OCR Document

.!I - ......~.~1I. I. II:I II.II IIiI'1",\. ~L ,..::~.-/@ID) I '-E~~~?.;;o~;efrPELJuDONTICS Table 1t'H~'the character~tics Of Hemophilia..

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- _C6agultion

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Classification

Depending upon factor level hemophilia A and B are classified as:

Degree of severity% of factor VIII/IX

Characteristics

available

SevereLess than 1 % \

-Frequent bleeding, episodes-

occurring 2-4 times! month

-'Bleeding without a specific history

of trauma

-Bleeding into joints and muscles

-Haemarthrosis

"--0,

-Musculoskeletal problems,

-Psuedotumors in the jaws

-Deep haematomasand haematuriaModerate1-5%

-Occasional spontaneous joint bleeding,

tliinor trauma may initiate hemorrhage

-Develops target joints' with repeated

,

episodes of bleeding

Mild5-35%

Significant hemorrhage only after a major

insult

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'I initiates er blood nostasis.I of blood damaged constrict. on. When jamaged idhere tovasoconconstriced blood nboxaneI TISSUE TRAUMA IJ,IINJURY TO WALL OF BLOOD VESSELlJ,DAMAGE OF ENDOTHELIUMJ, 'C.'k?O'e,'0?.'C. OF CO'-'-~GENJ,PLATELETSSerotonin ':;DP"Thromboxane 1\2 J,Adherence ofPlatelets1[ \1Vasoconstriction1Temporary Platelet Plug2Tight platelet plug FIGURE 19-1: Hemostasis. 3. COAGULATION OF BLOODFibrir'nFibrin3

.,... IJ'VVV a, IV LJvuy ""U'U;:'Tissue TraumaTissue thromboplastinPROTEIN GLYCOPROTEIN PHOSPHOLIPIDFACTOR VII~FACTOR X~ FACTOR Vt\.~~~~~\~f\G.U{\E '2.Q-'\ ~ S\~~e '\