Bleeding Disorders

Question 1

Platelet disorders characteristics

Answer 1

• increased bleeding times
• mucous membrane bleeding
• microhemorrhages
• platelet count either low or normal

Question 2

Platelet disorders

Answer 2

• Bernard-Soulier syndrome
• Glanzmann thrombasthenia
• Immune thrombocytopenia
• Uremic platelet dysfunction

Question 3

Coagulation disorders characteristics

Answer 3

• due to clotting factor deficiencies or acquired factor inhibitors
• diagnosed with mixing study–> clotting factor deficiencies correct but factor inhibitors don’t

Question 4

Coagulation disorders

Answer 4

-Hemophilia A, B, or C
- Vitamin K deficiency

Question 5

Mixed platelet and coagulation disorders

Answer 5

• von Willebrand disease
• disseminated intravascular coagulation

Question 6

Bernard-Soulier syndrome

Answer 6

• normal/ decreased platelet count
  increased bleeding time
• autosomal recessive defect in adhesion
• decreased GpIb–> decreased platelet-to-vWF adhesion

Question 7

Glanzmann thrombasthenia

Answer 7

• normal platelet count
• increased bleeding time
• autosomal recessive defect in aggregation
• decreased GpIIb/IIIa–> decreased platelet-to-platelet aggregation and defective platelet plug formation

Question 8

Immune thrombocytopenia

Answer 8

• decreased platelet count
• increased bleeding time
• destruction of platelets in spleen
  anti-GpIIb/IIIa antibodies–> splenic macrophages phagocytose platelets
• may be secondary to autoimmune disorders, viral illness, malignancy, or drug reaction

Question 9

Uremic platelet dysfunction

Answer 9

in patients with renal failure, uremic toxins accumulate and interfere with platelet adhesion

Question 10

Hemophilia

Answer 10

• normal PT
• increased PTT
• hemorrhage in hemophilia- hemarthroses, easy bruising, bleeding after trauma/ surgery

Question 11

Hemophilia A

Answer 11

deficiency of factor VIII

Question 12

Hemophilia B

Answer 12

deficiency of factor IX

Question 13

Hemophilia C

Answer 13

deficiency of factor XI

Question 14

Vitamin K deficiency

Answer 14

• increased PT and PTT
• generation coagulation defect
• decreased activity of factors II, VII, IX, X, protein C, protein S

Question 15

von Willebrand disease

Answer 15

• normal PC and PT
• normal or increased PTT
• increased BT
• intrinsic pathway coagulation defect
• defect in platelet in platelet plug formation
• presents with menorrhagia or epistaxis

Question 16

Disseminated intravascular coagulation

Answer 16

• decreased platelet count
• increased bleeding time, PT, PTT
• widespread clotting factor activation–> increased thromboses and hemorrhages
• presents with schistocytes, increased D-dimers, decreased fibrinogen, factors V and VIII