Bleeding disorders

Question 1

What kind of infection usually preceded henoch schonlein purpura?

Answer 1

GI infection

Question 2

Wat autoimmune condition causes peripheral platelet destruction?

Answer 2

Immune thrombocytopenic purpura

Question 3

Give three causes of peripheral platelet destruction?

Answer 3

Coagulopathy
Autoimmune
Hypersplenisa

Question 4

Where are platelets broken down?

Answer 4

Spleen

Question 5

What is the most common cause of a platelet function disorder?

Answer 5

Drus - Aspirin, NSAIDs Clopidogrel (Stop platelets aggregating
Renal failure

Question 6

What is the genetic pattern of von willebrand factor deficiency?

Answer 6

Autosomal dominant
Type 1 = low numbers
Type 2 = non functioning von willebrand factor
Type 3 = no von willebrand factor

Question 7

What are the three types of von willebrand factor deficiency?

Answer 7

Type 1 = low numbers
Type 2 = non functioning von willebrand factor
Type 3 = no von willebrand factor

Question 8

If you have no von willebrand factor then what factor will you also be deficient in?

Answer 8

Factor 8

Question 9

What drug is useful for nosebleed etc seen in haemostatic problems?

Answer 9

Transexemic acid = stabilised fibrin clot

Question 10

What factor is missing is haemophilia A?

Answer 10

Factor 8

Question 11

What factor is missing is haemophilia B?

Answer 11

9

Question 12

Where are all clotting factors made?

Answer 12

Liver

Question 13

What is the significance of low albumin in bleeding disorders?

Answer 13

If the albumin low then the liver probably isn’t making other clotting factors - liver failure is the most likely underlying cause

Question 14

In multiple factor deficiencies what will the PT and APPT be like?

Answer 14

Both prolonged

Question 15

Which factors are carboxylated by vitamin K?

Answer 15

2, 7, 9 and 10

Question 16

How do you get most of you vitamin K?

Answer 16

Synthesis by intestinal bacteria

Question 17

What are babies injected with just after birth to protect against bleeding?

Answer 17

Vitamin K

Question 18

What is DIC?

Answer 18

Excessive and inappropriate activation of the haemostatic system
(Primary, secondary and fibronolysis)

Question 19

Why do you get end organ failure in DIC?

Answer 19

Microvascular thrmobus formation

Question 20

Why do you get bleeding in DIC?

Answer 20

They have used up all their clotting factors causing

Question 21

If the PT and APPT are both prolonged what is the most likely cause?

Answer 21

Problem with multiple clotting factors

Question 22

Why do you get high D dimer level in DIC?

Answer 22

D dimer levels rise when there is an excess of fibrinolysis, as seen in DIC

Question 23

What is the most common cause of DIC?

Answer 23

Sepsis - meningococcal sepsis

Question 24

Give 4 causes of DIC

Answer 24

Sepsis

Obstetric emergencies

Question 25

What clotting substance is the placenta very high in?

Answer 25

Thromboplastin

Question 26

What does thromboplastin do?

Answer 26

Conversion of prothrombin to thrombin

Question 27

What is the treatment of DIC?

Answer 27

Treat underlying cause

Question 28

What three things can you give in DIC whilst trying to fix the underlying cause?

Answer 28

- Platelets - Plasma - Fibrinogen

Question 29

What is the genetic inheritence pattern of haemophiilia?

Answer 29

X linked

Question 30

Which of the haemophillia is more common?

Answer 30

Hameophillia A

Question 31

Why isn't minor trauma a problem to hameophillia?

Answer 31

Platelets are fine - platelet plug formation is normal but formation of a fibrin clot is not.

Question 32

When do you get excess bleeding in hameophelia?

Answer 32

Severe trauma or surgery

Question 33

What vessels are affected mostly in haemophillia?

Answer 33

Medium and Large blood vesses.

Question 34

What is the prothrombin time like in hameophillia?

Answer 34

Normal

Question 35

What is the APPT like in haemophillia?

Answer 35

Very high

Question 36

What is abnormal in haemophillia - PT or APPT?

Answer 36

APPT is very high | PT is normal

Question 37

What is the treatment for haemophillia?

Answer 37

IV factor given every second day