CP38 - Acquired Bleeding Disorder Flashcards
how can you determine whether the clotting factors are deficiency or inhibitor?
APTT test repeat with 50:50 patient to normal plasma - if deficiency, then the normal clotting factor in blood will correct the clotting factor if no correction then inhibitors present
why does patient with liver diseases have low platelet count
because 1/3 platelet sit on the spleen and liver disease might block the duct so spleen can not be released
what are the Vit K dependent clotting factors?
clotting factos II, VII, IX, X
where are all the clotting factors synthesed in the body?
liver
what happens to the clotting factors II , VII, IX, X when they are finished synthesised in the liver?
gemma glutyl carbroxylase add on the ending to the factors which are essential to the activity
what happens to the VIt K after the step of adding proteins by gemma glutyl carbroxylase
they become Vit K epoxide which is not usable as a co-factor for gemma glutyl carbroxylase
what enzyme return VIt K epoxide to Vit K
Vit K reductase
what enzyme does warfarin affect
Vit K reductase
how can Vit K be absorbed
fat soluble ie by intestine
what can cause Vit K deficiency
obstructive jaundice
prolonged nutritional deficiency
broad spectrum antibiotics
neonates (classical 1-7 days)
what does bacteria in gut do to Vit K
absorb them
what can cirrhotic coagulopathy cause?
liver produce all the clotting factors and so damage to liver = reduction to clotting factor production
what can liver impairment cause to haemostatsis
impaired - thrombocytopenia, platelet dysfunction, reduction plasm conc of all coagulation factors expect factor 8
definiton for massive transfusion
transfusion of a voluime equal to the patient’s total blood volume in less than 24 hours
or
50% blood volume loss within 3 hrs
why does massive transfusion syndrome happen
because when transfusing only blood cells are transfused
