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BLOOD Dr. Padmini Specific learning objectives List few natural and synthetic anticoagulants. Applied physiology – haemorrhagic disorders Describe blood groups with reference to ABO & Rh system, method of determination and importance. Describe indications and dangers of blood transfusion Anticoagulants - - Natural: Heparin Antithrombin Protein C SYNTHETIC – Vitamin K antagonists (effective orally,in vivo) – 1. Coumarin derivatives like dicoumarol 2. Warfarin 3. Phenindione Calcium chelating agents (in vitro) – Sodium citrate, sodium oxalate, EDTA Haemorrhagic disorder Hemophilia - Blood group LANDSTEINER’S LAWS: 1. “If an agglutinogen is present in the red cells of a blood, the corresponding agglutinin must be absent from the plasma.” 2.“If an agglutinogen is absent in the red cells of a blood, the corresponding agglutinin must be present in it’s plasma.” APPLICABILITY The first law is applicable to all groups and types of blood. It is a logical conclusion. The second part is a fact, but not necessarily true always. It is a fact for ABO Bloodgroups. The Rh, M,N and other groups or types do not follow the second part of the Landsteiner’sLaw. How to determine blood group? O +ve B +ve Rhesus (Rh) blood group Rh factor & hemolytic disease: Manifestations of hemolytic disease 1. 2. 3. Hydrops foetalis Icterus gravis neonatorum (hemolytic jaundice, erythroblastosis foetalis) Kernicterus Importance of blood grouping In blood transfusion In pregnancy (Rh incompatibility) Investigating cases of paternity dispute Medicolegal value Blood transfusion 1. 2. 3. 4. 5. IndicationsBlood loss: Blood disorders: Blood diseases: Pre-op or post-op: Shock: Cross matching Donor’s RBC with recipient’s plasma 1. 2. 3. 4. 5. 6. HazardsMismatched blood transfusion Mechanical overloading Chemical risks Transmission of diseases Allergic reactions Pyrogenic reactions