5-30 KRAFTS Bleeding Disorders Flashcards
What are some differences in bleeding caused by platelet issues versus those caused by Factor issues?
Platelet bleeding Superficial (skin) Petechiae (called purpura when coalesce together) Spontaneous Factor bleeding Deep (joints) Big bleeds Trauma
What is 1 thing you should absolutely remember about Factor bleeding?
Can involve deep joint bleeds
What are the 4 things you must know about Von Willebrand Disease?
Most common hereditary bleeding disorder
Auto dom
↓vWF –> platelets can’t adhere to endothelium
Variable severity
What are Sx of Von Willebrand Disease?
Mucosal bleeding in most (eg nosebleeds)
Deep joint bleeding in severe cases
What lab results would you see in vW diease (bleed time, PTT, INR, etc)
↑Bleed time
↑PTT (probably b/c less Factor VIII)
Normal INR (why?)
Abnormal platelet aggregation test
What surface protein on platelets binds vWF?
GP Ib
What does Ristocetin make platelets do?
Express their GP Ib
Tx of vW Disease?
DDAVP (make patient increase their vWF & Factor VII)
Cryoprecipitate (contains vWF and Factor VIII)
What are the 4 things you must know about Hemophilia A?
Most common coag factor deficiency
X-linked recessive (but 30% are random mutations)
↓Factor VIII
Variable amount of “factor bleeding”
Sx of Hemophilia A?
Factor bleeding – deep joint bleeds, ↑bleed time, mucosal bleed
Severity varies
What lab test results would you expect in Hemophilia A?
↑PTT, ↓Factor VIII
Everything else normal
Tx for Hemophilia A?
DDAVP
Factor VIII
What are the 4 things you must know about Hemophilia B?
↓Factor IX
Less common than A
X-linked recessive
Same clinical and lab findings
What is Bernard-Soulier Syndrome?
Abnormal GP Ib –> bad adhesion, big platelets, bleeding
What is Glanzmann Thrombasthenia?
No GP IIb-IIIa –> no platelet aggregation, bleeding
What is Gray Platelet Syndrome?
No α granules in platelets –> mild bleeding
What is δ Granule deficiency?
No δ Granules in platelets, can be part of a syndrome
What are the 4 things you must know about Disseminated Intravascular Coagulation?
Lots of underlying disorders
Something triggers coag thrombosis
Platelets & factors get used up bleeding
Microangiopathic hemolytic anemia (MAHA)
What 4 causes of DIC must you for sure remember (MOST)?
Malignancy
OB complications
Sepsis
Trauma
What lab tests would you see in DIC?
PTT, TT, INR prolonged
↑FDPs
↓Fibrinogen
How do you Tx DIC?
Treat underlying disorder, support patient w/ blood
What are the 4 things you must know about ITP?
Antiplatelet Ab’s
Acute vs Chronic
Dx of exclusion
Tx: Steroids or splenectomy
What do the Ab’s in ITP bind?
GP IIb-IIIa or Ib –> spleen eating platelets
What is a fear of chronic ITP?
Brain bleed (SA hemorrhage)
