MEKANISME HEMOSTASIS Essays - , Term Papers

MEKANISME HEMOSTASIS Urutan mekanisme hemostasis dan koagulasi dapat dijelaskan sebagai berikut: 1. Segera setelah pembuluh darah terpotong atau pecah, rangsangan dari pembuluh darah yang rusak itu menyebabkan dinding pembuluh berkontraksi sehingga dengan segera aliran darah dari pembuluh darah yang pecah akan berkurang (terjadi vasokontriksi). 2. Setelah itu, akan diikuti oleh adhesi trombosit, yaitu penempelan trombosit pada kolagen. ADP (adenosin difosfat) kemudian dilepaskan oleh trombosit kemudian ditambah dengan tromboksan A2 menyebabkan terjadinya agregasi (penempelan trombosit satu sama lain). Expositions aktivasi trombosit ini terus terjadi sampai terbentuk sumbat trombosit, disebut juga hemostasis preliminary. 3. Setelah itu dimulailah kaskade koagulasi (lihat gambar.1) yaitu hemostasis sekunder, diakhiri dengan pembentukan fibrin. Produksi fibrin dimulai dengan perubahan faktor X menjadi faktor Xa. Faktor X diaktifkan melalui dua jalur, yaitu jalur ekstrinsik dan jalur intrinsik. Jalur ekstrinsik dipicu oleh tissue factor/tromboplastin. Kompleks lipoprotein tromboplastin selanjutnya bergabung dengan faktor VII bersamaan dengan hadirnya particle kalsium yang nantinya akan mengaktifkan faktor X. Jalur intrinsik diawali oleh keluarnya plasma atau kolagen melalui pembuluh darah yang rusak dan mengenai kulit. Paparan kolagen yang rusak akan mengubah faktor XII menjadi faktor XII yang teraktivasi. Selanjutnya faktor XIIa akan bekerja secara enzimatik dan mengaktifkan faktor XI. Faktor XIa akan mengubah faktor IX menjadi faktor IXa. 4. faktor IXa akan bekerja sama dengan lipoprotein trombosit, faktor VIII, serta particle kalsium untuk mengaktifkan faktor X menjadi faktor Xa. 5. faktor Xa yang dihasilkan dua jalur berbeda itu akan memasuki jalur bersama. Faktor Xa akan berikatan dengan fosfolipid trombosit, particle kalsium, dan juga faktor V sehingga membentuk aktivator protrombin. 6. Selanjutnya senyawa itu akan mengubah protrombin menjadi trombin. Trombin selanjutnya akan mengubah fibrinogen menjadi fibrin (longgar), dan akhirnya dengan bantuan fakor VIIa dan particle kalsium, fibrin tersebut menjadi kuat. Fibrin inilah yang akan menjerat sumbat trombosit sehingga menjadi kuat. 7. Selanjutnya apabila sudah tidak dibutuhkan lagi, bekuan darah akan dilisiskan melalui expositions fibrinolitik. Compositions ini dimulai dengan adanya proaktivator plasminogen yang kemudian dikatalis menjadi aktivator plasminogen dengan adanya enzim streptokinase, kinase jaringan, serta faktor XIIa. Selanjutnya plasminogen akan diubah menjadi plasmin dengan bantuan enzim seperti urokinase. Plasmin inilah yang akan mendegradasi fibrinogen/fibrin menjadi fibrin debasement item [pic] Gangguan hemostasis (perdarahan unusual) dapat disebabkan oleh beberapa hal di bawah ini: 1. Kelainan vaskuler Kelainan vaskuler adalah sekelompok kelompok keadaan heterogen, yang ditandaiu oleh mudah memar dan perdarahan spontan dari poembuluh darah kecil. Kelainan yang mendasari terletak pada pembuluh darah itu sendiri atau dalam jaringan ikat perivaskular. Pada keadaan dseperti ini, uji penyaring standart part hasil typical. Masa perdarahan ordinary, uji hemostasis lain juga typical. Kelainan vaskular ini terdapat dua jenis yakni herediter yang berupa Telangiektasia hemoragik herediter, serta kelainan jaringan ikat. Jenis yang lain adalah Defek vaskular didapat . 2. Trombositopenia Trombositopenia didefinisikan sebagai jumlah trombosit kurang dari 100.000/mm3. Biasanya ditandai dengan purpura kulit spontan, perdarahan mukosa, dan perdarahan berkepanjangan setelah injury. Beberapa penyebab trombositopenia antara lain: (1)Kegagalan produksi trombosit .Ini merupakan penyebab tersering trombositopenia yang biasanya juga merupakan bagian dari kegagalan sumsum tulang generalisata Penekanan megakarisit selektif dapat disebabkan oleh toksisitas obat atau infeksi infection. (2)Peningkatan destruksi trombosit, Hal ini dibagi menjadi beberapa jenis yakni: a.Trombositopenia imun,termasuk di dalamnya ITP, karena infeksi, purpura pascatranfusi, Trombositopenia imun karena diinduksi obat, b.Purpura trombositopenia trombotik c.Koagulasi intravaskular diseminata, (3)Distribusi trombosit anomalous, (4)Kehilangan akibat dilusi, yakni berupa transfuse masif darah simpan pada pasien dengan perdarahan. 3. Gangguan koagulasi Bisa karena herediter maupun didapat, yang umumnya menggangu faktor-faktor koagulasi. a.Herediter : hemofilia A dan hemofilia B b.Didapat : defisiensi nutrient K dan penyakit hati 4.Gangguan fungsi trombosit Dibagi menjadi dua jenis, yakni: a.Didapat 1) karena obat hostile to trombosit seperti headache medicine, 2).hiperglobulinemia, 3).kelainan mieloproliferatif dan mielodisplastik , serta 4)Uremia. b.Kelainan herediter 1) Trombastenia, 2)Sinsrom Bernard soulier, 3) Penyakit penyimpanan KELAINAN KOAGULASI . Hemofili A . Hemofili B . Kekurangan vit K (II,VII, IX, XI) Ganggan fungsi hati . DIC Adanya tissue factor (endotoxin, kerusakan jaringan dll) TF aktivasi koagulasi diikuti aktifasi fibrinolitik bergantian. Trombositopeni, APTT, PPT, TT memanjang, fibrinogen turun, FDP squestrasi PEMERIKSAAN LAB HEMOFILIA . Coagulating time memanjang . APTT memanjang . Kadar Faktor VII menurun pada hemophilia A dan faktor IX menurun pada hemophilia B Conclusion DARI HASIL LAB PADA HEMOFILIA . Coagulating time memanjang, Bleeding time typical . APTT memanjang, PPT typical

