Bleeding Disorders Flashcards
What are causes of Peripheral Platelet Destruction?
Coagulopathy - Disseminated intravascular coagulation
Autoimmune - Immune thrombocytopenic Purpura (ITP)
Hypersplenism
What vascular abnormalities can cause platelet problems?
Vasculitis
What are other causes of acquired platelet dysfunction?
Drugs - Aspirin + NSAIDs
Renal failure
Describe Von Willebrand Factor deficiency?
Acquired or Hereditary
Autosomal dominant
Common
Variable severity
Name a type of multiple clotting factor deficiencies?
Disseminated Intravascular Coagulation (DIC)
Name a single clotting factor deficiency?
Haemophilia
What multiple factor deficiencies can cause bleeding issues?
Liver failure
Vit K deficiency, warfarin therapy
Complex coagulopathy - (DIC)
Where are all coagulation factors synthesised?
In hepatocytes
What factors does vit K carboxylate?
Factors II, VII, IX & X
How is Vit K sourced?
Diet
Intestinal synthesis
Absorbed in upper intestine
Required bile salts for absorption
What are causes for Vit K deficiency? (5)
Poor dietary intake Malabsorption Obstructive jaundice Vit K antagonists (warfarin) Haemorrhagic disease of the newborn
Describe Disseminated Intravascular Coagulation (DIC)?
Excessive and inappropriate activation of the haemostatic system - Primary, Secondary, Fibrinolysis
Microvascular thrombus formation - end organ failure
Clotting factor consumption - bruising, purpura and generalised bleeding
Describe Fibrinolysis?
Fibrinogen becomes fibrin
Plasminogen becomes plasmin
Plasmin converts fibrin into FDPs (Fibrin Degradation Products) e.g. D-Dimers
What are causes of DIC?
Sepsis
Obstetric emergencies
Malignancy
Hypovalaemic shock
How do you treat DIC?
Treat underlying cause Replacement therapy: - Platelet transfusion - Plasma transfusion - Fibrinogen replacement
