blood disorders 3

Question 1

what does Petechiae and Ecchymoses mean?

Answer 1

petechiae- visible

ecchymoses- bruises

Question 2

how do you differentiate platelet disorders and coagulation disorders?

Answer 2

site of bleeding/ tissues/ petechiae/ ecchymoses/Hemarthrosis / muscle bleeding / bleeding after cuts or scratches/ bleeding after surgery or trauma

Question 3

define haemostasis

Answer 3

arrest of bleeding, Maintaining steady state of blood volume, pressure and flow through the injured blood vessels after vascular damage

Question 4

what does haemostasis require?

Answer 4

Requires platelets, clotting cascade, blood flow, endothelial cells and fibrinolysis

Question 5

what is the 8-step mechanism for coagulation?

Answer 5

1- damaged tissue releases factor 3… +F7 and CA2+ - activate extrinsic pathway
2-factor 12 activate F11- intrinsic pathway
3-both F7 and F10 promote formation of thrombin- coagulation cascade
4-active factor 10 + 3/5/ca2+/PF3= activate prothrombin factor
5-prothrombin-thrombin
6-which converts fibrinogen to fibrin
7-F13 -cross links
8-platelets and RBC caught in mesh- clot formed

Question 6

what are the vitamin K clotting factors?

Answer 6

7/4/5/2

Question 7

what are the inherited bleeding disorders?

Answer 7

Hemophilia A and B
–vonWillebrandsdisease
–Other factordeficiencies

Question 8

what are the acquired bleeding disorders?

Answer 8

–Liver disease
–Vitamin Kdeficiency/warfarinoverdose
–DIC

Question 9

what is hemophilia?

Answer 9

An x-linked hereditary disease affecting males

Characterized by episodes of hemorrhage in joints and internal organs after minor injury

Question 10

what are the two types of haemophilia?

Answer 10

A and B

Question 11

What factors affect each type of haemophillia?

Answer 11

A-factor 8

B factor 9

Question 12

what are the complications associated with haemopheilia?

Answer 12

soft tissue bleeding

Question 13

what are the 4 clinical manifestations of haemophillia?

Answer 13

Hemarthrosis (most common)
•Fixed joints
–Soft tissue hematomas (e.g., muscle)
•Muscle atrophy
•Shortened tendons
–Other sites of bleeding
•Urinary tract
•CNS, neck (may be life-threatening)
–Prolonged bleeding after surgery or dentalextractions

Question 14

how is haemophilia treated?

Answer 14

treated with IV factors- A-8 and B-9

Question 15

what are the clinical features of the vonwilliebrand disease?

Answer 15

Synthesis in endothelium andmegakaryocytes
–Forms large multimer
–Carrier of factor VIII
–Anchors platelets to subendothelium
–Bridge between platelets
Clinical features - mucocutaneous bleeding

Question 16

what causes liver disease?

Answer 16

Decreased synthesis of II, VII, IX, X, XI, and fibrinogen
–Prolongation of PT, aPTT and Thrombin Time

Question 17

what is the treatment for liver disease?

Answer 17

–Fresh-frozen plasma infusion(immediate but temporary effect)
–Vitamin K (usually ineffective)

Question 18

where do we get vit K from?

Answer 18

Green vegetables

Synthesized by intestinal flora

Question 19

why do we require vit K?

Answer 19

Required for synthesis Factors II, VII, IX ,XProtein C and S

Question 20

what are the causes of vitamin K deficiency?

Answer 20

Malnutrition
Biliary obstruction
Malabsorption
Antibiotic therapy

Question 21

how do you treat vit K def?

Answer 21

Vitamin K

Fresh frozen plasma

Question 22

what is Disseminated Intravascular Coagulation Syndrome?

Answer 22

Abnormal bleeding state resulting from thenet effect of various events that lead to Activation of the coagulation mechanism:
diseases associated with shock
–overwhelming bacterial infection
–extensive necrosis of tissue

Question 23

what happens in disseminted intravascular coagulation syndrome?

Answer 23

in the process of clotting, platelets and the plasma coagulation factors are utilized, and the levels of these in the blood rapidly drop
•The body then activates the fibrinolys in system to defend itself against wide spread intravascular clotting, dissolving clots and preventing potentially the lethal obstruction of the circulatory system
•The net effect is Disseminated IntravascularCoagulation

Question 24

what do the lab tests reveal in DIC?

Answer 24

Laboratory tests reveal–Thrombocytopenia, Prolongation of the PT and PTT, increased fibrin split products, and decreased fibrinogen.

Question 25

what does acute and chronic DIC mean?

Answer 25

Acute DIC (e.g., that associated with infection or obstetric complications) is dominated by bleeding- lifethreatening
•Chronic DIC (e.g., as occurs in those with cancer) more often causes thrombosis.

Question 26

what are the lab tests you use to evaluate haemostasis?

Answer 26

Platelet count
•Examination of blood smear for platelet numbers
•Bleeding time
•Clotting time of whole blood
•Partial thromboplastin time
•Prothrombin time

Question 27

what are the Tests Measuring Phases of theClotting Mechanism?

Answer 27

Whole blood clotting timePartial thromboplastin time- 1-3
Prothrombin time- 2-3
Thrombin time- 3