bleeding disorders

Question 1

causes of DIC

Answer 1

sepsis, obstetric emergencies, malignancies, hypovolaemic shock

Question 1

what are DICs

Answer 1

conditions that inappropriately activate the clotting cascade

Question 2

what causes the bruising and purpura and generalised bleeding in DIC

Answer 2

clotting factor consumption

Question 3

blood film in DIC

Answer 3

fragmented red blood cells

Question 4

bloods in DIC

Answer 4

PT, APTT are very prolonged and fibrinogen is markedly reduced
high levels of D-dimer
severe thrombocytopenia

Question 5

haemophilia has what inheritance

Answer 5

X linked recessive

Question 6

what haemophilia is more common

Answer 6

A

Question 7

Haemophilia bleeding mostly occurs into

Answer 7

joints

Question 8

is there an abnormality of primary haemostats in haemophilia

Answer 8

No

Question 9

bloods for haemophilia

Answer 9

isolated prolonged. APTT

Question 10

complication of clotting factor infusions

Answer 10

your body becomes resistant

Question 11

what drug can be used for minor bleeds in haemophilia

Answer 11

desmopressin

Question 12

VWF gene is on chromosome

Answer 12

12

Question 13

reduced VWF in VW disease leads to what factor deficiency

Answer 13

8

Question 14

immune thrombocytoopenic purpura is when there is a decreased number of circulating

Answer 14

platelets

Question 15

immune thrombocytopenia purpura is caused by what hypersensitivity reaction

Answer 15

2

Question 16

how does immune thrombocytopenia purpura tend to present

Answer 16

In a child under 10 and often there is a history of a recent viral illness

Question 17

there is an isolated thrombocytopenia in what

Answer 17

immune thrombocytopenia purple

Question 18

mx for ITP

Answer 18

usually non but can give prednisolone, IV immunoglobulins

Question 19

Thrombotic thrombocytopenic purpura due to a deificnecy of

Answer 19

metalloproteinase ADAMTS13

Question 20

classic pentad in:- Fever
- Microangiopathic haemolytic anaemia (MAHA)
- Thrombocytopaenic purpura
- CNS involvement: headache, confusion, seizures
- AKI

Answer 20

TTP

Question 21

blood film can show what in TTP

Answer 21

schistocytes

Question 22

difference between TTP and DIC

Answer 22

coagulation screen will be normal in TTP, whereas it will be prolonged in DIC with low plasma fibrinogen

Question 23

what assay is diagnostic in TTP

Answer 23

low ADAMST13

Question 24

what does fresh frozen plasma do

Answer 24

replace coagulation factors

Question 25

what does cryoprecipitate replace

Answer 25

fibrinogen

Question 26

in what system are platelets not activated

Answer 26

venous system

Question 27

what is first line for DVT

Answer 27

apixaban or rivaroxaban

Question 28

options for secondary prevention of DVT

Answer 28

warfarin, DOAC, LMWH

Question 29

aetiology for what:- Factor V Leiden - Prothrombin 20210 mutation - Antithrombin deficiency - Protein C deficiency - Protein S deficiency

Answer 29

hereditary thrombophilias

Question 30

some examples of when you might suspect herediatary thrombophilias

Answer 30

venous thromboses in under 45 recurrent venous thromboses

Question 31

are thromboses arterial or venous in anti phospholipid syndrome

Answer 31

both

Question 32

lived reticualris is what ? it can be seen in antiphospholipid syndrome

Answer 32

purplish, net like discolouration of the skin

Question 33

at least one positive blood test on 2 occasions at least 12 weeks apart to diagnose anti phospholipid syndrome. the three are

Answer 33

1. anticardiolipin antibodies 2. anti-β2-GPI antibodies 3. positive lupus anticoagulant assay