Bleeding Disorders Flashcards
these 2 drugs elevate PTT and PT b/c both at common pathway
heparin and warfarin
in adults, most commonly due to disease or IV drug therapy; PTT and PT elevated
vitamin K deficiency
2 roles of vWF
binds activated platelets on subendothelium AND prolongs half-life of factor VIII
can present as teenage girl w/ heavy flow; PTT elevated
vWF disease
factor VIII deficiency w/ severe bleeding after trauma or surgery (into joints and muscles); PTT elevated
Hemophilia A
hemarthrosis (hemophilia A)
factor IX deficiency; looks the same as hemophilia A but not as common
Hemophilia B
breakdown of clots due to bacterial infection, medical disorder, or medicine
secondary fibrinolysis
lady presents to clinic and has history of miscarriages; (autoimmune)
Antiphospholipid syndrome
coagulation disorder most commonly due to infection and burns
Disseminated Intravascular Coagulation (DIC)
20% of patients w/ gram - sepsis can develop this
DIC
clots form and consume coagulation factors; result is hemorrhage
DIC
signs of this include bleeding into surgical wounds and at venous access sites; petechiae and ecchymoses
DIC (clotting factors taken up by disseminating clots)
L: petechiae
R: ecchymoses
tests for DIC
PT/PTT elevated
D-dimer elevated
low fibrinogen
platelet count
Ab mediated accelerated platelet destruction
Idiopathic Thrombocytopenic Purpura (ITP)
Increased arterial flow in large arteries and heart chambers can hamper platelet clot formation and repair of the endothelium leading to thrombosis
endothelial injury
disruption of blood flow causes what to come in contact with endothelium
platelets
most commonly due to endothelial injury and turbulent blood flow
arterial thrombi
more commonly due to stasis
venous thrombi
gross and microscopic alternating pale lines (platelets and fibrin) and dark line (red blood cells)
Lines of Zahn
this can make coagulation cascade more active (hypercoagulability)
birth control
3 components of Virchow’s triangle:
- endothelial injury
- hypercoagulability
- abnormal blood flow
besides birth control, what other factors affect hypercoagulability
antithrombin III deficiency
elevated factor V
immobilization
prevents protein C from inactivating factor V; thrombus in veins
Factor V Leiden mutation
nonblanching rash
no platelets (b/c in clots)
fatigue and fever
women in 30s-40s
Thrombotic Thrombocytopenic Purpura (TTP)
Fever
thrombocytopenia
hemolytic anemia
TTP triad
any patient who comes in complaining of fatigue
draw blood
patient presents w/ warm painful swollen leg and jaundice; discomfort in abdomen (mass on pancreas)
Trousseau syndrome
lots of clots due to cancer
thromboembuli
paraneoplastic syndrome
Trousseau syndrome
