Bleeding Disorders Flashcards
causes of a platelet plug failure?
vascular, platelets, vwf
vascular problems?
acquired vasculitis…henoch sconlein purpura
thrombocytopaenia, what is this?
low platelets
reduced production … marrow problem
platelets can be destroyed or there can be increased destruction
causes of peripheral platelet destruction?
DIC, immune thrombocytopaenic purpura
ITP, IMMUNE, what happens to platelets?
destroyed by immune system
hypersplenism - could this cause platelet destruction?
yes
remember drugs can prevent platelets clotting
such as aspirin and NSAIDS
vwd - common - variable severity
autosomal dominant so family member will have it. generally mild
commonest cause of primary haemostats failure?
thrombocytopaenia
multiple clotting factor deficiency?
DIC
single clotting factor deficiency?
haemophilia
liver failure can cause it
vitamin k deficiency/warfarin
complex coagulopathy
which factors are carboxylated by vitamin K?
2,7,9,10
y
where is vitamin k absorbed?
upper intestine
what does it require for digestion?
bile salts
ADEK fat soluble vitamins
require bile salts for absorption
how could obstructive jaundice cause clotting problems?
obstructive jaundice, no bile salts, no vitamin K absorption - no clotting
why do you get low platelets in DIC?
excessive and inappropriate activation of haemostats system
microvascular thrombus formation
clotting factor consumption
what are FDPs?
fibrin degredation products e.g. d dimers
causes of DIC?
sepsis, obstetric emergencies, malignancy, hypovolaemic shock
treatment of DIC?
replacement therapy
treat the underlying cause
platelet and plasma transfusions and fibrinogen replacement
haemophilia b also known as?
christmas tree disease
inheritance?
x linked
A is 8, B is 9
y
which is more common?
a
bleeding from medium to large blood vessels
joint swelling and pain
recurrent haemarthrosis, soft tissue bleeds, bruising in toddlers, prolonged bruising after dental extractions, surgery and invasive procedures
liver disease can cause clotting failures. obstructive jaundice - leading to vitamin k malabsorption, DIC uses up platelets, medications such as aspirin, warfarin and nsaids
