HEMORAGII Flashcards

1
Q

expresia clinica completa a hemofiliei se intalneste exclusiv la?

A

barbati - au un singur cromozom X

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2
Q

cum sunt copiii unui tata hemofilic?

A

baietii sanatosi si toate fetele purtatoare

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3
Q

pot transmite fetele heterozigote hemofilia la desc de sex M?

A

da, 50% risc la fiecare sarcina

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4
Q

tablou clinic de hemofilie la sex F - 3 cazuri

A
  1. tata hemofilic si mama purtatoare
  2. lionizare intensa = era purtatoare dar i s a inactivat si gena de pe celalalt cromozom
  3. sd turner + afectarea genei hemofilice
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5
Q

formele severe ale hemofiliei - 5

A
  1. postnatal, nicodata la sectionarea cordonului ombilical
  2. caderea CO
  3. vaccinari
  4. primele caderi
  5. eruptia dentitiei
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6
Q

carac hemoragii, indif de localizare - 7

A
  1. provocate
  2. NU purpura
  3. profunde
  4. prelungite
  5. tardiv
  6. greu de controlat
  7. tend la recidiva
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7
Q

cea mai frecventa cauza de deces a hemoragiilor?

A

intracraniene - 20% mortalitate

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8
Q

cele mai frecv hemoragii?

A

hematroze 90%

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9
Q

cele mai putin frecv hemoragii?

A

SNC <5%

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10
Q

ce articulatii afecteaza frecv hemartrozele?

A

cele mari
1. genunhi
2. cot
3. maleola
4. pumn
5. sold

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11
Q

spre ce evolueaza hemartroza pura?

A

artropatie hemofilica - anchiloza articulara

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12
Q

pot fihemartrozele provocate de traumatism usor?

A

da

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13
Q

ce este caracteristic hemartrozelor?

A

tendinta la recidiva

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14
Q

hemoragii musculare - frecventa

A

10-20%

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15
Q

henmoragii musculare - localizari

A
  1. m psoas
  2. retroperitoneal
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16
Q

hemofilia A - frecv

A

80-85% din total

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17
Q

care e mai frecv ? hemofilia Asau B

A

A

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18
Q

def factor 8

A

hemofilia A

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19
Q

def factor 9

A

hemofilia B

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20
Q

la ce varsta apar formele idiopatice ale hemofiliilor dob?

A

peste 50 ani

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21
Q

forme asociate ale hemofiliilor dob?

A
  1. colagenoze
  2. peripartum
  3. medicam - peniciline
    4.malign limfoprolif
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22
Q

hemoragii SEVERE:

A
  1. hemartroze
  2. musculare
  3. mb mucoase
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23
Q

hemoragii AMENINTATOARE DE VIATA:

A
  1. cerebrale
  2. gat si laringe
  3. GI
24
Q

este mai mare incid hemorag intracr la pac cu hemofilie decat la restul pop?

A

da, de 5 ori mai mare

25
Q

au hemoragiile intracr risc de recadere?

A

da, la 12 luni de la ep initial

26
Q

scad activit fizica si calitatea vietii pac cu hemoragie cerebrala?

A

da

27
Q

screening factori cale comuna

A

aPTT, PT

28
Q

factori cxale comuna

A

fibrinogen, 2, 5, 10

29
Q

factori cale extrinseca

A

tisular/3 si 7

30
Q

factori cale intrinseca

A

8, 9,11,12

31
Q

PT=?

A

11-13 sec

32
Q

aPTT=?

A

23-31 sec

33
Q

aPTT e pt?

A

f cale comuna si intrinseca

34
Q

PT/INR e pt?

A

f cale comuna si extrinseca

35
Q

cum sunt trombocitele in hemofilii?

A

normale

36
Q

cum este Hb in hemofilii?

A

n/scazute prin sangerari prel

37
Q

val normala a f de coag

A

50-150%

38
Q

cum e f 8 la nn termen/prematuri sanatosi?

A

mereu normal

39
Q

cum e f 9 la nn termen/prematuri sanatosi?

A

initial scazut la 20-50% din cauza imaturitatii hepatice si apoi creste la normal dupa 6 luni

40
Q

cine det gradul de severitate al hemofiliilor?

A

concentratia de f de coag

41
Q

conc factor de coag in hemor severe

A

<1%

42
Q

conc f de coag in hemor moderate

A

1-5%

43
Q

conc f de coag in hemor usoare

A

5-40%

44
Q

nr ep hemor in hemor severe

A

24-48/an

45
Q

nr ep hemor in hemor moderate

A

4-6/an

46
Q

nr ep hemor in hemor usoare

A

rare

47
Q

cauza ep hemor in hemor severe

A

spontane

48
Q

cauza ep hemor in hemor moderate

A

traumat minor

49
Q

cauza ep hemor in hemor usoare

A

traumat maj sau interv chir

50
Q

complicatii hemartroza recur;

A
  1. sinovita hipertrofica
  2. degradare progresiva cartilaj
  3. artropatia hemofilica
  4. anchiloza artic
51
Q

investigatii hemartroza

A
  1. eco articular
  2. RMN articular
52
Q

eco artic ce vede

A
  1. efuziuni acute/cr
  2. sinoviala
  3. cartilaj
  4. os
53
Q

rmn artic ce vede

A
  1. sinoviala
  2. cartilaj
  3. spatiul artic
54
Q

dg poz hemofilii

A
  1. sex m
  2. sg excesiva fara purpura
  3. simpt carac
  4. teste coag modif
  5. ancheta fam
55
Q
A