121214 cases

Question 1

giant platelets are characteristic of

Answer 1

ITP

Question 2

mucocutaneous bleeding

Answer 2

generally able to see

Question 3

course of ITP in child vs adult?

Answer 3

in children-resolves more frequently. caused commonly by viruses

in aduldts-can get chronic form (from viruses, autoimmune conditions, drugs)

Question 4

tx for ITP?

Answer 4

initially: corticosteroids
IVIG
if refractory: splenectomy (spleen is site of platelet destruction and the primary source of Ig)

Question 5

D dimer

Answer 5

clot production and breakdown

Question 6

when doing a question on bleeding, what to consider FIRST?

Answer 6

mucocutaneous or deep bleeding?

Question 7

ITP vs DIC in terms of how pt looks

Answer 7

ITP-relatively ok

DIC-not well

Question 8

how to separate out hemophilia from von willebrand dis

Answer 8

von willebrand–mucosal bleeding

hemophilia–deep tissue bleeding

Question 9

if have history of mucosal bleeding and normal PT&PTT, what tests should you do?

Answer 9

consider PFA-100

then tests of von Willebrand factor

Question 10

inheritance pattern of hemophilia

Answer 10

X linked recessive

Question 11

hemophilia–which factors?

Answer 11

8 and 9

Question 12

desmopressin (DDAVP) is used for

Answer 12

von Willebrand’s disease
it promotes vWF release from endothelial cells

in severe dis, may use viral-inactivated VWF-FVIII concentrate

Question 13

types of bleeding in secondary hemostasis defect

Answer 13

joint bleeding-hemarthrosis
muscle hemorrhage
soft tissue
life threatening bleeding
surgery

Question 14

if pt has very heavy periods, what can result?

Answer 14

iron deficiency anemia

Question 15

clinical symptoms of von willdbrand dis

Answer 15

mucosal bleeding, esp epistaxis and menorrhagia
post-op bleeding
bleeding from oral cavity
gastrointestinal bleeding

Question 16

von willebrand’s disease causes what kind of hemostasis-impairment?

Answer 16

primary (mucocutaneous bleeding)