Dental management of coagluopathies

Question 1

acquired medical conditions affecting coagluapaties

Answer 1

chronic kidney disease
liver diseaseHF
myeloproliferative disorders
chemotherapy

Question 2

congenital med conditions affecting coaglauation

Answer 2

haemophilia
von willebrans
erlers danlos

Question 3

haemophilia A

Answer 3

A factor VIII deficiency

B factor 9

Question 4

haemophilia B

Answer 4

factor IX deficeicy

Question 5

haemophilia is

Answer 5

X linked recessive
females become carriers
males will be symptomatic

Question 6

signs and symptoms of haemophilia

Answer 6

nose bleeds
easy brusing
spontaneous gingival bleeding 
GI bleeds
difficultiy clotting after cuts
hemarthosis
crainal bleeds

Question 7

treatment for haempphilia

Answer 7

antifirbinolytic agents (transexamic acid)
DDAVP
direct factor replacement

Question 8

transexamic acid

Answer 8

anti fibrinolytic agent that inhibits breakdown of fibrin clots
blocks binding of plasminogen and plasmin to fibrin i.e. no fibrinolysis

Question 9

desmopressin DDAVP

Answer 9

synthetic replacement for vasopressin (hormone reducing urine production)
stimulates release of VWF and FV/VIII

Question 10

what does VW do

Answer 10

promotes plate aggregation (primary haemostats)

carrier protien for factor VIII (Secondary haemostasis)

Question 11

treatment of VW disease

Answer 11

DDVAP

direct factor replacemtn

Question 12

types of VW disease

Answer 12

1 D
2 D
3 - recessive

Question 13

blood test platelet counts

Answer 13

less than 20 spontaneous bleeding

>80 haemostatic

Question 14

what do NSAIDS do blood wise

Answer 14

impari platlet function

Question 15

what do SSRI anti depressants do blood wise

Answer 15

affect plateletaggregation

Question 16

what do immunosuppresants do do blood wise

Answer 16

reduce amount of platelets available

Question 17

warfarin

Answer 17

antigoagulant
vit K anatagonists
used in DVT, AF, strokes and valve repalement

Question 18

INR

Answer 18

time taken for clot to form in blood relative to standard of 1

Question 19

antipletlet drugs

Answer 19

impar primary homeostasis by interring with platelet aggregation
e.g. asparin
clopidogrel

Question 20

NOACS

Answer 20

novel oral anticaogluans
e.g. dibigatran
rivaoxiban(affect Xa clotting factor)
apixiban

Question 21

antidote for warfarin overdose

Answer 21

vit K

Question 22

low molecular weight heparin

Answer 22

usually SC injection

prevention of VTE

Question 23

INR stable and unstable

Answer 23

stable
- can be assessed 72 Horus before proedure
ustabe
24 hours of dental procedure

Question 24

local measures for extraction

Answer 24

horizontal mattress sutues
use haemostat packing material
warm wet absorbent cause to put pressure directly on site of extraction