Bleeding Disorders Flashcards
How do disorders of primary haemostasis formation typically present?
Easy/spontaneous bruising and purpura
Disorders of primary haemostasis will show what on fundoscopy?
Retinal haemorrhages
Use of what medication may cause failure of primary haemostasis as a result of vascular damage?
Steroids
Deficiency of which vitamin may cause failure of primary haemostasis as a result of vascular damage?
Vitamin C
The acute form of immune thrombocytopenia (ITP) is most likely to occur in who, and when?
In children, following an infection or vaccination
How is the acute form of immune thrombocytopenia treated?
Usually self-limiting over 1-2 weeks
The chronic form of immune thrombocytopenia is most likely to occur in who?
Young and middle aged females
How is the chronic form of immune thrombocytopenia treated?
Prednisolone
Abnormally large and sticky multimers of Von Willebrand’s factor cause platelets to clump within vessels describes the pathophysiology behind what condition?
Thrombotic thrombocytopenic purpura (TTP)
Thrombotic thrombocytopenic purpura is rare, but is generally seen in who?
Adult females
What is Evan’s syndrome?
ITP with autoimmune haemolytic anaemia
What is the most common inherited bleeding disorder?
Von Willebrand’s disease
How is Von Willebrand’s disease usually inherited?
Autosomal dominant
What are the two most common presentations of Von Willebrand’s disease?
Menorrhagia and epistaxis
What happens to the bleeding time in individuals with Von Willebrand’s disease?
Increased
Does Von Willebrand’s disease cause a prolonged PT, APTT, both or neither?
APTT
Levels of which clotting factor maybe moderately reduced in those with Von Willebrand’s disease?
Factor VIII
What is used as a treatment for mild bleeding caused by Von Willebrand’s disease?
Tranexamic acid
What medication can be used to raise the levels of Von Willebrand’s factor in those with Von Willebrand’s disease?
Desmopressin
Which clotting factors are vitamin K dependent?
II, VII, IX and X
What are the three main examples of multiple clotting factor deficiencies?
Liver disease, vitamin K deficiency and DIC
What are some potential causes of DIC?
Sepsis, trauma, malignancies and obstetric complications
What is the cause of end organ failure in DIC?
Microvascular thrombus formation (from excess clotting)
Which end organs are most likely to be damaged as a result of DIC?
Kidneys, liver, lungs, brain
How are haemophilias inherited?
X linked recessive
Which type of haemophilia is more common?
Haemophilia A
In haemophilia A, there is a deficiency of which clotting factor?
Factor VIII
In haemophilia B, there is a deficiency of which clotting factor?
Factor IX
Which type of haemophilia can also be known as Christmas disease?
Haemophilia B
What are the two most common presentations of haemophilia?
Haemarthrosis/haematomas or prolonged bleeding after surgery or trauma
How are haemophilias treated?
Injections of factor concentrate every 2-3 days
What happens to the platelet count in DIC?
Low
Does DIC cause a prolonged PT, APTT, both or neither?
Both
What happens to the D-dimer count in DIC?
Increased
What may be seen on a blood film of someone with DIC due to microangiopathic haemolytic anaemia?
Schistocytes
What happens to the fibrinogen level in DIC?
Low
Does haemophilia cause a prolonged PT, APTT, both or neither?
APTT
In which bleeding conditions will the bleeding time be increased?
Von Willebrand’s disease and DIC
Does a deficiency of vitamin K cause a prolonged PT, APTT, both or neither?
Both
What are some potential treatments for mild bleeding in haemophilia?
Desmopressin and tranexamic acid
Desmopressin should only be used as a treatment for which type of haemophilia?
Haemophilia A
Tranexamic acid is not a useful treatment for what type of bleeding in patients with haemophilia?
Haemarthroses or haematomas
What is the treatment for severe bleeding in haemophilia?
Factor VIII/IX factor concentrate IV infusion
