Bleeding Disorders Flashcards
Causes of thrombocytopenia?
Production failure due to loss of megakaryocytes (aplastic anemia) or marrow suppression (drugs)
Reduced life-span due to antibodies (ITP), consumption (DIC, HIT, TTP), hypersplenism
What types of bleeding are associated with thrombocytopenia?
Bruising
Petechiae
Mucosal bleeding (nose, gums)
(Infrequently) brain, GI tract
2 causes of acquired thrombasthenia:
Drugs (ASA, NSAIDS)
Metabolic (renal failure, liver failure)
2 causes of congenital thrombasthenia:
Bernard Soulier (Ib) Glanzman’s thrombasthenia (IIb IIIa)
How do you treat thrombocytopenia or thrombasthenia locally?
pressure, gelfoam and topical thrombin
How do you treat thrombocytopenia or thrombasthenia systemically?
Prednisone (ITP)/Rituximab
Platelet transfusion
Eltrombopag
Stop all non-essential drugs
(*treat the cause)
Causes of acquired coag disorders:
Iatrogenic – heparins, warfarin
Secondary to liver disease
Disseminated intravascular coagulation (DIC)
Antibodies – acquired hemophilia
*usually multiple deficiencies
Causes of inherited coag disorders:
Absence/lack of a single factor
Bleed into deep structures
*usually single deficiency
Hemophilia A is due to a factor ___ deficiency
VIII
*1 out of every 10,000 male births
Hemophilia B is due to a factor ___ deficiency
IX
*1 for every 9 Hemophilia A’s
What is a “very common” inherited coag disease?
von Willebrand disease
How are Hemophilia A and B inherited?
sex-linked
How do you treat acute Hemophilia bleeding systemically?
replace deficient factor
desmopressin (DDAVP; Stimate) = intranasal
E-aminocaproic acid (Amicar) = used for cuts around nose and mouth
How do you treat acute Hemophilia bleeding locally?
immobilize
topical thrombin/Gelfoam/pressure
What supplement should be given to patients with Hemophilia?
Iron
What are symptoms of von Willebrand type 1?
bruising
mucosal bleeding (nosebleeds, menorrhagia)
What are treatments for von Willebrand type 1?
DDAVP
E. aminocaproic acid
Three causes of fibrinolysis?
Only common cause: cirrhosis of liver
Occasionally: prostatic cancer or prostate surgery
What is symptomatic of Hemophilia, in terms of spontaneous bleeding?
Bleeding/swelling at joints
*i think this is what the pictures were saying?
What is the major difference between thrombocytopenias and coagulation dysfunction?
Thrombocyopenia = superficial bleeding Coagulation = bleed into deep structures (joints and retroperitoneal spaces)
