Bleeding Disorders Revision Questions Flashcards
Hemarthrosis
bleeding into the joint space and assoicated with haemophillia patients
Haemophillia A
deficenecy in factor VII (8) - xlinked recessive
Haemophillia B
Definency in factor IX (9) - x linked recsessive
Von willebrand
Factor VII levels reduced - effects bleeding time
abnormal plasma proteins
Dental procedures that are safe for haemophillic patients
exam
supra ging resotrations
crowns and brdiges with infiltration LA
use articaine infilitration and intraligamental to avoid IDBs
Procedures carried out in haemophillic centres
XLAs, surgical XLA
subging scaling
LA - IDB or lingual infiltraion
Treatment for mild or von wilebrand patients
DDAVP which present increased risk of bleeding in procedures
consider antibiotics
Treatment for moderate to severe patients
factor replacement
tranxemic acid - inhibits the breakdown of firbin in blood clots - anti-fibrnolytic agent
What are the severity of haemophlila
mild = 6040% factor present moderate = >2,5% factor present - 1-5% of normal factor in their blood severe = <= 1%factor present
Blood tests for bleeding disorders
FBC
LFT
Thrombophillia and haemophillia factor screen
Cogulation screen - includes prothrombin time and acitvated partial thromboplastin time
Prothrombin time
measures factors VII, X, V, prothrombin and fibrinogen I, II
deranged in liver disease or warfarin therapy
Activated partial thromboplastin time
measures factors VII, IX, XI, XII, X, V, prothrombin, fribrnogen
deranged in haemophilia
Thrombocytopenia
low platelet count <80
Antiplatelet combination
aspirin and clopidogrel - for acute cornonary syndrome
Why might you be unable to achieve haemostasis
medicaiton - antocgulants, antiplatelets.
disease - haemophillia, von willebrand
liver disease
infections - HIV, Hep C
chronic renal failure
chemo - low counts for RBC, WBC, platelets
