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physiology > Bleeding and coagulation disorder > Flashcards

Bleeding and coagulation disorder Flashcards

1
Q

Hemostatic Disorders
-Classified into two main categories:
1.
2.

A

I. Bleeding Diseases.
II. Intravascular Thrombosis.

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2
Q

illustrate the def & causes of Bleeding Diseases

A
  • def :
    These are a group of diseases
    chc. by an in tendency to bleeding spontaneously or after trauma.

-causes: due to
1. Vessel wall defects.
2. Platelet disorders (Count or Function).
lead to superficial bleeding
3. Blood clotting disorders
lead to deep bleeding

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3
Q

illustrate the def & causes of Bleeding due to defect in the blood vessel (Purpura)

A
  • def :It is a bleeding tendency due to weak fragile vessel wall causing poor constriction of the injured vessel
  • causes :
    1. Hereditary.
    2. Acquired:
  • nutrient deficiency as Scurvy (Vitamin C deficiency).
  • Drugs (e.g. steroid).
  • Aging (senile purpura).
  • Infections (streptococcal).
  • Malignancies.
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4
Q

illustrate the causes of Bleeding due to platelet disorder (Purpura)

A
  1. Decreased platelet count (Thrombocytopenia)
    (Thrombocytopenic Purpura)
  2. Weak platelet function (Thrombasthenia orThrombocytopathia) (Thrombocytopathic purpura)
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5
Q

def of Bleeding due to platelet disorder caused by Decreased platelet count

A

It is a bleeding tendency due to deficient in platelet plug formation, clot retraction and poor constriction of injured vessel

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6
Q

-the normal platelet count range is ……
- Bleeding occurs when platelets count………….
-Internal bleeding occurs when platelets count………….
- Lethal (Fatal) platelets count…………..

A

150,000-410,000/mm3
< 50,000/µL.
< 20,000/ µl
< 10,000/ µl

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7
Q
  • People with thrombocytopenia have a tendency to bleed from………….
  • The skin of such people displays many small and purplish blotches called……., large………or larger…………
  • Bleeding time is …………. with……… clotting time
A
  • small blood vessel
    (venules and capillaries).
  • petechiae /ecchymosis/ecchymotic patches
  • prolonged / normal
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8
Q

illustrate Causes of Decreased platelet count

A

1.Primary:
Autoimmune disease (Idiopathic thrombocytopenic purpura) (ITP)
2.Secondary:
-Hypersplenism.
-Sever destruction of bone marrow.

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9
Q

………..It gives the same clinical picture as thrombocytopenia.

A

Weak platelet function

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10
Q

list Causes of Weak platelet function

A

1.Prolonged use of aspirin (inhibit platelet aggregation).
2. Renal failure (Toxins or dialysis machine).
3. Deficiency of Von Willebrand factor (inhibit platelet adhesion)

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11
Q

what’s the Treatment of bleeding disorders due to vessel wall or
platelet defects?

A
  1. Vitamin C administration.
  2. Platelet transfusions.
  3. Fresh whole blood transfusion that contain large number of platelets.
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12
Q

-In Bleeding due to abnormal coagulation, bleeding tendency due to…
-It is result from………..
-These people usually have a tendency to bleed from ……………..
-……………… is prolonged, while bleeding time is…………

A
  • deficient in clot formation
  • lack of any of the clotting factors
  • large blood vessel.
  • Clotting time / normal
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13
Q

list causes of Bleeding due to abnormal
coagulation

A
  1. Acquired:
    Liver diseases
    Vitamin K deficiency
  2. Congenital:
  3. Due to deficiency of one of the clotting factors
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14
Q

why the liver disease cause bleeding ?

A

because almost all clotting factors are formed by the liver.

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15
Q
  • in liver disease both PT & aPTT are ……………..
  • in early liver disease ……is prolonged & …….. is normal.
A
  • prolonged
  • PT / aPTT
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16
Q

Vitamin K deficiency lead to insufficiency of the clotting factors …………….

A

II, VII, IX and X

17
Q

illustrate causes of vitamin K deficiency.

