lbm 6 Hemofili type B : cristmas disease, disorder of deficiency factor IX, herdit disesaese in of the mecanishm of blood clotting

it caused by mutation factor IX Just 12-1 ! of all case "he blood coagulation ha#e abnormality $iferent type % factor &III but tpe factor IX H'" : Hemtocrit is presentation red blood cell in plasma, blood test that mesure percentage of the #olume (hole blood that is made up of red blood cell

)tep 2 1* pre#ention of e+traction, the hemofili patient in dental

2* classification of hemofili, -* (hat ma.es the bleedimg cant stop, /hatofisiology of hemofily type b 0* patient management (ith bleeding post e+traction, * (hat (e must concern for this patient, 6* (hat the meaning of all this laboratory test and ho(1s the normal #alue, 2* (hat the drug (e can gi#e to the patient, $rug of choice, 3* ho( to do anamnesa so to the doctor can get accurate anamnesa,

4* sympthom and sign of hematologic disorder 15* effect of bleeding of the patient dont ha#e treatment 11* supportif e+amination e+cept the blood test 12* recuirment e+traction for a patient (ith blood disorder

)tep 1* classification of hemofili, %ns(er: Hemofily % : disfuntion factor &III 6oderate 1 - ! mild -2 !

se#ere 7 1 ! Hemofily B : factor IX "he case of hemofily % 35! and until 12-1 ! hemofily B Hemofily ' : factor XI

2* sympthom and sign of hematologic disorder ans(er : bruises

 prolong bleeding after geting a cut e+tracting remo#ing tooth or ha#ing surgery and traumatic blood dificult to stop blur #ision hematrosis : bleeding in 8oint pain rhinore in daily act patient ha#e purpurae of the s.inlls e#idence hematom s(elling

-* (hat the meaning of all this laboratory test and ho(1s the normal #alue, %ns(er : 9ormal #alue :B' : man ;0*2 < 15*- + 154=litre> :omen ;0*- < 11*- + 154=?> @B' : men ; 0*- < *4 > :omen ; -*4 < 0*3> Infant ; <2>

"oddler ; -*2-0*3> 'hild 1 year old ;-*6 < *2>

15- 12 years old ; 0 < *0>

0* pre#ention of e+traction, %ns(er :

the

hemofili

patient

in

dental

Aor simple dental e+traction the treatment for mild calssification B 25-2 unit of factor IX concentrete before procedure 6ay repeat 20 hours 'an be gi#en mouth(ash -2 hari before e+traction Hemofily B : 05- 5 of factor IX concentrate

* (hat ma.es the bleedimg cant stop, /hatofisiology of hemofily type b dont ha#e coagulated clotting factor blood cant be

* patient management (ith bleeding post e+traction, "ara: Ci(i : D%'% reduce bleeding patient (ith hemofily, but before (e gi#e D%'% (e gi#e topical hemostate ;I& or oral> 6* (hat (e must concern for this patient, /atient history /hysics e+amination ?aboratory screening

$rug comsumption

2* (hat the drug (e can gi#e to the patient, $rug of choice, %pa.ah ada .elainan sistemi., %ns(ering: %rum : transfution platelet, 2a factor (ith steroid %sam tranecsamad "ransamin

3* ho( to do anamnesa so the doctor can get accurate anamnesa, %ns(er: disease and drug

4* effect of bleeding of the patient dont ha#e treatment ans(er : (ill be died, usually in children shoc. hipopolemic,anemia,malaise, conscious 15* decrease

supportif e+amination e+cept the blood test

ans(ering : %/"" : untu. mengetahui e.trinsi. factor 2

/"" : intrinsic factor 3,4,11,12 "" : untu. mengetahui (a.tu fribinogen berubah men8adi fibrin

11* reEuirment e+traction for a patient (ith blood disorder ans(ering : re#ered to the internist 12* classification of bleeding