Bleeding disorders

Question 1

What is the response to vessel injury?

Answer 1

• Vasoconstriction to reduce blood flow
• Platelet plug formation (von willebrand factor binds damaged vessle and platelets)
• Activation of clotting cascade with generation of fibrin clot formation
• Fibrinolysis (clot breakdown)

Question 2

Hemostasis phases?

Answer 2

• Vascular phase- Vasoconstriction
• PLATELET PHASE - Primary hemostasis
• COAGULATION PHASE - Secondary hemostasis
• FIBRINOLYTIC PHASE

Question 3

What are the factors that the hemeostasis depend on?

Answer 3

• Vessel Wall Integrity
• Adequate Numbers of Platelets
• Proper Functioning Platelets
• Adequate Levels of Clotting Factors
• Proper Function of Fibrinolytic Pathway

Question 4

hemorrhagic syndrome?- Medical emergency))))

Answer 4

bleeding:
- without obvious cause or minimal trauma
- repeated
- involving several territories

Question 5

Biological tests?

Answer 5

• CBC (plq)+BT
• PT+PTT+ fibrinogen

Question 6

What Medicins that can cause hemorrhagic syndrome?

Answer 6

• Aspirin
• VKA
• NSAIDs

Question 7

Visceral hemorrhages?

Answer 7

hematemesis
moelena
rectal bleeding
hematuria
hemoptysis
metrorrhagia, menorrhagia

Question 8

What are the charcteristics of Primary haemostasis abnormality- Platelet?

Answer 8

• Petechia
• Purpura
• Immediate bleeding after trauma < Mild
• small vessels
• Site of bleeding: skin, and Mucous Membrane

Question 9

what are the test used to diagnosis Primary haemostasis abnormality?

Answer 9

• CBC- Platelet count
• Bleeding time

Question 10

Low Platelet cound, and Prolonged bleeding time?

Answer 10

• Thrombocytopenia < central or peripheral (myelogram)

Question 11

Normal platelets + prolonged BT?

Answer 11

Congenital or acquired
thrombopathy

Question 12

What are the charcteristics of Coagulation disorders?

Answer 12

• Involvement of larger vessels
• Visceral hemorrhages - Deep bleeding
• Hematoma - hemarthrosis
• Never purpura
• sever, Delayed bleeding( 1-2 days) after trauma

Question 13

What are some examples of coagulation factor disorders * Inherited?

Answer 13

• Hemophilia A and B
  – vonWillebrands disease

Question 14

What are some examples of coagulation factor disorders * Acquired?

Answer 14

• – Liver disease
  – Vitamin K deficiency/warfarin
  overdose( anticoagulant medication - nhibiting the action of vitamin K)

Question 15

What is a Pupura?

Answer 15

• bleeding underneath the skins surface
• small blood vessels (capillaries) leak blood into the skin
• small pinpoint spots (petechiae)
• larger patches (ecchymoses)

Question 16

key features of Petechia?

Answer 16

• Don’t blach with pressure( Angiomas)
• Not palpable( Vasculitis)

Question 17

What the differential diagnosis of the Purpura?

Answer 17

• Erythema nodosum
• Angiomas
• Mite stings

Question 18

When the purpura is an Emergency

Answer 18

+ Fever

Question 19

Tests in case of Purpura?

Answer 19

• CBC + Platelets + blood smear
• Bleeding time

Question 20

What are the diseases that can cause Purpura fever?

Answer 20

• Meningococcal purpura fulminans
• Endocarditis
• Severe sepsis
• vasculitis

Question 21

The normal value of bleeding time?

Answer 21

• 2-8 MINUTES

Question 22

Low platelet count + Long time bleeding?

Answer 22

• Thrombocytopenic purpura

Question 23

Normal platelet count + Long time bleeding?

Answer 23

Thrombopathic purpura

Question 24

Normal platelet count + Normal time bleeding?

Answer 24

Vascular purpura

Question 25

Nomal range of plateles?

Answer 25

150,000 to 450,000/mm3

Question 26

How to differentiate between peripheral and Central Thrombocytopenia?

Answer 26

• Myelogram