corelation between easly bruises with hemostasis?

Histologi dari pembuluh darah?
FAKTOR KOAGULASI
6. What are the coagulation factor means? What are there function?
Organ apa yng memproduksi?

There are 13 blood clotting factors:

I. Fibrinogen
: Plasma proteins are synthesized in the liver, converted to
fibrin.
II. Prothrombin
: plasma protein synthesized in the liver, converted into
thrombin.
III. Thromboplastin : Lipoprotein released damaged tissues, activates factor VII to
the formation of thrombin.
IV. Calcium ions
: inorganic ions in the plasma, obtained from food and bones, is
required in all stages of blood clotting.
V. Factor V
: plasma protein synthesized in the liver, is required for the
extrinsic-intrinsic mechanisms.
VI. Number not used anymore: Functions the same as the function of the factors
believed to V.
VII. Factor VII
: plasma protein synthesized in the liver, is required for intrinsic
mechanism.
VIII. Antihemofilik factors : plasma proteins (enzymes) that are synthesized in the
liver (requires vitamin K) function in extrinsic mechanisms.
IX. Plasma thromboplastin
: plasma protein synthesized in the liver (requires
vitamin K) function in the intrinsic mechanism.
X. Stuart-Prower factor
: plasma protein synthesized in the liver (requires vitamin
K) functioning in the extrinsic and intrinsic mechanisms.
XI. Plasma thromboplastin Antiseden : plasma protein synthesized in the liver
(requires vitamin K) function in the intrinsic mechanism.
XII. Hageman factor
: plasma protein synthesized in the liver function in the
intrinsic mechanism.
XIII. Fibrin stabilizing factor
: proteins found in plasma and platelets, crosslinked fibrin filaments
(Guyton and Hall, 2007; Price, SA and Wilson, LM, 2006; Sherwood, 2001)

7. How does the patofisiologi of coagulation factor?

TROMBOSIT
8. What kind of trombosit disorder?
9. What the therapi of trombosit disorder?

10.What is the characterictic of normally trombosit? Gambar!

shaped discs
The smaller size in bandingankan erythrocytes
Colorless
Not nucleated
The cytoplasm contains mitochondria
There granules
diameter 1-4 um
Located in peripheral blood
Not activism if not needed

 Aged 10 days
The normal amount of 150-400 thousand / mm3
Silvertoon, Human Physiology and Patofisologi, sylvia

11.How can ptechiae appear?

12.Bagaimana cara trombosit bekerja?

13.Seberapa kuat pembuluh darah dapat menahan aliran darah yang kuat +
video?
14.Petechae,purpura, echimosis + gambar?
What the interpretation of laboratory result?