Poetry and Stylistic Features

I'll transfer one later, I'm on my telephone Elizabeth Bishop offers fascinating conversation starters conveyed by methods for a remarkable style. Do u concur with this assesment of her verse? Your answer should concentrate on the two topics and complex highlights . Bolster your focuses with the guide of appropriate reference to the sonnets you have contemplated. *Good Luck ;)* Elizabeth Bishop offers intriguing conversation starters conveyed by methods for an exceptional style. Do u concur with this assesment of her verse? Your answer should concentrate on the two subjects and expressive highlights .Support your focuses with the guide of reasonable reference to the sonnets you have contemplated. *Good Luck ;)*qElizabeth Bishop offers fascinating conversation starters conveyed by methods for a one of a kind style. Do u concur with this assesment of her verse? Your answer should concentrate on the two subjects and complex highlights . Bolster your focuses with the guide of reasonable reference to the sonnets you have contemplated. *Good Luck ;)*Elizabeth Bishop offers intriguing conversation starters conveyed by methods for a one of a kind style. Do u concur with this assesment of her poetry?Your answer should concentrate on the two topics and expressive highlights . Bolster your focuses with the guide of appropriate reference to the sonnets you have considered. *Good Luck ;)*Elizabeth Bishop suggests intriguing conversation starters conveyed by methods for a remarkable style. Do u concur with this assesment of her verse? Your answer should concentrate on the two topics and expressive highlights . Bolster your focuses with the guide of appropriate reference to the sonnets you have examined. *Good Luck ;)*Elizabeth Bishop suggests fascinating conversation starters conveyed by methods for a remarkable style. Do u concur with this assesment of her poetry?Your answer should concentrate on the two subjects and elaborate highlights . Bolster your focuses with the guid e of appropriate reference to the sonnets you have considered. *Good Luck ;)*Elizabeth Bishop suggests intriguing conversation starters conveyed by methods for an extraordinary style. Do u concur with this assesment of her verse? Your answer should concentrate on the two topics and complex highlights . Bolster your focuses with the guide of appropriate reference to the sonnets you have contemplated. *Good Luck ;)*Elizabeth Bishop offers intriguing conversation starters conveyed by methods for a remarkable style. Do u concur with this assesment of her poetry?Your answer should concentrate on the two subjects and expressive highlights . Bolster your focuses with the guide of reasonable reference to the sonnets you have considered. *Good Luck ;)*Elizabeth Bishop suggests intriguing conversation starters conveyed by methods for a special style. Do u concur with this assesment of her verse? Your answer should concentrate on the two topics and complex highlights . Bolster your focuses wit h the guide of appropriate reference to the sonnets you have contemplated. *Good Luck ;)*Elizabeth Bishop suggests fascinating conversation starters conveyed by methods for a special style. Do u concur with this assesment of her poetry?Your answer should concentrate on the two subjects and complex highlights . Bolster your focuses with the guide of reasonable reference to the sonnets you have considered. *Good Luck ;)*Elizabeth Bishop offers intriguing conversation starters conveyed by methods for a novel style. Do u concur with this assesment of her verse? Your answer should concentrate on the two subjects and complex highlights . Bolster your focuses with the guide of reasonable reference to the sonnets you have examined. *Good Luck ;)*Elizabeth Bishop offers intriguing conversation starters conveyed by methods for a one of a kind style.Do u concur with this assesment of her verse? Your answer should concentrate on the two topics and complex highlights . Bolster your focuses with the guide of reasonable reference to the sonnets you have considered. *Good Luck ;)*Elizabeth Bishop suggests fascinating conversation starters conveyed by methods for an interesting style. Do u concur with this assesment of her verse? Your answer should concentrate on the two topics and elaborate highlights . Bolster your focuses with the guide of reasonable reference to the sonnets you have contemplated.

