Acquired Bleeding Disordres Flashcards
What are the major Acquired bleeding disorders?
1) Thrombocytopenia
2) Liver Failure
3) Drugs
4) Haemorrhagic Disease of Newborn
How would you spot someone who’s thrombocytopenic?
Petechia
Ecchymosis
Mucosal bleeding
Rarely a CNS bleed
Then FBC
What are the major causes of thrombocytopenia?
Marrow failure or infiltration
ITP, DIC or hypersplenism
What could trigger Idiopathic Thrombocytopenic Purpura?
EBV HIV Lymphoma Collagenosis Quinine use
How do you diagnose ITP?
Patient presents with clinical history of thrombocytopenia i.e. bruising, petechia & mucosal bleeds
+ FBC showing thrombocytopenia
Very rarely need marrow tests
How do we treat ITP acutely?
Steroids & IV IgG
How do we manage ITP chronically?
Most cases are just one episode but if its long term:
- Platelet count good between episodes? Then leave it
- Platelet count consistently low? –> Thombopoietin Analogues
How does liver disease contribute to bleeding?
Liver produces a lot of coagulation factors + Fibrinogen + Thrombopoietin
So someone with chronic liver disease will produce less –> Excess of both bleeding
Where do people with liver disease tend to bleed from?
Varices
Drugs cause most cases of acquired bleeding disorder, what ones particularly?
Warfarin Heparins Aspirin Anti-platelets DOACs
What is haemorrhagic disease of a newborn?
Babies with immature coagulation system + Vit K deficiency —> Fatal Haemorrhage
Very rare in the western world as we give newborns a Vit K inj