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12- Haematolgy > Haemostatis and Bleeding Disorders > Flashcards

Haemostatis and Bleeding Disorders Flashcards

1
Q

define haemostasis

A

arrest of bleeding and maintenaince of vascular patency

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2
Q

what is the primary stage of haemostasis?

A

formation of platelet plug

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3
Q

what is the secondary stage of haemostasis?

A

formation of fibrin clot

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4
Q

what is the lifespan of platelets and why is this important with regards to surgery?

A

7-10 days, if someone on anti-platelets need to stop medication week before surgery to achieve normal homeostasis level

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5
Q

failure of the platelet pluf formation can be caused by what?

A

vascular

platelets

Von willebrand factor

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6
Q

what are vascular causes of failure to form the platelet plug?

A

hereditary i.e. marfans

aquired i.e. vasculitis (HS purpura)

inc in age (lack of collagen)

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7
Q

what are platlet casues of failure to form platelet plug?

A

thrombocytopenia (reduced number)

renal disease (reduced function)

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8
Q

failure of platelet plug formation can result in what?

A

spontaneous bruising and purpura

mucosal bleeding

intracranial haemorrhage

retinal haemorrhage

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9
Q

what are the three ‘stages’ of platelet plug formation?

A

initiation

propagation

amplification

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10
Q

TF and VIIa activate what?

A

V and Xa

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11
Q

V and Xa activate what?

A

prthrombin

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12
Q

prothrombin is converted to what during platelet plug formation?

A

thrombin

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13
Q

thrombin stimulates further relase of which factors?

A

VIII and IXa

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14
Q

VIII and IXa activate more of which other factors?

A

V and Xa

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15
Q

fibrin is broken down by what?

A

plasmin

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16
Q

what converts plasminogen to plasmin?

A

tissue plasminogen activator

17
Q

what is looked at in a coagulation screen?

A

prothrombin time

activated partial thromboplasmin time

FBC

18
Q

what is the prothrombin time measuring?

A

Tissue factor and VIIa

19
Q

what is the activated partial prothrombin time measuring?

A

VIII and IXa

20
Q

what is the FBC used to look at in a coagulation screen?

A

platelet count

21
Q

what is thrombophilia?

A

deficiency of naturally occuring anti-coagulants

22
Q

what is the commenest cause of primary haemostatic failure?

A

thrombocytopenia

23
Q

what can cause secondary haemostatic failure (fibrin clot)?

A

multiple or single clotting factor deficiences

24
Q

what can cause multiple clotting factor deficiencies?

A

liver failure

Vit K deficiency/warfarin therapy

DIC

25
Q

why does a vit K deficiency affect clotting factors?

A

required to make 2,7,9,10

26
Q

how can obstrucitve jaundice i.e. pancreatic cancer/gallstones cause a clotting factor deficiency?

A

need bile salts for absoprtion of Vit K- without vit K can’t carboxylate 2,7,9,10

27
Q

what can cause DIC?

A

sepsis

obstetirc emergencies

malignancy

hypovolaemic shock

28
Q

what is a single clotting factor deficiency?

A

hameophilia

29
Q

which is more common haemophilia A or B?

A

A

30
Q

which clotting factor is deficient in haemophilia A and in B?

A

A - factor VIII

B- factor IX

31
Q

what mode of inheritance is haemophilia?

A

X-linked

32
Q

what occurs in someone with haemophilia?

A

recurrent haemarthroses, soft tissue bleeds

prolonged bleeding after dental extractions/surgery

33
Q

atypical picture of menorrhagia and easy bruising would suggest deficiency of what?

A

Von Willebrand Factor

34
Q

where do people with haemophilia most commnly suffer haemarthroses?

A

ankle/knee- this is where you’re most liekly to bump/twist

35
Q

elevated PT time would indicate deficeincy in?

A

TF and VII

36
Q

elevated APTT would indicate deficiency in?

A

VIII and IX

37
Q

platelet adhesion at injury sites occut via what?

A

glycoprotein 1b and VWF

38
Q

what is dipyridamole?

A

phosphodiesterase inhibitor- reduces cAMP production

12- Haematolgy (9 decks)

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