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RIA - HAEMATOLOGY > Bleeding > Flashcards

Bleeding Flashcards

1
Q

pathophysiology of ITP

A

immune system makes antibodies against platelets… resulting in destruction of platelets

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2
Q

mechanism of rituximab

A

monoclonal antibody against B cells

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3
Q

management of ITP (4)

A
  • IVIG
  • steroids
  • Rituximab
  • Splenectomy
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4
Q

in ITP what complex on platelets are attacked?

A

GPIIb/IIIa complex

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5
Q

blood test findings in ITP

A
  • raised megakaryocytes in bone marrow

- antiplatelet autoantibodies

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6
Q

1st line trx ITP (2)

A
  • Oral corticosteroids

- IVIG

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7
Q

non immune causes of destruction of platelets

A
  • HUS

- TTP

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8
Q

medications that destroy platelets

A
  • Methotrexate
  • Isotretinoin
  • PPI
  • Antihistamines
  • Na Valporate
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9
Q

condition where tiny blood clots form throughout the small vessels of the body

A

TTP - thrombotic thromocytopenic purpura

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10
Q

deficiency in which protein in ITP?

A

ADAMTS13

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11
Q

role of ADAMTS13 usually?

A

this protein inactivates vWF & reduces platelet aggregation to vessel walls … therefore reducing clot formation

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12
Q

3 poss treatments for ITP

A
  • Rituximab
  • Steroids
  • Plasma exchange
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13
Q

4 symptoms/signs of ITP

A
  • florid purpura
  • fever
  • haemolytic anaemia
  • fluc cerebral dysfunction
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14
Q

name of the heparin induced antibodies that specifically target a protein on platelets?

A

anti-PF4

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15
Q

4 acquired coagulation disorders

A
  • liver dysfunction
  • anticoagulant medications
  • DIC
  • Vit K def
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16
Q

congenital coagulation disorders (2)

A
  • vWF disease

- Haemophilia A & B

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17
Q

what happens in platelet plug formation?

A

Platelets aggregate to form a platelet plug that temp seals the break in the vessel wall

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18
Q

3 tings released that i) enhance vascular spasm ii) cause more platelets to aggregate to area

A
  • Thromboxane A2
  • ADP
  • Serotonin
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19
Q

what activates platelet plug formation

A

vWF

20
Q

which pathway involves F7

A

extrinsic pathway

21
Q

what happens in extrinsic pathway?

A

TF + F7 –> TF-F7a

which activates FX + FIX

22
Q

Vitamin K dependant coagulation factors?

A

F2,7,9,10 and Protein C & S

23
Q

inheritance of Haemophilia A & B

A

X linked recessive

24
Q

F8 deficiency

A

Haemophilia A

25
Q

Haemophilia B - deficiency of?

A

F9

26
Q

what is Haemophilia B also known as?

A

Christmas disease

27
Q

what is haemoarthrosis

A

spontaneous bleeding into joints

28
Q

half life of F8

A

8 hours

29
Q

management of acute episodes of bleeding in haemophilia?

A
  • IV infusions (F8/9)
  • Desmopressin
  • Tranexamic acid
30
Q

desmopressin affect on vWF

A

stimulated the release of von Willebrand Factor

31
Q

most common inherited cause fo abnormal bleeding?

A

Von Willebrand disease

32
Q

vWD inheritance?

A

type 1&2 = autosomal dominant

type 3 = recessive

33
Q

type 1 vWD caused by?

A

quantitative deficiency of vWF

34
Q

type 3 vWD caused by?

A

complete deficiency of vWF

35
Q

type 2a & b vWD caused by?

A

type 2a - reduced/abnormal vWF

type 2b - abnormal vWF

36
Q

role of vWF (2)

A
  • promotes platelet adhesion to damaged endothelium

- carrier molecule for F8

37
Q

avoid desmopressin in which vWD

A

type 2b

38
Q

which vWD can result in thrombocytopenia

A

Type 2b

39
Q

what is virchows triad

A

3 factors thought to contirbute to thrombosis:

  • blood flow stasis
  • endothelial injury
  • hypercoagulability
40
Q

mechanism of aspirin

A

irreversibly inhibits cyclo-oxygenase

41
Q

mechanism of clopidogrel

A

blocks platelet aggregation and prolongs platelet survival by inhibiting the binding of ADP to its platelet receptor

42
Q

differentials of unilateral swollen painful calf?

A
  • DVT
  • Cellulitis
  • Ruptured bakers cyst
  • muscle haematoma
43
Q

what is Homans sign?

A

calf tenderness worse on dorsiflexion of ankle

44
Q

calf circumferences in DVT?

A

> 3 cm compared to unaffected leg when measured 10cm from tibial tuberosity

45
Q

what is a PE called when SBP < 100 mmHg

A

Massive PE

46
Q

PE ECG changes

A
  • Sinus tachycardia

- S1Q3T3

47
Q

management options for women with vWD with heavy periods (5)

A
  • COCP
  • mirena coil
  • tranexamic acid
  • mefanamic acid
  • norethisterone

RIA - HAEMATOLOGY (6 decks)

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