15b alteration to thrombocyte

Question 1

DISORDERS OF COAGULATION

13

Answer 1

 Acquired coagulation disorders: liver disease, anticoagulants, vitamin K deficiency,
 DIC - disseminated intravascular coagulation is not a disease but a sign of an underlying disorder

Question 2

DISORDERS OF COAGULATION severity and triggers

Answer 2

Severity is variable; may be life-threatening
 Triggers may include sepsis, trauma, shock cancer, abrupto placenta, toxins, and allergic reactions
 Altered haemostasis mechanism causes massive clotting in microcirculation. As clotting factors are consumed,
bleeding occurs. Symptoms are related to tissue ischemia and bleeding
 Laboratory tests

Question 3

DISORDERS OF COAGULATION treatment

Answer 3

treat underlying cause, correct tissue ischaemia, replace fluids and electrolytes, maintain blood pressure,
replace coagulation factors

Question 4

Heparin-induced thrombocytopenia (HIT)

Answer 4

s a complication of heparin therapy.
 Typically occurs 4 -10 days after exposure to heparin and has life-and limb-threatening thrombotic
complications.
 HIT must be suspected when a patient who is receiving heparin has a decrease in the platelet count

Question 5

, HIT may manifest as

Answer 5

skin lesions at heparin injection sites or by acute systemic reactions (eg,
chills, fever, dyspnoea, chest pain) after administration of an intravenous bolus of heparin.

Question 6

a, HIT is generally not marked by bleeding;

Answer 6

instead, venous
thromboembolism (eg, deep venous thrombosis, pulmonary embolism) is the most common
complication. Less often, arterial thrombosis (eg, myocardial infarction) may occur. For that reason, the
disorder is sometimes termed heparin-induced thrombocytopenia and thrombosis (HITT).

Question 7

HAEMOPHILLIA types

Answer 7

Haemophilia A

 Haemophilia B

Question 8

Haemophilia A

Answer 8

is the most common form, and is caused

by having low levels of factor VIII (8)

Question 9

 Haemophilia B

Answer 9

(sometimes called Christmas Disease) is

caused by having low levels of factor IX (9). 

Question 10

Haemophilia A and B

Answer 10

are both recessive conditions, which
means that someone has to have two mutated copies of the
gene to display symptoms (with just one mutated copy they
are a carrier).

Question 11

SPLENECTOMY

Answer 11

The surgical removal of the spleen (splenectomy) is sometimes necessary and may be
required after trauma to the abdomen

Question 12

Splenectomy is also a possible treatment of other haematological disorders. like

Answer 12

For example, an enlarged spleen may be the site of excessive destruction of blood cells. If
either of these conditions occurs, splenectomy is performed as an emergency
procedure.
 In addition, some patients with grossly enlarged spleens develop severe
thrombocytopenia as a result of platelets being sequestered (hidden) in the spleen.
Splenectomy removes the ‘trap,’ and platelet counts may normalise over time.
 Severe haemorrhage can result if the spleen is ruptured because the spleen is highly
vascular.

Question 13

Plasmapheresis

Answer 13

refers to the process of separating plasma from blood, typically by
centrifugation or filtration

Question 14

Plasmapheresis is often done on

Answer 14

healthy donors to obtain
plasma only, which is used for transfusion to patients or as a source for plasma
derivative preparations (eg, albumin, clotting factor) derived from plasma pooled from
thousands of donated units. Because donors typically give only 1 unit (about 500 mL)
of plasma and must be in good health, there is no need to replace the removed
plasma.

Question 15

Plasmapheresis also may be done therapeutically to remove

Answer 15

certain substances (eg,
autoantibodies, immune complexes) that circulate in plasma. Because large volumes
of plasma must be removed, patients are transfused with plasma from healthy donors;
thus the process is termed plasma exchange.