Haemostasis And Thrombosis

Question 1

20 month year old with refusal to walk,
Right knee slightly swollen,
Knee warm to touch
Blood aspirated from knee

Answer 1

Haemophilia

Question 2

Investigations that should be done

Answer 2

APTT (prolonged)
PT (normal)
Measure factor 8 and 9 levels (GOLD)

Question 3

Haemophilia inheritance

Answer 3

X linked

Question 4

Optimal treatment for haemophilia

Answer 4

Recombinant factor 8 (emergency)

DDAVP (In mild)

Question 5

Infections that can occur with factor 8/9 treatment

Answer 5

Hepatitis B, C
HIV

Not A

Question 6

Main complication of treatment of severe haemophilia A with factor VIII concentrates

Answer 6

Development of inhibitory antibodies

Question 7

Prophylaxis for haemophilia A

Answer 7

factor VIII 3 times a week

Or once weekly

Question 8

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

Answer 8

Thrombocytopenia

Causes of thrombocytopenia:
Acute myeloid leukaemia,
Aplastic anaemia,
ITP

Question 9

Platelet count needed for spontaneous bleeding

Answer 9

<10

Question 10

Illnesses associated with ITP

Answer 10

HIV,
SLE,
Glandular fever

Question 11

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
Which is the most likely cause of this?

Answer 11

Poor surgical technique

Question 12

What condition can contribute to VTE risk in patient on COCP

Answer 12

Factor V Leiden