Bleeding Disorders Flashcards
what are bleeding disorders?
conditions in which the blood doesn’t clot properly, making it hard for a person to stop bleeding
Normally, platelets and clotting factors work together to stop bleeding; platelets form a soft plug and fibrin anchors it. But if there is a shortage of platelets, or if there are abnormalities in the clotting system, clotting can be impaired and excessive bleeding can occur
what are the two causes of bleeding disorders?
- lack of platelets = thrombocytopenia (primary hemostasis)
2. abnormalities in the clotting system (secondary hemostasis)
which bleeding disorders result from a lack of platelets?
- Idiopathic thrombocytopenic purpura (ITP)
- thrombotic thrombocytopenic purpura (TTP)
- hemolytic uremic syndrome (HUS)
which bleeding disorders result from problems with the clotting system?
- Coagulation disorders; like hemophilia
- Platelet disorders; like Bernard-Soulier syndrome
• Disorders that involve both coagulation and platelets; like von Willebrand
disease and disseminated intravascular coagulation
what are some types of coagulation disorders?
hemophilia
what is a type of platelet disorder?
Bernard-Soulier syndrome
what disorders involve both coagulation and platelets?
- von Willebrand
disease - disseminated intravascular coagulation
how do you get a bleeding disorder?
inherited or acquired
why do people get petechiae?
spontaneous skin and mucous membrane bleeding
normally, the platelets lining the vessel walls provide physical protection against blood seepage between endothelial cells
if there are very few platelets around, or if the platelets are there but are not functioning properly, there is less protection, and blood seeps from capillaries, forming little red dots (or petechiae) on the skin
seen in patients with thrombocytopenia and patients with platelet disorders (causing intrinsic platelet abnormalities)
what is mucous membrane bleeding?
seen in platelet bleeding
includes things like nosebleeds, heavy periods, or oral/gingival bleeding
what is factor bleeding?
patients with coagulation disorders tend to bleed after a traumatic incident – but not right away
they can form a platelet plug just fine, so right after an injury they are able to achieve temporary hemostasis. But they are not able to make fibrin well, so the platelet plug isn’t sealed up, and it just washes away after some time
what are the types of bleeding that can happen if you have a bleeding disorder?
- platelet bleeding
bleeding is due to platelet abnormalities (problems with primary hemostasis)
- factor bleeding
factor abnormalities (problems with secondary hemostasis)
what types of diseases are factor bleeding?
- severe factor deficiencies like severe hemophilia
- hemarthrosis = bleeding into joints
- hematoma = bleeding into deep soft tissue
How do patients with platelet problems present, compared to patients with coagulation problems?
Patients with platelet problems tend to have superficial, spontaneous bleeding, whereas patients with coagulation problems tend to have delayed, deep bleeding related to trauma.
which bleeding disorders are hereditary?
- von Willebrand disease
- Hemophilia A
- Hemophilia B
- hereditary platelet disorders
which bleeding disorders are acquired?
- disseminated intravascular coagulation (DIC)
- Idiopathic thrombocytopenic purpura (ITP)
- Thrombotic microangiopathies: thrombotic thrombocytopenic purpura (TTP)
- hemolytic-uremic syndrome (HUS)
what is von Willebrand disease?
caused by a decreased amount of functional von Willebrand factor (that protein that helps platelets bind to the subendothelium)
most common hereditary bleeding disorder
occurs in about 1 in 100 people, many of whom are totally asymptomatic
what is the most common hereditary bleeding disorder?
von Willebrand disease
what is Hemophilia A?
X-linked disorder in which patients are deficient in factor VIII
most common factor deficiency - NOT the most common hereditary bleeding disorder!
what is the most common factor deficiency?
Hemophilia A
what is Hemophilia B?
x-linked deficiency in factor IX
more rare than hemophilia A
what are hereditary platelet disorders?
the platelets are missing some important structure, like glycoprotein IIb/IIIa, resulting in loss of platelet function
ex. Bernard-Soulier syndrome
what is disseminated intravascular coagulation
sometimes called “Death is Coming” because it can be such a dangerous problem
the whole thing starts when something kicks off the coagulation cascade causing rampant, widespread clot formation
then, as platelets and coagulation factors are depleted, bleeding becomes a problem
what is
Idiopathic thrombocytopenic purpura?
patients make antibodies against their platelets for some unknown (idiopathic) reason, marking them for destruction in the spleen
eventually, the platelet count drops so low that patients begin to get symptoms, such as purpura or easy bruising
