KULIAH PolistemiaDIC

8/19/2019 KULIAH PolistemiaDIC

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PENDAHULUAN


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DEFINISI

Polisitemia didefnisikan sebaai!eninkatan "#mla$ sel da%a$

me%a$ & e%it%osit ' danbebe%a!a kom!onen da%a$( Defnisi lama ) !eninkatan

konsent%asi $emolobin diatasnilai no%mal be%dasa% kelom!ok#m#% ata# "enis kelamin


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Nilai Hemoglobin dan Hematokrit normalterendah

WHO Group Experts on Nutritional Anaemia.

Umur dan jenis kelamin Hb Ht

Anak - anak 6 bulan – 6 tahun 11 36

Anak – anak 6 tahun – 14 tahun 12 38

Laki-laki dewasa 13 40

Wanita dewasa tidak hamil 12 38

Wanita dewasa hamil 11 36


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Packed Cell Volume

Laki*laki + ,- .

/anita + 01 .2 PolisitemiaRed 3ell Mass + 4, . da%i!%ediksi be%dasa% #m#% danbe%at badan


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5LASIFI5ASI POLISITEMIA


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POLISITEMIA 6ERA

ANAMNESA )

Se%in dikel#$kan !ende%ita ) n7e%ike!ala8 mi%ain 7an $ebat8 9a"a$ 7an

meme%a$8 %asa atal be%#lan !adat#b#$8 o#t(

Be%$#b#nan denan %i9a7at an#an

:ask#la% se!e%ti st%oke8 iskemik


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KRITERIA DIAGNOTIKPO!IITE"IA VERA


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11/30FAIZAL DRISSA HASIBUAN

DisseminatedIntravasular

!"a#ulati"n

5OA;ULASI INTRA6AS5ULARDISSEMINATA


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PENDAHULUAN

i#tem Hemo#ta#i#-( Sistem !emb#l#$ da%a$4( Sistem t%ombosit( Sistem !embek#an

da%a$0( Sistem fb%inolisis


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-( Sistem !emb#l#$ da%a$

F#nsin7a)

-( 5ont%aksi !emb#l#$ da%a$( 4( Akti:asi !embek#an da%a$ d

mem!%od#ksi t%ombo!lastin( ( Akti:asi t%ombosit d mem!%od#ksi


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4( Sistem t%ombosit

F#nsin7a)-( Memeli$a%a s#!a7a !emb#l#$ da%a$

teta! #t#$ setela$ mik%o t%a#ma !adaendotel(

4( Mena9ali !en7#mbatan !emb#l#$da%a$ d membent#k s#mbat !%ime%(

( Stabilisasi s#mbat t%ombosit &fb%in'8melal#i bebe%a!a ta$a!)

Ad$esi t%ombosit( A%easi t%ombosit( Reaksi !ele!asan &%elease'(


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( Sistem !embek#an da%a$

Pembek#an te%"adi o(k inte%aksianta%a !%o koa#lan &


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0( Sistem fb%inolisis

-( P%oakti:ato% !lasminoen dioba$men"adi akti:ato% !lasminoen(

4( Akti:ato% !lasminoen akanmenoba$ !lasminoen men"adi!lasmin(

( Plasmin men$id%olisis fb%inoendan fb%in men"adi fb%in&oen'de%adation !%od#Ct &FDP'(


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DEFINISI

“ ….an a$uired s%ndr"me harateri&ed b% the intravasular ativati"n "'

"a#ulati"n with l"ss "' l"ali&ati"n arisin# 'r"m di''erent auses( It an

"ri#inate 'r"m and ause dama#e t" the mir"vasulature) whih i'su''iientl% severe) an *r"due "r#an d%s'unti"n+,

Scientific and Standardization Committee of the International Society on Thrombosis

and Haemostasis, Paris July 2001


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Patofsioloi

5e%#sakan !emb#l#$ da%a$ akanme%ansan !%oses koa#lasi dan!embent#kan fb%in8 diik#ti ole$ fb%inolisis(

Akti:asi koa#lasi be%lebi$an8menakibatkan !en#naan &kons#msi'


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;e"ala klinis

Pe%da%a$an di


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Pen7ebab

In


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Labo%ato%i#m

Hitung trombo#it$ PT$ aPTT$ TT$ Kadar %brinogen$ &DP$

D'dimer$ Darah te(i ) cari *ragmenta#i eritro#it$


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E:idenCe o< !%oCoa#lant aCti:ation

E:idenCe o< fb%inol7tiC aCti:ation

E:idenCe o< in$ibito% Cons#m!tionE:idenCe o< end*o%an damae o%


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E:idenCe o< !%oCoa#lation

Ele:ated !%ot$%ombin


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E:idenCe o< fb%inol7tiCaCti:ationEle:ated D*dime%Ele:ated FDP

Ele:ated !lasminEle:ated !lasmin anti!lasmin

Com!le


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E:idenCe


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E:idenCe


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Te%a!i

Obati !en7akit dasa%( T%ans


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DI3 SCo%e

Platelet count

+ -== 2 = ? -== 2 - ? ,= 2 4 Ele+ated %brin'related marker

no inC%ease 2 = mode%ate inC%ease 2 4st%on inC%ease 2

Prolonged (rothrombin time

? seC 2 = + seC b#t 8 @ seC 2 -

+ @ seC 2 4 &ibrinogen le+el

+ -(= >L 2 = ? -(= >L 2 -


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I< + , ) Com!atible 9it$ o:e%tDI3 G %e!eat sCo%in dail7

I< ? , ) s#esti:e

&not a%mati:e'

KULIAH PolistemiaDIC

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