Bleeding Disorders

Question 1

Causes of failure of platelet plug formation ?

Answer 1

Vascular
Platelets - thrombocytopenia / decreased function
Von willebrand factor

Question 2

Vascular abnormalities preventing platelet plug formation?

Answer 2

Vasculitis eg he notch-schonlein purpura

Question 3

Decreased production cause of thrombocytopenia?

Answer 3

Marrow problem

Question 4

Increased destruction causes of thrombocytopenia?

Answer 4

Coagulopathy - DIC
Autoimmune - immune thrombocytopenic purpura
Hypersplenism

Question 5

Causes of platelet functional defects?

Answer 5

Drugs - aspirin NSAIDs

Renal failure

Question 6

Is Von willebrand deficiency autosomal recessive or dominant?

Answer 6

Autosomal dominant

Question 7

Secondary haemostasis?

Answer 7

Failure of Fibrin clot formation

Question 8

Causes of failure of fibrin clot formation?

Answer 8

Multiple clotting factor deficiencies

Single clotting factor deficiencies

Question 9

Examples of multiple factor deficiencies?

Answer 9

Liver failure
Vit k deficiency/ warfarin
DIC

Question 10

Where are coagulation factors synthesised?

Answer 10

Hepatocytes so reduced in liver failure

Question 11

What factors are carboxylate do by vit k so acted upon by warfarin?

Answer 11

II, VII, IX, X

Question 12

Causes of vitamin k deficiency ?

Answer 12

Dietary
Malabsorption 
Obstructive jaundice
Warfarin
Haemorrhaging disease of the newborn

Question 13

What does DIC stand for?

Answer 13

Disseminated intravascular coagulation

Question 14

What happens in DIC?

Answer 14

Excessive and inappropriate activation of haemostasis system - formation of thrombus and bleeds

Question 15

Causes of DIC?

Answer 15

Sepsis
Obstetric emergencies
Malignancy
Hypovolaemic shock

Question 16

Treatment of DIC?

Answer 16

Treat underling cause
Platelet transfusion
Plasma transfusion
Fibrinogen transfusion

Question 17

Genetics of haemophilia?

Answer 17

X linked

Hereditary

Question 18

What happens in haemophilia?

Answer 18

Abnormally Prolonged bleeding

Question 19

Types of haemophilia?

Answer 19

A

B

Question 20

Haemophilia a is due to what?

Answer 20

Factor VIII deficiency

Question 21

Haemophilia B is due to what?

Answer 21

Factor IX deficiency

Question 22

Clinical features of severe haemophilia?

Answer 22

Recurrent haemarthoses
Recurrent soft tissue bleeds - bruising in toddlers
Prolonged bleeding after dental extraction, surgery and invasive procedures

Question 23

Is vitamin k fat or water soluble?

Answer 23

Fat soluble, not water soluble

Question 24

An isolated prolonged ATPP is a sign of what?

Answer 24

Haemophilia