Haematology Flashcards
Haemophilia A is a deficiency of which factor?
VIII
Apixiban inhibits which factor?
Factor Xa
The extraction of a single tooth is a high risk procedure when assessing bleeding risk
True or false.
False
A person with moderate haemophilia has what percentage of normal factor in their blood?
1-5%
Von williebrands type 2 is normally managed with which product to manage bleeding
Factor VIII concentrate
Augmentation of factor levels is required for which of the inherited bleeding conditions
-Moderate Haemophilia B
-Type 3 Von Willebrand’s Disease
-Mild Haemophilia A
-Type 2a Von Willebrand’s Disease
-All of the above
All of the above
Takes the medication warfarin with associated blood testing every week and requires a single tooth extraction.
What is the most appropriate management strategy?
INR required within 24 hours
Takes the medications aspirin and clopidogrel following a STEMI two weeks ago and requires the extraction of two asymptomatic teeth.
What is the most appropriate management strategy?
Delay extractions until 6 month point
Takes the medication Rivaroxaban once a day in the morning and requires the extraction of 5 teeth at 0900 in the morning.
Most appropriate management strategy
Delay the morning dose and take it four hours after haemostatis has been achieved
Takes the medication Dabigatran and requires the surgical extraction of two teeth at 0900 in the morning
Most appropriate management?
Miss the morning dose of medication and take the evening dose as usual
Takes the medication Apixaban and requires a single extraction
Most appropriate management?
Do not change drug regime
The prothrombin time(PT) would be deranged in
Liver disease or warfarin therapy
The activated partial thromboplastin time (APTT) would be deranged in
Haemophilia
Activated partial thromboplastin time (APTT) measures
Factors VIII,IX,XI,XII and factors X,V, prothrombin and fibrinogen
Prothrombin time (PT) measures
Factors VII,X,V,prothrombin and fibrinogen
A patient with moderate haemophilia A requires factor coverage for supra—gingival scaling true or false
False
Topical miconazole for the management of oral candidosis presents a risk for patients prescribed Warfarin by potentiating bleeding
True
What kind of inheritance pattern do haemophilia A and B follow
Sex linked recessive
Defective gene on the X chromosome - males are affected and females are the carries.
Unusual for females to have both X chromosomes affected
If a patient has a severe/ moderate case of haemophilia A - what treatment would the use
Recombinant factor 8
If a patient has a mild case of haemophilia A or they are a carrier what treatment would they receive
The majority of patients respond well to DDVAP ( desmppressin)
Very mild cases may only require oral tranexaic acid
How does DDVAP work and what are its limitations
It works by releasing the factor VIII that has Beene bound to endothelial cells giving a temporary boost to factor 8 levels and clotting ability
This has no effect on the coagulation cascade and can only be used a few times before all of the factor 8 has been displaced.
Therefore this isn’t a medication that is used on a daily basis.
How does tranexamic acid work?
Inhibits fibrinolysis
This works by counteracting the affect of the clot breaking down therefore allowing the clot to persist for longer.
A person who has haemophilia B is deficient in what factor
Factor 9
What ar the deficiency’s in VON-willebrands disease
Reduced factor 8 level
Reduced platelet aggregation
