Subjek Lemah

1. OnG:
- Ovarian Cancer

2. Surgery
- Venous insufficiency √
- Thyroid √
- BPH
- Renal

3. Paeds
- Syndromic (down, turner) √
- Croup √ (barking cough like sea lion), divide into mild, moderate and
severe. Usually we give oral dexa, if severe, we give adrenaline.
- Measles √
- Types of Rash
- Congenital Heart failure
- NRP
- UTI investigation
- HSP √

4. Psychi
- Elicit symptoms of
i. Anxiety √
ii. Psychosis √
iii. Depression √
iv. Maniac √
v. Alcohol abuse

Thrombocytopenia vs Haemophilia

The presence of abnormally low levels Hemophilia is a hematological disorder

of platelets in the blood is termed as that is almost exclusively seen in males.
thrombocytopenia.

Deficiency
There is a deficiency of platelets. There is a deficiency of factor VIII or
factor IX.

Bleeding
Bleeding predominantly happens from Large blood vessels are the commonest
small capillaries and venules. site of bleeding in hemophilia.

Genetics
This is not a genetic disorder. This is a genetic disorder.
Patients
Both men and women are equally This almost exclusively affects men.
affected.

  Clinical Features
The most notable clinical features are, The clinical picture varies depending on
·       Petechiae the severity of the disease.
· Severe hemophilia (factor concentration
is less than 1IU/dL)
·       Easy bruising

There is spontaneous bleeding from early

·       Prolonged bleeding even after a
life typically into the joints and muscles.
minor injury
The lack of proper treatments can be a
cause of joint deformities
·       Bleeding from gums
· Moderate hemophilia ( factor
·       Epistaxis concentration is between 1-5 IU/dL)

·       Hematuria This is associated with severe bleeding

following an injury and occasional
spontaneous bleedings.
·       Heavy menstrual bleeding

· Mild hemophilia (factor concentration is

·       Yellowish discoloration of the skin
more than 5 IU/dL)
(jaundice)

There are no spontaneous bleedings in

this condition. Bleeding occurs only after
an injury or during surgeries.

Causes
The most common causes of Hemophilia is a congenital disease with
thrombocytopenia are, no known acquired causes.
·       Splenomegaly

·       Leukemia

·       Idiopathic thrombocytopenia

·       Chronic alcoholism

·       Viral infections such as hepatitis C

·       Pregnancy

·       Adverse effects of different drugs

such as heparin

·       Hemolytic uremic syndrome

Investigations
 A full blood count can reveal the Diagnosis is through the results of the
abnormally low levels of platelets. following investigations
· Prothrombin Time – normal

· APTT – increased

· The factor VIII or factor IX levels-

abnormally low

Management
 · If thrombocytopenia is due to an Intravenous infusion of factor VIII or
immune response, immune factor IX to normalize their levels is the
suppressants have to be administered. mainstay intervention in the
Corticosteroids are the drug of choice management of hemophilia.
to suppress undue inflammatory
processes and to boost the platelet
production
· A lethally low level of platelets requires
the immediate transfusion of blood
products and platelets to avoid life-
threatening complications.

· If splenomegaly is the cause of

thrombocytopenia, surgical resection of
the spleen is necessary.

· Different other medical and surgical

interventions may be required
depending on the underlying pathology.