Bleeding disorders Flashcards
Bleeding patterns in primary and secondary haemostatic failure are the same. true or false?
False
Primary haemostatic failure - name 3 causes (broad)
Vascular (vessel wall problem)
Platelets
vWF deficiency
Primary haemostatic failure - causes - vascular
Hereditary
Acquired
Loss of collagen from the vessel wall increases/decreases with age?
Loss increases with age.
Which condition is characterised by a hereditary deficiency of collagen?
Marfan’s syndrome
Primary haemostatic failure - causes - platelets
Reduced number
Reduced function
Primary haemostatic failure - causes - reduced number of platelets is called
Thrombocytopenia
What is the commonest cause of primary haemostatic failure?
Thrombocytopenia
Mechanisms of thrombocytopenia
Reduced production
Increased destruction
- DIC
- Autoimmune (ITP)
- hypersplenism
Thrombocytopenia - investigations
FBC screening test
- low platelet count
Primary haemostatic failure - causes - reduced function of platelets
Drugs (aspirin, NSAIDs)
Renal failure
Primary haemostatic failure - causes - vWF deficiency - what mode of inheritance
Autosomal dominant
How does vWF deficiency present
Low levels of vWF
Node bleeds
Heavy periods
Primary haemostatic failure - clinical features
Spontaneous bruising - purpura - petichae Mucosal bleeding - epistaxis - GI bleed - conjunctival bleed - menorrhagia Intracranial haemorrhage Retinal haemorrhage
Secondary haemostatic failure - causes
Single clotting factor deficiency
Multiple clotting factor deficiencies
Second haemostatic failure - single clotting factor deficiency - name a condition
haemophilia
Haemophilia - what is the mode of inheritance
X linked (only affects males)
Haemophilia - example of primary or secondary haemostatic failure?
Secondary
Haemophilia is a multiple clotting factor deficiency. True or false?
False
- single clotting factor deficiency
Haemophilia - definition
Prolonged bleeding recurs episodically at one or more sites on each occasion
Haemophilia - patients can’t form ____
Fibrin
Haemophilia - there is an abnormality with both primary and secondary haemostasis? true or false
False
- primary haemostasis is normal
Haemophilia A - which clotting factor is affected
VIII defieicncy
Haemophilia B - which clotting factor is affected
IX defieicny
Haemophilia - clinical features
Haemarthrosis (blood in the joint)
- inflammation due to iron irritation
- neovascularisation
Recurrent soft tissue bleeds
Prolonged bleeding after dental extractions, surgery
Haemophilia - location of bleeding
Usually target joints
- areas of the body that are put under strain (ankle, knee)
Haemophilia
- PT
- APTT
PT = normal
APTT = abnormal (prolonged)
- since there is low level of VIII or IX
Single clotting factor deficiencies are usually hereditary/acquired?
Hereditary
Multiple clotting factor deficiencies are usually hereditary/acquired?
Acquired
Name 3 causes of multiple clotting factor deficiency
Liver failure Vitamin K deficiency Complex coagulopathy (DIC)
Multiple clotting factor deficiency - Complex coagulopathy
Massive tissue damage leads to excessive activation of haemostatic system.
Thrombus forms and gets stuck in the small vessels.
Multiple clotting factor deficiency - Complex coagulopathy - there is release of lots of ??
Tissue factor
Name 4 conditions which can cause complex coagulopathy
Sepsis
RTA
Hypovolaemic shock
Obstetric emergency
Complex coagulopathy - clinical features
Lots of bleeding
Bruising
Purpura
Multiple clotting factor deficiency - Vitamin K defieicny - causes
Poor dietary uptake
- low in leafy green veg
Malabsorption
Warfarin
Hemorrhagic disease of newborn
Multiple clotting factor deficiency
PT
APTT
PT = prolonged APTT = prolonged
