Bleeding and Clotting Disorders Flashcards
What is a normal Hgb value
Around 14 mg/dL (lower in females)
What is the most common hemophilia?
Hemophilia A
What is the factor involved in Hemophilia A?
Congenital factor 8 deficiency , X-linked recessive disorder
What is the factor involved in Hemophilia B?
Factor IX (9) deficiency, x-linked recessive disorder
What is the factor involved in Hemophilia C?
Factor XI (11) deficiency, heritable but not x-linked
What is the most common presenting symptom in hemophilia?
Hemarthrosis- bleeding into a joint
What defines a “target joint”
4 or more bleeds in the same joint within 6 months
How is the function of the intrinsic pathway measured?
With a aPTT
How is the function of the extrinsic pathway measured?
PT
What is the finding on a aPTT in someone testing positive for hemophilia?
Prolonged activated partial thromboplastin time (aPTT)
What is the treatment for hemophilia?
Mainstay is factor replacement with factor concentrate (human derived or recombinant)
What is an alternative treatment for Hemophilia A?
Desmopressin (DDAVP) (only for mild or moderate disease)
What adjunctive treatments should be avoided in persons with hemophilia?
NSAIDS
Anticoagulants including ASA
Antiplatelet agents
What bleeding disorder is most associated with females?
Von Willebrand’s Disease (VWD)
What pathway is Willebrand’s Factor apart of?
Intrinsic Pathway
What pathway is Willebrand’s Factor apart of?
Intrinsic Pathway
What is the role of Von Willbrand’s Factor?
Bind to factor VIII to extend its half life
What is the most severe form of VWD?
Type 3
What is the treatment for Type 1 VWD?
Desmopressin (DDAVP)
What is the treatment for Type 3 VWD?
Replacement of vWF
What are secondary or acquired reasons for hyper-coagulable states?
Malignancy
Pregnancy
Immobilization
Surgery or Trauma
Medications
Myeloproliferative disorders
Nephrotic syndrome
What medications can cause secondary hypercoagulable states?
OCPs
Hormone Replacement
Tamoxifen
What proteins are natural anticoagulants?
Protein C and Protein S
What is the treatment for Protein C Deficiency?
Anticoagulation, Protein C concentrate
What is the treatment for Protein S Deficiency?
Anticoagulation
What is the treatment for Antithrombin Deficiency?
Anticoagulation, antithrombin concentrate
What are the two common inherited blood clotting disorders?
Factor V Leiden Mutation
Prothrombin Gene Mutation
Is Heparin giving outpatient?
No, just in the inpatient setting
