https://padlet.com/nransh2002/k56kwgug4xtp4p3t en-us 2023-02-26 02:45:20 UTC 2023-07-14 16:21:35 UTC hello@padlet.com nransh2002 https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495054996 Adam, a 7-year-old boy presented with prolonged bleeding for 2 days duration following circumcision. His grandmother was blaming Adam’s father on his decision in doing circumcision at the early years. His maternal uncle had history of frequent hospitalizations due to recurrent bleeding in the knee joint. Bleeding disorder was suspected and investigated ]]> 2023-02-26 02:48:06 UTC https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495054996 https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495058963 - whats the exact age to perform circumcision 
- share awareness 
- Risk factor : aging 
- circumcised at early age : easy to take care 
- Decision made by Adam's parents as he is just 7 years old 
- Educate the parents about the risk factors , complications 
- ]]> 2023-02-26 03:05:35 UTC https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495058963 fatihaainaumaira https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495059330 2023-02-26 03:07:12 UTC https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495059330 nransh2002 https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495059807 1. Adam , 7 year old boy
- minor 
-presence of  congenital or inherited disease 
- gender : pattern of inheritance 
- age for circumcision : Malaysia ( 7 -12 yrs )]]> 2023-02-26 03:09:08 UTC https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495059807 nransh2002 https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495061271 2. Prolonged bleeding for 2 days ( CC )
- impaired of haemostasis ( def : keep the blood in fluid form in circulation to arrest bleeding following injury to blood vessel )
- impaired to 5 major component ( blood vessel , platelet , vwf, coagulation factor , coagulation inhibitir , fibrinolytic system )]]> 2023-02-26 03:15:34 UTC https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495061271 nransh2002 https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495063788 4. Maternal uncle - frequent hospitalization due to recurrent bleeding in knee joint 
 
- uncle from mother side 
- mother is asymptomatic 
- disease carried by chromosome X 
- to know the disease carried by which chromosome is through pedigree

]]> 2023-02-26 03:26:20 UTC https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495063788 nransh2002 https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495064884 5. Bleeding disorder 
- rare disorders affecting the way the body controls blood clotting
- inherited : platelet dysfunction , thrombocytopathy , hemophilia , von Willebrand disease]]> 2023-02-26 03:30:51 UTC https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495064884 nransh2002 https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495065480 Laboratory investigation results were as follows:
PT :14 seconds (Normal Range: 12.6-15.7 seconds)
APTT : 60 seconds (Normal Range: 30.0-45.8 seconds)
Platelet : 200 x109/L
Factor VIII level : 5% (Normal Range: 50-150%)

He was diagnosed with Haemophilia A and managed accordingly after discussion with the parents ]]> 2023-02-26 03:33:15 UTC https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495065480 nransh2002 https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495067222 PT ( Prothrombin Time ): Normal
- extrinsic pathway & common pathway

APTT ( Activated Partial Thromboplastin time ) : Prolonged
- problem with intrinsic pathway
- effect coagulation cascade

Platelet : Normal

Factor VIII : Low

* List Examples of disease for other factors deficiency

-

]]> 2023-02-26 03:40:00 UTC https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495067222 nransh2002 https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495068648 - inherited bleeding disorder in which the blood does not clot properly
- decrease in activity of coagulating factor (reduce or dysfunction )
- why A? - due to reduce in factor VIII
- B - reduce in factor XI 
- determine by specific factor assay 
- ]]> 2023-02-26 03:46:00 UTC https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495068648 nransh2002 https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495071372 Medical 
- prolonged bleeding 
- Risk factor of circumcision : bleeding & injury
- suggested to done circumcision early ( easy to take care )
- advice patient to take care of hygiene
- circumcision get risky when you get older - pain , infection

Empathy 
- ]]> 2023-02-26 03:56:58 UTC https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495071372 nransh2002 https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495073120 1. Pedigree + Pathogenesis of Hemophilia
2. Types of bleeding disorder ( inherited )
  - focus more on Hemophilia A ( clinical features , 
3. Complications of hemophilia
4. Pathophysiology of hemarthrosis 
5. Interpret Laboratory investigations 
  - explain coagulation cascade 
- list examples of disease for other factor deficiency
6. Hemophilia vs von Willebrand disease
7. Ethical concerns
   - Exceptions for having circumcision due to diseases
   - MERCI 
    - Treatment 
8. Symptoms of bleeding disorder correlate with ddx ]]> 2023-02-26 04:03:41 UTC https://padlet.com/nransh2002/k56kwgug4xtp4p3t/wish/2495073120