Acquired bleeding and anticoagulants Flashcards
What is thrombophilia?
- Increased risk of clots developing
- Often an acquired condition superimposed on a genetic condition
- Usually possible to find a cause for the clot
What are possible inherited causes of thrombophilia? (4 points)
- Protein C deficiency
- Protein S deficiency
- Factor V Leiden
- Antithrombin III deficiency
What are acquired causes of thrombophilia? (7 points)
- Antiphospholipid syndrome
- Oral contraceptives
- Surgery
- Trauma
- Cancer
- Pregnancy
- Immobilisation
What is thrombocytopenia?
- Reduced platelet numbers
What is a qualitative disorder?
- Normal platelet number but abnormal function
What is thrombocythemia?
Increased platelet numbers
What are the possible causes of thrombocytopenia? (3 points)
- Idiopathic
- Drug related (alcohol, penicillin’s, Heparin)
- Secondary to lymphoproliferative disorder
Dental treatment can proceed safely providing the platelet count is what?
> 50*10^9
Are inherited qualitative disorders common or rare?
Rare
What are examples of acquired qualitative disorders? (4 points)
- Cirrhosis
- Drugs
- Alcohol
- Cardiopulmonary bypass (tend to have platelets that don’t work well)
Is thrombocythemia common or uncommon?
Uncommon disease
What medication are patients with thrombocythemia usually on to prevent clot formation?
Usually on aspirin
What are common causes of liver disease? (3 points)
- Alcohol
- Hepatitis
- Drug indiced
What is the value of a normal INR?
- 1
What is the haematological change in haemoglobin in liver disease?
Little change
What is the haematological change in platelets in liver disease?
Decrease
What is the haematological change in PT in liver disease?
Increase
What is the haematological change in APPT in liver disease?
Increase
What is the haematological change in TT in liver disease?
Increase
What does PT mean?
Prothrombin time
What does APTT stand for?
- Activated Partial Thromboplastin Time
What effect does mild stage liver disease have on dental surgery?
- Blood results often normal so normal precautions apply
What effect does moderate stage liver disease have on dental surgery? (3 points)
- Often only one parameter abnormal and platelet count >100
- No problem with treatment
- Local measures following extraction