Bleeding Symptoms

Question 1

It is the excessive bleeding that requires medical or physical intervention

Answer 1

Hemorrhage

Question 2

Type of bleeding may result from primary (platelet- related) or secondary (coagulation factor-related) hemostasis disorders or from unregulated fibrinolysis in which clots are rapidly metabolized.

Answer 2

Congenital Bleeding

Question 3

Bleeding from a single location usually indicates injury, infection, tumor, or an isolated blood vessel defect and is called

Answer 3

Localized bleeding or Localized hemorrhage

Question 4

Give and example of localized bleeding

Answer 4

Inadequately cauterized or ineffectively sutured surgical site or an arteriovenous malformation (AVM)

Question 5

This is a reduced platelet count (thrombocytopenia), or a coagulation factor deficiency cause systemic and not localized bleeding

Answer 5

Qualitative platelet defect

Question 6

Bleeding from multiple sites, spontaneous and recurring bleeds, or a hemorrhage that requires physical intervention is called

Answer 6

Generalized bleeding

Question 7

It is a potential evidence for a disorder of primary hemostasis such as a blood vessel or platelet defect or thrombocytopenia; or secondary hemostasis characterized by single or multiple coagulation factor deficiencies or uncontrolled fibrinolysis.

Answer 7

Generalized bleeding

Question 8

Generalized bleeding may exhibit either _ or _

Answer 8

Mucutaneous (typically in skin or at body orifices) or anatomic (soft tissue, muscle, joints, deep tissue)

Question 9

Red pin points (<3mm)

Answer 9

Petechiae

Question 10

Purple skin lesions (3mm to 1cm)

Answer 10

Purpura

Question 11

Greater than 1 cm, typically seen after trauma

Answer 11

Ecchymoses (bruises)

Question 12

Other symptoms of a primary hemostasis defect include:

Answer 12

• Bleeding from the gums,
• Epistaxis (uncontrolled nosebleed)
• Hematemesis (vomiting of blood),
• Blood in the urine or stool
• Menorrhagia (profuse menstrual flow)

Question 13

Mucocutaneous hemorrhage is most likely to be associated with

Answer 13

• Thrombocytopenia (platelet count less than 150,000/uL
• Qualitative platelet dsd.
• vWF dse.
• Vascular dsd. (scurvy or telangiectasia)

Question 14

Seen in acquired or congenital defects in secondary hemostasis such as plasma coagulation factor deficiencies (coagulopathies)

Answer 14

Anatomic Hemorrhage

Question 15

Examples of anatomic bleeding include:

Answer 15

• Recurrent or excessive bleeding after minor trauma
• Dental extraction
• Surgical procedure.

Question 16

Bleeds that are internal, such as bleeds into joints, body cavities, muscles, or the central nervous system, and may have few initially discernible signs.

Answer 16

Anatomic bleeds

Question 17

Cause swelling and acute pain; may not be immediately perceived as hemorrhages,

Answer 17

Joint bleeds (Hemathroses)

Question 18

Cause inflammation that may culminate in permanent cartilage damage that immobilizes the joint.

Answer 18

Recurrent hemarthroses

Question 19

May cause nerve compression and subsequent temporary or permanent loss of function

Answer 19

Bleeds into soft tissues such as muscle or fat

Question 20

Bleeds into the kidney may present as hematuria and may be associated with

Answer 20

Acute Renal Failure

Question 21

This test isessential whenever a generalized mucocutaneous or anatomic bleed is detected

Answer 21

Hemostasis laboratory testing

Question 22

Assess anemia associated with chronic bleeding or a hemolytic anemia; bone marrow response

Answer 22

Hemoglobin, Hematocrit, Reticulocyte count

Question 23

Assesses thrombocytopenia

Answer 23

Platelet count

Question 24

Assess clotting time prolonged in deficiencies of
factors II (prothrombin), V, VII, or X

Answer 24

Prothrombin Time (PTT)

Question 25

Assess clotting time prolonged in deficiencies of all
factors except VII and XIII

Answer 25

Partial thromboplastin time (PTT)

Question 26

Assess prolonged by unfractionated heparin therapy, dysfibrinogenemia, hypofibrinogenemia, and afibrinogenemia; qualitative

Answer 26

Thrombin Time (TT)

Question 27

Reduced in dysfibrinogenemia, hypofibrinogenemia, and afibrinogenemia; quantitative result

Answer 27

Fibrinogen assay (FG)

Question 28

Are coagulometers that measure whole blood clotting, a process called global hemostasis. Both report clot onset dynamics, clot strength, and fibrinolysis in 15 to 30 minutes

Answer 28

Thromboelastograph (TEG) or thromboelastometry (TEM)

Question 29

Are uncommon, occurring in fewer than 1 per 100 people, and are usually diagnosed in infancy or during the first years of life

Answer 29

Congenital Hemorrhagic disorder

Question 30

Lead to recurrent hemorrhages that may be spontaneous or may occur after minor injury or in unexpected locations, such as joints, body cavities, retinal veins and arteries, or the central nervous system

Answer 30

Congenital Bleeding disorders

Question 31

May have no symptoms until they reach adult- hood or experience some physical challenge, such as trauma, dental extraction, or a surgical procedure.

Answer 31

Mild congenital hemorrhagic disorders

Question 32

The most common congenital deficiencies are:

Answer 32

• vWD
• factor VIII (FVIII, hemophilia A)
• factor IX deficiencies (FIX, hemophilia B)
• platelet function disorders