Bleeding Disorders

Question 1

causes of a platelet plug failure?

Answer 1

vascular, platelets, vwf

Question 2

vascular problems?

Answer 2

acquired vasculitis…henoch sconlein purpura

Question 3

thrombocytopaenia, what is this?

Answer 3

low platelets

Question 4

reduced production … marrow problem

Answer 4

platelets can be destroyed or there can be increased destruction

Question 5

causes of peripheral platelet destruction?

Answer 5

DIC, immune thrombocytopaenic purpura

Question 6

ITP, IMMUNE, what happens to platelets?

Answer 6

destroyed by immune system

Question 7

hypersplenism - could this cause platelet destruction?

Answer 7

yes

Question 8

remember drugs can prevent platelets clotting

Answer 8

such as aspirin and NSAIDS

Question 9

vwd - common - variable severity

Answer 9

autosomal dominant so family member will have it. generally mild

Question 10

commonest cause of primary haemostats failure?

Answer 10

thrombocytopaenia

Question 11

multiple clotting factor deficiency?

Answer 11

DIC

Question 12

single clotting factor deficiency?

Answer 12

haemophilia

Question 13

liver failure can cause it
vitamin k deficiency/warfarin
complex coagulopathy

Answer 13

which factors are carboxylated by vitamin K?

Question 14

2,7,9,10

Answer 14

y

Question 15

where is vitamin k absorbed?

Answer 15

upper intestine

Question 16

what does it require for digestion?

Answer 16

bile salts

Question 17

ADEK fat soluble vitamins

Answer 17

require bile salts for absorption

Question 18

how could obstructive jaundice cause clotting problems?

Answer 18

obstructive jaundice, no bile salts, no vitamin K absorption - no clotting

Question 19

why do you get low platelets in DIC?

Answer 19

excessive and inappropriate activation of haemostats system
microvascular thrombus formation
clotting factor consumption

Question 20

what are FDPs?

Answer 20

fibrin degredation products e.g. d dimers

Question 21

causes of DIC?

Answer 21

sepsis, obstetric emergencies, malignancy, hypovolaemic shock

Question 22

treatment of DIC?

Answer 22

replacement therapy
treat the underlying cause
platelet and plasma transfusions and fibrinogen replacement

Question 23

haemophilia b also known as?

Answer 23

christmas tree disease

Question 24

inheritance?

Answer 24

x linked

Question 25

A is 8, B is 9

Answer 25

y

Question 26

which is more common?

Answer 26

a

Question 27

bleeding from medium to large blood vessels

Answer 27

joint swelling and pain

Question 28

recurrent haemarthrosis, soft tissue bleeds, bruising in toddlers, prolonged bruising after dental extractions, surgery and invasive procedures

Answer 28

liver disease can cause clotting failures. obstructive jaundice - leading to vitamin k malabsorption, DIC uses up platelets, medications such as aspirin, warfarin and nsaids