Hemostatic disorder from RR? can anyone

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Hemostatic disorder from RR? can anyone

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antidepressant
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04/18/08 - 11:18 AM

Can anyone read through these and clear something

Hemostasis disorders in liver disease:
1. Pathogenesis
Decreased synthesis of coagulation factors Multiple coagulation factor deficiencies

Decreased γ-carboxylation of vitamin K-dependent factors Decreased synthesis of anticoagulants Examples-ATIII, proteins C and S

Decreased synthesis of fibrinolytic agents (e.g., plasminogen)

Decreased clearance of FDPs and d-dimers Interfere with platelet aggregation and polymerization of fibrin

Decreased clearance of tPA and decreased synthesis of α2-antiplasmin ,May produce primary fibrinolysis

Laboratory findings in liver disease

Increased PT and PTT

Increased FDPs and d-dimers

Increased bleeding time

Primary fibrinolysis
Causes

Open heart surgery Cardiopulmonary bypass causes a decrease in α2-antiplasmin and increase in tPA.

Radical prostatectomy Causes increased release of urokinase.

Diffuse liver disease Causes a decrease in the synthesis of α2-antiplasmin

Pathogenesis

FDPs interfere with platelet aggregation. Plasmin degrades coagulation factors causing multiple factor deficiencies.

Clinical findings Severe bleeding

Laboratory findings:

Increased PT and PTT Due to multiple factor deficiencies

Increased bleeding time Due to interference with platelet aggregation

Positive test for FDPs

Negative d-dimer assay No fibrin thrombi are present.

Normal platelet count

My question is
If we see negative D-dimer assay in primary fibrinolysis, then in lab findings of liver disease due to primary fibrinolysis as i underlined from book, D-dimer shouldnt be increased?

I typed everything above my questions from rapid reveiw path of goljan.)

Edited by antidepressant on 04/18/08 - 01:42 PM

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new_n_lost
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04/24/08 - 05:40 AM

Bro i tried to think of every which way that could be possible but nothing comes to mind. Cos the effects in both are teh same yet yielding a differnt lab result. Will search for it.

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antidepressant
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04/24/08 - 02:59 PM

thanks NNL, i was wondering if i asked too dumb a question, no one replied sticking out tongue

thanks for taking time to help out! God bless you! nod

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new_n_lost
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04/24/08 - 03:47 PM

No problem mate i usually try to answer posts where no one has replied so that no one feels anything otherwise.

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Kalyann
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04/27/08 - 04:20 AM

IT depends on what part of the hemostatic pathway is mostly hit , depends on severity of liver disease, meaning one needs to expect all those symptoms listed in a severe liver disease patient.

ITs not that u get all the above listed features in a single person.

ITs given in RR onli to let us know that all listed symptoms are possible in a liver disease.

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new_n_lost
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04/27/08 - 06:26 AM

Kalyann wrote:
IT depends on what part of the hemostatic pathway is mostly hit , depends on severity of liver disease, meaning one needs to expect all those symptoms listed in a severe liver disease patient.

ITs not that u get all the above listed features in a single person.

ITs given in RR onli to let us know that all listed symptoms are possible in a liver disease.

Ahh didnt quite get you. The 2 diseases have the same pathogenesis yet have a different D-dimer result. Why. This what Antidepressant asked.

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