Bleeding Disorders

Question 1

what to ask in the history?

Answer 1

have you got a bleeding disorder
how severe
bruising 
epistaxis
post surgical bleeding
menorragic 
post trauma

Question 2

what ar examples of platelet bleeding

Answer 2

muscosal-petechiae
epistaxis
purpura
GI

Question 3

what are examples of coagulation factor bleeding

Answer 3

muscle haematoma

CNS-cranial haematoma

Question 4

what is haemophilia and the typs

Answer 4

a is missing coagulation factor 8
b is missing cogailaiton factor 9 
they have identical phenotypes 
measure 8 and 9 levels 
normal is 55-200
bleeding every couple weeks into joints and muscles

Question 5

what are the ranges of bleeding

Answer 5

severe-bleeds spontaneously
moderate-never bleeds spontaneously
mild

Question 6

what are clinical features of haemophilia

Answer 6

• Ankle joint is the worst joint
  
  • Hemarthrosis
  • Hinge joints worse than ball and socket
  • Tingling in joint then throbbing-immobilised
  • Muscle withers away as they arent used
  • Muscle haematoma-leg muscles

Question 7

what is the treatment for haemophilia

Answer 7

• Coagulation factor replacement FVIII/IX
	• Tranexamic acid 
	• Prophylaxis 
	• Splints
	• Physiotherapy
	• Analgesia
	• Synovectomy 
Joint replacement

Question 8

what is von willibrand disease

Answer 8

autosomal

platelet type bleeding

Question 9

how do you treat von willibrand disease

Answer 9

vWF concentrate

tranexamic acid

Question 10

what is thrombocytopenia

Answer 10

low platelets

Question 11

what are the causes of thrombcytopenia

Answer 11

decreased production-marrow failure

increased consumption- immune ITP, non-immune DIC

Question 12

what is the clinical features of thrombocytopenia

Answer 12

petechiae , ankles
mucosal bleeding
?<10 platelets

Question 13

how do you treat haemorrhage disease of newborn

Answer 13

vitamin k injection