Bleeding Application Exercise - Foy Flashcards
A patient presents with low platelet counts. What are the potential ddx?
ITP
HUS
TTP
DIC
What is the initial treatment for ITP?
What is the secondary treatment?
corticosteroids
limited platelet transfusion
How is ITP different in adults than in children?
Milder in children
Quicker onset in children
More likely to resolve in children
Typically viral cause in children
How should platelets be administered to patients with ITP?
not chronically
platelets given only in emergencies
What sites of bleeding are seen in platelet defects?
What sites of bleeding are seen in clotting factor deficiency?
mucocutaneous bleeds seen in platelet defects
deep bleeding seen in clotting factor deficiency
Are petechiae seen in platelet defects?
Are petechiae seen in clotting factor deficiency?
Yes
No
What are some causes of DIC?
Infections Snake Venom Cancer Cardiovascular events Necrosis ETC ETC
Basically anything
Is DIC considered a platelet defect or a clotting factor deficiency?
Both!
During the initial clotting phase, factor and platelets are used up
What are some positive tests results seen in DIC?
D-dimer increased PTT increased PT increased Thrombin time Low platelets
What is pathognomonic for bleeding in the joints?
Hemophilia
What study can test for a clotting factor deficiency?
plasma 1:1 mixing study
How is hemophilia inherited?
X-linked for hemophilia A and B
Autosomal for hemophilia C
What are the types of hemophilia?
hemophilia A- factor 8
hemophilia B- factor 9
hemophilia C- factor 11
What is Von Willebrand’s Disease?
A qualitative or quantitative defect in Von Willebrand’s factor.
What tests results are seen in VWD?
Prolonged bleeding time Prolonged OR normal PTT Normal PT Normal platelet count Low factor 8 activity
