Bleeding disorders Flashcards
What processes act to halt bleeding?
- Vasoconstriction
- Gap-plugging by platelets
- Coagulation cascade
What type of bleeding do vascular and platelet disorders lead to?
- Prolonged bleeding from cuts
- Bleeding into the skin
- Bleeding from mucous membranes
What type of bleeding do coagulation disorders cause?
delayed bleeding into joints and muscles
Give examples of congenital vascular defects?
Osler-Weber-Rendu syndrome
CTD - e.g. Ehlers Danlos syndrome
Give examples of acquired vascular defects?
Senile purpura
Infection e.g. meningococcal, measles, dengue, scurvy
Henoch-Schonlein purpurn
Give examples of disorders with decreased marrow production of platelets
- Aplastic anaemia
- Megaloblastic anaemia
- Marrow infiltration - leukaemia, myeloma
- Marrow suppression - cytotoxic drugs, radiotherapy
Give examples of disorders with XS destruction of platelets
- Immune - ITP, SLE, CLL, drugs e.g. heparin, viruses
2. Non-immune - DIC, TTP, HUS, sequestration
What are causes of poorly functioning platelets?
Myeloproliferative disease
NSAIDs
Raised urea
Give examples of congenital coagulation disorders
Haemophilia
vWD
Give examples of acquired coagulation disorders
Anticoagulants
Liver disease
DIC
Vitamin K deficiency
What is haemophilia A? Give the inheritance pattern
Factor VIII deficiency
X-linked recessive
How does haemophilia A tend to present?
Depends on severity Bleeds into: i. joints -> crippling arthropathy ii. muscle -> haematomas (pressure -> nerve palsies, compartment syndrome)
What Ix would u do for haemophilia A?
↑ APTT
↓ Factor VIII assay
What is the management of haemophilia A?
Minor bleeds: desmopression - raises factor VIII
Major bleeds: recombinant factor VIII
How does liver disease cause bleeding disorders?
↓ synthesis of clotting factors
↓ absorption of vitamin K
abnormalities of platelet function