Analysis of Addiction Service

Examination of Addiction Service Colin O’Rourke Sankalpa Addiction Services Sankalpa is a Sanskrit word meaning thought or idea shaped in the heart or psyche, a serious promise or assurance to perform and a craving or positive aim. History of the office The Millennium Carvings program which was set up in 1998 and was bolstered and financed by FAS and the Local Drug Task Force (LDTF). Intended to convey recovery programs for settled or previous medication clients in the Finglas/Cabra territory it offered all encompassing projects investigating singular innovativeness along with restorative restoration programs. Thousand years Carvings advanced into Sankalpa and kept on making an all encompassing and remedial condition using fine art and imagination. This permits customers take an interest in their own recuperation procedure while tending to a portion of the mind boggling requirements of administration clients through self-awareness and gathering work. The LDTF currently guarantee Sankalpa cling to the National Drug Strategy. Office Ethos ‘A feasible pathway out of enslavement driving towards a culture of recuperation in Finglas and Cabra, worked by help associations and administration clients working in solidarity’ The trademark soul supporting the Sankalpa culture is that of customer focused remedial condition in an inventive, all encompassing condition, the accentuation being on network. In making this network empowers the customers to change naturally, the acknowledgment being that the customer comprehends what inspires them superior to the specialist, change originates from inside. It is perceived that the connection between the customer and the advisor is of prime significance while assessing the achievement of the helpful procedure, and that the foundation of recuperation is this relationship. Points Sankalpa intend to regard the respect and privileges of the customer in a fair and safe condition while understanding that sole obligation regarding any enslavement is the duty of the customer that created it. In doing so it plans to upgrade characteristic worth in a restorative domain that qualities learning with the end goal of encouraging the recuperating procedure. It is accepted that the helpful procedure is helped by making a space where medication related mischief is limited and where efficient degrees of medication administrations are made accessible. Best practice and proof based intercessions are expected to be used just like the help of non clinical treatment of torment. Sankalpa mean to advance critical thinking and basic deduction with their customers while staying legitimate and receptive in their issues. Goals To meet their points Sankalpa convey quality projects while using prepared staff who areâ focused on accomplishing the ideal results by being a piece of the continuum of clients’ recoveryâ and connecting and banding together with different organizations to aid this continuum. Sankalpa supportâ clients by offering CE pla ns to help with proceeding onward to business and training. Theyâ offer licensed further instruction to clients’ giving compulsion issues or settled onâ their medicine and help propelled customers in the continuum of recuperation by method of theâ development and usage of their restorative model. What sort of treatment approach supports the organization? The Sankalpa remedial model is psychosocial, customer focused and proof based. It uses organized mediations the point being to decrease or balance out the damages related with illegal medication use. The restorative work is for the most part done in gatherings and utilizations Cognitive Behavior Therapy (CBT), Community Reinforcement Approach (CRA), Motivational Interviewing (M.I) and Mindfulness. Coordinated meetings incorporate objective setting, surveys and evaluations. It is comprehended by workers of Sankalpa that entrance to training and business that may already have been far off because of social hardship can be th e foundation of fruitful recuperation.