A
  1. Liver disease:
    failure of liver to secrete bile.
  2. Failure of absorption:
    - bile duct obstruction
    - chronic diarrhea
    - gastrointestinal disease
  3. Deficient intestinal bacteria:
    - prolonged use of antibiotic
    - newly borne infant
  4. Anticoagulant drugs :(coumarin) prevent utilization of vit K by liver.
18
Q

def of Hemophilia

A
  • congenital deficiency of factor VIII or IX or XI
  • It is an inherited sex-linked anomaly, transmitted by females, who are carriers (show no symptoms), to males who manifest signs of the disease
19
Q

def of Parahemophilia

A

congenital deficiency of factor V

20
Q

def of Afibrinogenemia

A

deficiency of fibrinogen

21
Q

def of Hypoprothrombinemia

A

decreased prothrombin synthesis
by the liver, usually in vitamin K deficiency.

22
Q

illustrate the symptoms and pathological findings in hemophilia

A

*Symptoms (begin early in life):
- Bleeding either from natural orifices (spontaneously) or after injury or incisions.
- Recurrent hemarthrosis i.e., bleeding in joints, following minor trauma leading to crippling deformity due to fibrous
adhesions.
- Marked increase in clotting time

23
Q

in hemophilia :
- prolonged ……….
- normal …….

A
  • aPTT
  • PT
24
Q

illustrate Treatment of hemophilia

A

Supplying the patient with the deficient clotting factor (Cryoprecipitate)

25
Q

list types of hemophilia

A

1.Hemophilia A (Classical hemophilia):
- due to deficiency of factor VIII.
- Represents 85% of hemophilic patients

2.Hemophilia B:
- factor IX deficiency (Christmas disease).

3.Hemophilia C:
- factor XI deficiency

4.Parahemophilia:
factor V deficiency

26
Q

Compare between Hemophilia
and Purpura: from
-Hereditary
-Sex
-Causes
- Clotting Time (aPTT)
-Bleeding Time

A
  1. Hemophilia
    -Hereditary: Congenital
    -Sex: Males
    -Causes Lack of clotting factors
    - Clotting Time (aPTT): Prolonged
    -Bleeding Time: Normal
  2. Purpura
    -Hereditary: Not congenital
    -Sex: Males & Females
    -Causes: Platelet defect (count & function)
    - Clotting Time (aPTT): Normal
    -Bleeding Time: Prolonged

** NOTE : PT is normal in both
** PT evaluate extrinsic pathway
**aPTT evaluate intrinsic pathway

27
Q

def Intravascular Thrombosis

A

Abnormal formation of clot inside the blood vessel (thrombus)

28
Q

illustrate the causes of Intravascular Thrombosis

A

1.Sluggish blood flow:
activation of clotting factors & enhance platelet aggregation.
2.Damaged or roughened endothelial surface of blood vessel as in atherosclerosis.
3. As a complication of septicemia (septic shock) or extensive tissue damage (crush injury).
4.Imbalance between clotting-anticlotting systems
5. Factor V Leiden

29
Q

what’s Factor V Leiden?

A

1- An inherited disorder with abnormal form of factor V.
2- Caused by mutation in the gene coding for clotting factor V.
3- Factor V Leiden is resistant to the action of activated protein C.
4- It leads to increased risk of developing blood clots in legs (DVT) or lungs (PE).
5-It is a life-threatening condition

30
Q

illustrate Effects (Complications) of intravascular thrombosis

A
  1. A thrombus may enlarge → complete occlusion of the blood vessel → prevent blood flow and oxygen from getting to tissues and organs leading to organ failure.
    e.g. DVT
  2. A thrombus may detach or break loose → forming an embolus → stuck in a narrower blood vessel in distant sites
    (Thromboembolism).
    e.g., pulmonary embolism: obstruction of the pulmonary
    artery or its branches by thrombi from the leg veins.
31
Q

Treatment of intravascular thrombosis or abnormal increase in blood coagulation is …………..

A

Administration of anticoagulant drugs either oral or parenteral.

physiology (9 decks)

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