Hemorrhage Flashcards
name 5 causes of hemorrhage
- trauma
- aneurysms
- erosion; microbes, neoplasia
- vitamin deficiency (eg. vit K involved in clotting)
- thrombocytopenia (low platelets -> people on chemotherapeutics)
clinical significance of hemorrhage is dependent on what 3 things?
- volume of blood loss
- rate of blood loss
- location of hemorrhage
what is bleeding into thorax called?
hemothorax
what is ripping of heart and bleeding into pericardium called?
hemopericardium
what is hemoperitoneum?
bleeding into peritoneum
what is hemarthrosis?
bleeding in a joint
what is hematoma?
bleeding into a tissue (non-specific)
what is purpura?
multiple hemorrhages <1cm
what is the most common purpura in children?
Henoch-Schonlein Purpura
what is the name for purpura in older adults?
senile purpura
what is the name for a common skin bruise
ecchymosis
what are 2 other names for petechiae?
pinpoint/splinter hemorrhage
an ascending aortic aneurism would cause what type of hemorrhage?
hemopericardium
an abdominal aortic aneurism would cause what type of hemorrhage?
hemoperitoneum
name 3 examples of hemorrhages in the skin?
purpura
ecchymosis
petechiae
what causes petechiae?
rapid increase in intercapillary P
(eg. valsalva maneuver, choking someone, gastritis w/vomitting)
what is idiopathic (autoimmune) thrombocytopenic purpura (ITP)?
syndrome in which antibodies against platelet or megakaryocytic antigens cause thrombocytopenia
what is the clinical presentation of acute ITP in children?
- 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
what is a rare major threat for ITP (idiopathic thrombocytopenic purpura)?
intracranial hemorrhage
what is the clinical presentation of chronic ITP in adults?
- bleeding episodes, such as epistaxis, menorrhagia or ecchymoses
- excessive bleeding after trauma and minor procedures (eg. tooth extraction)
what is the most common X-linked inherited bleeding disorder?
hemophilia A (factor VIII Deficiency)
how do patients with Hemophilia A present?
- mild, moderate, or severe bleeding tendencies
- hematuria (bleed into bladder), intestinal obstruction, respiratory obstruction may occur with bleeding into respective organs
- hemarthrosis
what is the most frequent complication of hemophilia A?
degenerative joint disease caused by repeated bleeding into many joints
In Hemophilia A, what was formerly the most common cause of death which is now largely prevented by treatment?
bleeding into the brain
hemophilia B is an X-linked inherited disorder of deficiency of what clotting factor?
IX
clotting factor IX is a vitamin ____-dependent protein made in the liver
K
what are the bleeding manifestations of hemophilia B?
similar to hemophilia A
what can’t you make if you are vitamin K deficient?
you cant make a fibrin plug
what is von Willebrand disease?
heterogeneous complex of hereditary bleeding disorders related to deficiency or abnormality of vWF (von willebrand factor)
most cases of vWD entail only a mild bleeding diathesis, except for what type?
type III
what is the presenting symptom of von Willebrand disease?
excessive hemorrhage after trauma or surgery
what life-threatening complication may occur in patients with type III vWD?
life-threating hemorrhage from the gut; hemarthroses like those in hemophilia are not unusual
what would the laboratory diagnosis of ITP be?
low platelet count
hemophilia A is a deficiency in what clotting factor?
VIII
(“hemophilia AAAAAAte”)
what is the laboratory diagnosis for hemophilia A and B?
deficient in clotting factors VIII or IX
how does von willebrand disease compare to hemophilia?
patients with vWD show immediate, mucocutaneous bleeding such as easy bruising, epstaxis, GI bleeding, and (in women) menorrhagia