The Adventures Of Huck Finn 2 Essay free essay sample

, Research Paper The Adventures of Huckleberry Finn By ; Mark Twain I have perused the book The Adventures of Huckleberry Finn up to section 14. I have discovered one thing I wear # 8217 ; t like, the etymological correspondence which is utilized is straight out of the 1800 # 8217 ; s. A delineation of this can be found on each page in the book. Couple shows one of these representations when he composes, # 8220 ; I took to it again on the grounds that pablum hadn # 8217 ; t no protests. # 8221 ; This semantic correspondence is non worthy in current English, it should be, # 8220 ; I took to it again on the grounds that pablum had no complaints. # 8221 ; At the point when Tom and Huckleberry were outside and came up short on tightens and required a greater amount of them, I thought it was acceptable of Tom to go forward cash for the shapes he took. Couple shows this when he composes, # 8220 ; But Tom needed to resk it ; so we slid in there and got three shapes, and Tom laid five pennies on the even cluster for pay. We will compose a custom article test on The Adventures Of Huck Finn 2 Essay or on the other hand any comparative point explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page # 8221 ; This shows however it was off base of Tom to take the shapes it legit of him to go forward compensation for the shapes. I think Ts cap Tom and Huck are truly shrewd male childs, when Huck escaped the house Tom imagined that he was a feline to procure Hucks joining in. In the event that he hadn’t done this the widow may hold got them go forthing in the focal point of the dim. Couple shows their genius when he composes, â€Å"Directly I could simply barely hear a me-yow! me-yow! down at that place. That was acceptable! Says I, me-yow! me-yow! each piece delicate as I could, thus I put out the noticeable radiation and mixed out of the window on to the shed.† This shows the male childs creativity and knowledge. I think it is sick that the gathering of male childs made their ain pack. The pack intended to ransack individuals, slaughter individuals and take individuals for deliver. Twain shows this when he composes, # 8220 ; We ain # 8217 ; t thieves. That ain # 8217 ; t no sort of way. We are highjackers. We stop stages and traveler vehicles on the course, with covers on and slaughter the individuals and take their tickers and cash. # 8221 ; I think that its monstrous that some juvenile school male childs would be after to execute individuals. In choice the book is non each piece awful as I anticipated that it should be.

Senior Week Jonathan Lii

Senior Week Jonathan Lii Name: Jonathan Lii Hometown: Manhasset, NY Degrees and Minor: 18 and 15 with a minor in 14 [in laymans terms: a double major in Mathematics and Management, and a minor in Economics] Whats next: Working as a trader at Lehman Brothers. Favorite class at MIT: 18.440: Probability and Random Variables with Prof. Richard Dudley. It was a class in probability where we calculated the probability of holding poker hands and other interesting problems. Other cool problems were the marriage problem, and birthday problem. This class really helped me out for my finance interviews too. Favorite professor at MIT: Prof. Daniel Kleitman is my favorite professor here. He is the coolest guy to talk to about ANYTHING. He has all sorts of crazy artifacts in his office and visiting him is always a treat. Going to him for one on one help really pulled me through 18.310. I feel like I learned a lot from him. We have talked about various things like Ping Pong, the Enigma Machine, and bike lamps. Favorite MIT event: Its a toss up between Battle of the Bands and NightMarket. Battle of the Bands was awesome because ZBT gets all the awesome local bands together and there is a giant music free-for-all. Its definitely one of the most exciting events out there. NightMarket is also sweet because theres so much food. Association of Taiwanese Students does a great job with getting the event going and provides some of the most dedicated students to make the event a reality. UROPs: I worked with Nate Quitoriano (my TA for 3.091 gotta work those graduate student connections!) for a Course 3 [Materials Science] lab that doped germanium wafers. Later I UROPed for Prof. Kleitman helping him to revise some of his 18.310 notes. Living groups: I had a one year stint at Simmons Hall and then spent my last three years living at Zeta Beta Tau (ZBT). At ZBT I was community service chairman, academic chairman, and then Vice President. Activities: I have been involved with Sport Tae Kwon Do, Used Computer Factory, Association of Taiwanese Students, the Undergraduate Association Finance Board, and ZBT. What Ill miss most about Cambridge/Boston: The biggest thing Ill miss about Cambridge/Boston is the town-y feel I get here. Its not as urban as NYC and there is a certain charm to that. The restaurants in Boston are awesome and theres so many fun things to do! What Ill miss most about MIT: Ill miss my friends in Association of Taiwanese Students and brothers at Zeta Beta Tau. I have an amazing social network here that I am really reluctant to leave, and of course Ill miss walking into Matts office just to talk! Seriously just walk into his office, hell spend some time to talk with you! He is awesome. Final thoughts: MIT ROCKS.