Haem- bleeding disorders Flashcards
haemophilia
An X-linked recessive, hereditary disorder in which abnormally prolonged bleeding recurs episodically at one or a few sites on each occasion
haemophilia aetiology
haemophilia A- factor VIII deficiency
haemophilia B- factor IX deficiency
what is more common haemophilia A/haemophilia B?
haemophilia A- 5x more common
haemophilia affects which vessels
Bleeding from medium to large blood vessels, most commonly into joints
haemarthroses
bleeding into a joint space. It can cause pain, swelling, and limited joint movement
blood results in haemophilia
Isolated prolonged APTT
Coagulation factor assays (factor VIII for A, factor IX for B)
Desmopressin moa
stimulates the release ofvon Willebrand Factor
Von Willebrand factor
a protein in the blood that helps blood clot
von willebrand’s disease
Inherited bleeding disorder characterized by a reduced quantity or function of von Willebrand factor
VWF gene is located on chromosome __
12
immune thrombocytopenic purpura
Clinical syndrome in which a decreased number of circulating platelets manifests as a bleeding tendency, causing petechiae, ecchymoses, purpura and bleeding from venepuncture sites, nose etc., in an otherwise healthy patient
Causes of secondary ITP
other autoimmune disorders- antiphospholipids syndrome and SLE
infections- HIV etc
H.pylori infection
medication
Lymphoproliferative disorders
which type of hypersensitivity reaction is ITP
type II hypersensitivity reaction
ITP is caused by antibodies that target and destroy what?
platelets
which age group of patients does ITP usually affect
children under 10 years old
first line treatment for ITP when treatment required
oral prednisolone
thrombotic thrombocytopenic purpura
Rare form of thrombotic microangiopathy characterised by microangiopathic haemolysis, thrombocytopenia, and neurological abnomalities
TTP caused by a deficiency of what
metalloproteinase ADAMTS13
TTP associated with what triggers
medication
AIDS
malignancy
Classic pentad of TTP
fever
Microangiopathic haemolytic anaemia
Thrombocytopaenic purpura
CNS involvement: headache, confusion, seizures
AKI
Microangiopathic haemolytic anaemia
a type of anemia that occurs when red blood cells break down in small blood vessels. It’s characterized by the presence of schistocytes, which are fragments of red blood cells, in a blood sample
definitive treatment of TTP
plasma exchange
blood film findings in TTP
schistocytes
raised reticulocyte count
massive haemorrhage
bleeding patient with signs of shock
bleeding which has already prompt emergency O Rh(D) negative red cells
most appropriate medical management for von willebrand’s disease
Desmopressin
most common inherited bleeding disorder
von willebrand’s disease
disseminated intravascular coagulation (DIC)
Complex condition that describes the inappropriate activation of the clotting cascades, resulting in thrombus formation and subsequently leading to the depletion of clotting factors and platelets
causes of DIC
sepsis
obstetric emergencies
malignancy
hypovolaemic shock