Clinical cases in thrombosis and haemostasis Flashcards
A 65 year old man takes aspirin because of a previous history of TIA.
…
How does asprin work?
REDUCES PLATLET AGGREGATION - inhibits cyclooxygenase from working, inhibits arachadonic acid from turning into thrmoboxane A2.
which drugs prevent pletlet funciton?
clopidogrel, adciximab, ticagrelor.
how does dabigatran work?
small molecule whichh bind to and inactivates thrombin
A 21-year old medical student uses the combined oral contraceptive. She is clinically well
…
what is true?
she has an increased risk of stroke and VTE
what increases VTE risk?
Fcator V leiden in combination with COCP and fhx of VTE.
what is given to prevent blood clot formation in hospital?
thromboprophylaxis
what are rf’s for arterial thromboembolism?
smoking, dm, af
A 20 month old boy attends accident and emergency with his father, The child has refused to walk for the past 2 days having been walking unsupported for 4 months, The right knee is slightly swollen and feels warm to touch. Blood is aspirated from the knee.
ponder…
differentiate between haemophilia a and b
measure APTT then measure factor 8 and 9 levels
how is heamophilia a inherited?
x linked
tx for haemophilia a
recominant factor 8
complicaition of factor 8 tx
hapatitis a and development of inhibitory antibodies
what is the best tx regimen for the pt?
give factor 8 at least 3 times a week or small amounts every day. Gene therapy,
A 24 year old female student presents with a 4 day history of easy bruising and small red spots on her ankles
She has no previous history of abnormal bleeding
Previous tonsillectomy with no bleeding
Recently been off colour with flu like symptoms
Only medication COCP
ponder…
hwat is seen oin the skin as a sx
unblanching petichiae
which sy is she likely to have
menorrhagia, epistaxis, busccal bleeding
what is the likely cause of her sy?
thrombocytopenia, vitamin k deficiency (obstruction of the biliary tree
what are common causes of thrombocytopenia?
AML, anaplastic anaemia, ITP, (VIT K. deficiency does not)
what is her platelt count most likely to be?
10
which underlying illness is associated with ITP?
HIV, SLE, EBV (glandular fever) - all of thhe autoimmune mediated diseases.
A 70 year old man has excessive bleeding after a colectomy for cancer
He has bleeding from his abdominal wound but not from his drain or his indwelling line
He has had surgery in the past but had no abnormal bleeding
ponder…
Which is the most likely cause of this?
poor surgical technique (single site does not suggest coagulopathic bleeding).
