Blood Clotting Disorders Flashcards
occurs when the immune system IgG mistakenly attacks and destroys platelets
immune thrombocytopenia (ITP)
patient presents with bleeding, mucosal and gingival bleeding, petechiae, and fatigue. CBC and PBS reveals low platelets. Dx?
immune thrombocytopenia (ITP)
treatment for ITP in adults? in children?
steroids
watchful waiting + close follow up
a thrombotic microangiopathy caused by ADAMTS13 deficiency which causes too much vWF on endothelial cells and thus clotting occurs.
thrombotic thrombocytopenic purpura (TTP)
patient presents with petechiae, hematuria, easy bruising, headache, AMS, seizures, and vertigo. the labs show anemia, thrombocytopenia, presence of schistocytes (active hemolysis), and increased indirect bilirubin, retic count, and LDH. Dx?
thrombotic thrombocytopenic purpura (TTP)
treatment for TTP? (2)
plasma exchange
high-dose corticosteroids
patient presents with thrombocytopenia, anemia, acute kidney injury, painful bloody diarrhea, abdominal cramping, fever. the CBC and PBS shows schistocytes, increased Cr/BUN, increased LDH, indirect bilirubin, plasma hemoglobin and low haptoglobin. Dx?
hemolytic-uremic syndrome (HUS)
what is the most common cause of HUS?
E. coli (shiga-like toxins)
what is one of the most common causes of pediatric acute renal failure?
shiga-toxin-producing E. coli
what is the treatment for HUS? (4)
fluids
anti-emetics
+/- dialysis
+/- blood transfusion
what should be AVOIDED in the treatment for HUS?
anti-motility / antibiotics
what are 3 common causes of disseminated intravascular coagulation (DIC)?
OB
sepsis
trauma
the release of factor III leads to a deposition of fibrin (clotting, eating up the clotting factors and platelets, which then leads to bleeding
DIC
patients labs reveal increased PT, PTT, and D-Dimer. There are schistocytes, a decrease in fibrinogen and clotting factors, decreased platelets, and decreased hematocrit.
DIC
what is the treatment for DIC? (2)
treat cause
LMWH
deficiency in clotting factor 8, leads to a prolonged PTT, a normal PT, and normal platelets.
hemophilia A
treatment for acute bleeding associated with hemophilia A?
administer recombinant factor replacement
deficiency in the clotting factor 9
hemophilia B (christmas disease)
deficiency in clotting factor 11
hemophilia C (rosenthal syndrome)
patient presents with epistaxis, excessive bleeding with dental procedures, heavy menstrual bleeding, and easy bruising. Dx?
Von Willebrand Disease (vWD)
what is the treatment for vWD?
DDAVP (desmopressin)
what is essential for the synthesis of prothrombin and clotting factors II, VII, IX, and X?
vitamin K
what do decreased levels of vitamin K lead to?
increased arterial calcification
patient presents with bleeding at venipuncture site or after minor trauma, they have ecchymoses and petechiae, bloody urine/stool, and weakened bones. Dx?
Vitamin K deficiency
PT is 4x the normal range, there are normal/increased platelets, normal fibrinogen, and absence of degradation products. Dx?
vitamin K deficiency
what is the treatment for vitamin K deficiency?
oral/SQ vitamin K
what is the second most common cardiovascular disorder, after MI?
venous thromboembolism
is a result of overactivity of pro-coagulant factors or a deficiency in anti-coagulants
hypercoagulable state
what is the second most common acquired hypercoagulable state that leads to prothrombotic state through the production of procoagulant factors?
malignancy
should a hypercoagulable state always be treated?
no
depends on risk-benefit analysis
what are 3 treatments for hypercoagulable states?
LMWH
direct anticoagulants
thrombolytics
myeloproliferative disorder associated with a Janus Kinase-2 mutation that causes neoplastic proliferation of the hematopoietic cells, leading to overproduction of RBCs
polycythemia vera
patient presents with fatigue, headache, dizziness, peripheral tingling/burning, hypertension, mucosal cyanosis, bruising, petechiae, and episodic blurred vision. Dx?
polycythemia vera
treatment for polycythemia vera? (3)
phlebotomy
fluids
aspirin
which disease causes acute renal failure in children?
HUS
which 2 diseases cause thrombotic microangiopathy?
TTP
HUS
