Bleeding disorder - Haemophilia (Type A and B) Flashcards

1
Q

What type of disease in haemophilia?

A

X linked recessive disorder

1/3rd have no family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How do you know if its type A or B haemophilia?

A

Its impossible to tell through signs alone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which type of haemophilia is more common?

A

Type A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the two types of haemophilia?

A

Type A - deficiency in clotting factor 8

Type B - deficiency in clotting factor 9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is type B haemophilia ilso known as?

A

Christmas disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Who is mostly affected by haemophilia A and B?

A
Mostly men (X linked recessive)
Women are usually just carriers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which exception is there of women developing haemophilia A or B?

A

Those with turners syndrome
Those with affected dad + (affected mum or carrier mum who passes on her gene)

VERY rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is haemophilia?

A

A severe bleeding disorder causing a disorder in coagulation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How many people have a sporadic mutation?

A

30% / 1/3rd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the presentations of haemophilia?

A
Excessive bleeding after minor trauma
Haematomas 
Haemoarthrosis 
Muscle haematoma
CNS bleeding 
Retroperotineal bleeding
Spontaneous bleeding  
Bleeding from umbilical cord  
Gum bleeding
GI tract bleeding
Haematuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the presentations of haemophilia?

A
Excessive bleeding after minor trauma
Haematomas 
Haemoarthrosis 
Muscle haematoma
CNS bleeding 
Retroperotineal bleeding
Spontaneous bleeding  
Bleeding from umbilical cord  
Gum bleeding
GI tract bleeding
Haematuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the more classic features of SEVERE haemophilia?

A

Haemoarthrosis (bleeding into joints)

Muscle bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the investigations for haemophilia?

A
Prolonged aPTT
Normal PT time
Reduced FVIII or FIX
Coagulation factor tests 
Bleeding scores
Coagulation factor assays
Genetic tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the management for haemophilia?

A
IV Clotting factor replacement (prophylactically or in response to bleeding)
Factor 8 or 9 concentrate 
Desmopressin (DDAVP) 
Tranexamic acid 
Emicuzimab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is Emicuzimab given?

A

When patients have developed antibodies against factor 8

It is a monoclonal antibody that functions as factor 8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When is desmopressin used?

A

In mild haemophilia and VWF disease

Should be considered before thinking about transfusion

17
Q

What is a risk with using factor VIII treatment?

A

10-15% of patients develop antibodies against factor 8.

18
Q

What is a risk with using factor VIII treatment?

A

10-15% of patients develop antibodies against factor 8.

19
Q

what does desmporessin do?

A

DDAVP stimulates the release of von willebrand factor

20
Q

What are the complications of DDAVP?

A

MI

Hyponatraemia (in babies causing fits)

21
Q

what are complications of haemophilia?

A

Synovitis
compartment syndrome
stroke
chronic haemophilic arthropathy

22
Q

What joints are commonly affected in end stage haemophilic arthropathy?

A

Hinge joints > ball and socket joints
Ankles
Knees
Fixed flexion of the elbow