bleeding disorders Flashcards
causes of DIC
sepsis, obstetric emergencies, malignancies, hypovolaemic shock
what are DICs
conditions that inappropriately activate the clotting cascade
what causes the bruising and purpura and generalised bleeding in DIC
clotting factor consumption
blood film in DIC
fragmented red blood cells
bloods in DIC
PT, APTT are very prolonged and fibrinogen is markedly reduced
high levels of D-dimer
severe thrombocytopenia
haemophilia has what inheritance
X linked recessive
what haemophilia is more common
A
Haemophilia bleeding mostly occurs into
joints
is there an abnormality of primary haemostats in haemophilia
No
bloods for haemophilia
isolated prolonged. APTT
complication of clotting factor infusions
your body becomes resistant
what drug can be used for minor bleeds in haemophilia
desmopressin
VWF gene is on chromosome
12
reduced VWF in VW disease leads to what factor deficiency
8
immune thrombocytoopenic purpura is when there is a decreased number of circulating
platelets
immune thrombocytopenia purpura is caused by what hypersensitivity reaction
2
how does immune thrombocytopenia purpura tend to present
In a child under 10 and often there is a history of a recent viral illness
there is an isolated thrombocytopenia in what
immune thrombocytopenia purple
mx for ITP
usually non but can give prednisolone, IV immunoglobulins
Thrombotic thrombocytopenic purpura due to a deificnecy of
metalloproteinase ADAMTS13
classic pentad in:- Fever
- Microangiopathic haemolytic anaemia (MAHA)
- Thrombocytopaenic purpura
- CNS involvement: headache, confusion, seizures
- AKI
TTP
blood film can show what in TTP
schistocytes
difference between TTP and DIC
coagulation screen will be normal in TTP, whereas it will be prolonged in DIC with low plasma fibrinogen
what assay is diagnostic in TTP
low ADAMST13
what does fresh frozen plasma do
replace coagulation factors
what does cryoprecipitate replace
fibrinogen
in what system are platelets not activated
venous system
what is first line for DVT
apixaban or rivaroxaban
options for secondary prevention of DVT
warfarin, DOAC, LMWH
aetiology for what:- Factor V Leiden
- Prothrombin 20210 mutation
- Antithrombin deficiency
- Protein C deficiency
- Protein S deficiency
hereditary thrombophilias
some examples of when you might suspect herediatary thrombophilias
venous thromboses in under 45
recurrent venous thromboses
are thromboses arterial or venous in anti phospholipid syndrome
both
lived reticualris is what ? it can be seen in antiphospholipid syndrome
purplish, net like discolouration of the skin
at least one positive blood test on 2 occasions at least 12 weeks apart to diagnose anti phospholipid syndrome. the three are
- anticardiolipin antibodies
- anti-β2-GPI antibodies
- positive lupus anticoagulant assay
