Hemorrhage

Question 1

name 5 causes of hemorrhage

Answer 1

• trauma
• aneurysms
• erosion; microbes, neoplasia
• vitamin deficiency (eg. vit K involved in clotting)
• thrombocytopenia (low platelets -> people on chemotherapeutics)

Question 2

clinical significance of hemorrhage is dependent on what 3 things?

Answer 2

• volume of blood loss
• rate of blood loss
• location of hemorrhage

Question 3

what is bleeding into thorax called?

Answer 3

hemothorax

Question 4

what is ripping of heart and bleeding into pericardium called?

Answer 4

hemopericardium

Question 5

what is hemoperitoneum?

Answer 5

bleeding into peritoneum

Question 6

what is hemarthrosis?

Answer 6

bleeding in a joint

Question 7

what is hematoma?

Answer 7

bleeding into a tissue (non-specific)

Question 8

what is purpura?

Answer 8

multiple hemorrhages <1cm

Question 9

what is the most common purpura in children?

Answer 9

Henoch-Schonlein Purpura

Question 10

what is the name for purpura in older adults?

Answer 10

senile purpura

Question 11

what is the name for a common skin bruise

Answer 11

ecchymosis

Question 12

what are 2 other names for petechiae?

Answer 12

pinpoint/splinter hemorrhage

Question 13

an ascending aortic aneurism would cause what type of hemorrhage?

Answer 13

hemopericardium

Question 14

an abdominal aortic aneurism would cause what type of hemorrhage?

Answer 14

hemoperitoneum

Question 15

name 3 examples of hemorrhages in the skin?

Answer 15

purpura
ecchymosis
petechiae

Question 16

what causes petechiae?

Answer 16

rapid increase in intercapillary P
(eg. valsalva maneuver, choking someone, gastritis w/vomitting)

Question 17

what is idiopathic (autoimmune) thrombocytopenic purpura (ITP)?

Answer 17

syndrome in which antibodies against platelet or megakaryocytic antigens cause thrombocytopenia

Question 18

what is the clinical presentation of acute ITP in children?

Answer 18

• sudden onset of petechiae and purpura but are otherwise asymptomatic (may have frequent nose bleeds)
• Spontaneous recovery occurs within 6 months in over 80% of cases

Question 19

what is a rare major threat for ITP (idiopathic thrombocytopenic purpura)?

Answer 19

intracranial hemorrhage

Question 20

what is the clinical presentation of chronic ITP in adults?

Answer 20

• bleeding episodes, such as epistaxis, menorrhagia or ecchymoses
• excessive bleeding after trauma and minor procedures (eg. tooth extraction)

Question 21

what is the most common X-linked inherited bleeding disorder?

Answer 21

hemophilia A (factor VIII Deficiency)

Question 22

how do patients with Hemophilia A present?

Answer 22

• mild, moderate, or severe bleeding tendencies
• hematuria (bleed into bladder), intestinal obstruction, respiratory obstruction may occur with bleeding into respective organs

Question 23

what is the most frequent complication of hemophilia A?

Answer 23

degenerative joint disease caused by repeated bleeding into many joints

Question 24

In Hemophilia A, what was formerly the most common cause of death which is now largely prevented by treatment?

Answer 24

bleeding into the brain

Question 25

hemophilia B is an X-linked inherited disorder of deficiency of what clotting factor?

Answer 25

IX

Question 26

clotting factor IX is a vitamin ____-dependent protein made in the liver

Answer 26

K

Question 27

what are the bleeding manifestations of hemophilia B?

Answer 27

similar to hemophilia A

Question 28

what can’t you make if you are vitamin K deficient?

Answer 28

you cant make a fibrin plug

Question 29

what is von Willebrand disease?

Answer 29

heterogeneous complex of hereditary bleeding disorders related to deficiency or abnormality of vWF (von willebrand factor)

Question 30

most cases of vWD entail only a mild bleeding diathesis, except for what type?

Answer 30

type III

Question 31

what is the presenting symptom of von Willebrand disease?

Answer 31

excessive hemorrhage after trauma or surgery

Question 32

what life-threatening complication may occur in patients with type III vWD?

Answer 32

life-threating hemorrhage from the gut; hemarthroses like those in hemophilia are not unusual

Question 33

what would the laboratory diagnosis of ITP be?

Answer 33

low platelet count

Question 34

hemophilia A is a deficiency in what clotting factor?

Answer 34

VIII
(“hemophilia AAAAAAte”)

Question 35

what is the laboratory diagnosis for hemophilia A and B?

Answer 35

deficient in clotting factors VIII or IX

Question 36

how does von willebrand disease compare to hemophilia?

Answer 36

patients with vWD show immediate, mucocutaneous bleeding such as easy bruising, epstaxis, GI bleeding, and (in women) menorrhagia