bleeding disorders Flashcards
massive haemorrhage protocol
6 units blood (4degrees)
4 units of plasma (frozen)
1 unit of platelets (22degrees)
screened for in donated blood?
hep B, hep C, syphilis, HIV
availability
- minutes?
- urgent?
- non-urgent?
minutes: O, Rh neg RBCs, AB plasma
urgent: type specific (ABO, RhD)
non-urgent: full cross match, allo-Abs test
describe minor and major reaction to blood
minor: urticarial rash + fever
major: begins with wheeze, facial oedema etc
progresses onto…
fever + urticarial rash + resp distress, hypotension, tachycardia, oliguria, bleeding, collapse
Tx of major transfusion reaction
bronchodilator adrenaline steroids oxygen antihistamine fluid challenge
what week is prophylactic anti-D given to a Rh+ mother with an Rh-baby
28/40wks
arterial thrombosis
white clot of platelets + fibrin
infarct, ischaemia
- triggered by vessel damage
venous thrombosis
red clot: FBCs, fibrin
VTE, PE
- hypercoaguability
- stasis
Microvascular thrombosis?
DIC - disseminated intravascular coagulopathy
never in isolation - with eclampsia, sepsis, malignancy
universal triggered of tissue factor - mass clotting - diffuse ischaemia -> bleeds
Tx: replace clotting factors
main extrinsic tissue damage trigger for coagulation cascade?
tissue factor (TF)
innate anticoagulants?
tissue factor pathway inhibitor (TFPI)
antithrombin(AT)
proteins C and S
injury –> resolved? steps?
- clot formed: platelets, vWF, coagulation factors
- clot confined: anticoagulants.
- clot broken down: fibrinolysis
clopidogrel acts on
inhibits ADP receptor
aspirin acts on
inhibits arachidonic acid -> COX -> thromboxane A2
warfarin acts on
prevents prothrombin activation (increase PT) - extrinsic pathway
