Capillary fragility test

Question 1

measures the ability of the capillaries to withstand the increased stress

Answer 1

Capillary fragility

Question 2

Tourniquet test

Answer 2

Capillary fragility

Question 3

Rumpel-Leede test, Hess test

Answer 3

Capillary Fragility

Question 4

Capillary fragility is used to indicate

Answer 4

Thrombocytopenia, and can used with dengue

Question 5

A positive-pressure test, used to measure the capillaries ability to remain intact under increased intracapillary pressure, is controlled by a blood pressure cuff around the patient’s upper arm.

Answer 5

Capillary Fragility Tourniquet test Rumpel-Leede test, Hess test

Question 6

To assess the fragility of capillary walls.

To identify a platelet deficiency (thrombocytopenia).

Answer 6

Capillary Fragility Tourniquet test Rumpel-Leede test, Hess test

Question 7

Patient preparation

Answer 7

Explain to the patient that this test is used to identify abnormal bleeding tendencies.

Tell him who will perform the procedure and when.

Inform him that food or fluids need not be restricted.

Explain that he may feel discomfort from the pressure of the blood pressure cuff.

Question 8

Materials

Answer 8

Stetoscope, blood pressure cuff or sphygmomanometer

Question 9

Parts of blood pressure cuff

Answer 9

Cuff, aneroid momanometer gauge, inflation bulb, air release

Question 10

Parts of stetoscope

Answer 10

Eartips, bell, diaphragm.

Question 11

small red or purple spots of the skin surface that can be caused by minor hemorrhage due to the rupture off capillaries

Answer 11

Petechiae

Question 12

Step 1 of the procedure

Answer 12

Examine the forearm, hand and fingers to make certain that no petechiae are present.

Question 13

step 2

Answer 13

Apply a blood pressure cuff on the upper arm above the elbow, and take blood pressure reading.

Question 14

Step 3

Answer 14

Inflate the blood pressure cuff to a point midway between the systolic and diastolic blood pressures for five minutes. (systolic+diastolic=____ / 2 =

Question 15

Step 4

Answer 15

After deflating the cuff, wait for the skin to return to its normal color (usually about five to ten minutes).

Question 16

step 5

Answer 16

Count the number of petechiae visible in a one-inch square area on the ventral surface of the forearm. Disregard any petechiae within 1.2 inch if the blood pressure cuff because this may be due to pinching of the skin by the cuff.

Question 17

What will you do if there is a petechiae present in step 1?

Answer 17

Take note of the petechiae and do not count that petechiae after deflating the pressure from the cuff

Question 18

reported as positive

Answer 18

> 10 petechiae

Question 19

1+

Answer 19

a few petechiae on the anterior part of the forearm

Question 20

2+

Answer 20

many petechiae on the anterior part of the forearm

Question 21

3+

Answer 21

multiple petechiae over the whole arm and the back of the hand

Question 22

4+

Answer 22

confluent petechiae on the anterior part and back of the hand

Question 23

Precautions

Answer 23

Do not repeat this test on the same arm within 1 week.

This test is contraindicated in patients with disseminated intra vascular coagulation (DIC) or other bleeding disorders, and in those with significant petechiae already present.

Question 24

A positive finding (more than 10 petechiae or a Score of 2+ to 4+) indicates ________.

Answer 24

weakness of the capillary walls (vascular purpura) or a platelet defect.

Question 25

Give atleast 8-12 conditions that may occur in abnormal findings.

Answer 25

thromboccytopenia, thrombasthenia, purpua senilis, scurvy, DIC, von Willebrand’s disease, vitamin K deficiency, dysproteinemia, and polycythemia vera and in severe deficiencies of factor VII, fibrinogen, or prothrombin.

Question 26

Conditions unrelated to bleeding defects, such as scarlet fever, measles, influenza, chronic renal disease, hypertension, and diabetes with coexistent vascular disease, may also increase capillary fragility. True or False?

Answer 26

True

Question 27

abnormal finding

Answer 27

An abnormal number of petechiae sometimes appear before menstruation and at other times in some healthy persons, especially in women over age 40.

Question 28

Interfering factors

Answer 28

Decreasing estrogen levels in postmenopausal women (possible increase)
Glucocorticoids (possible decrease)
Repeating the test on the same arm within 1 week, causing errors in counting the number of petechiae.
Overinflation or underinflation of the cuff.