Hemostasis 3 Flashcards
petechia
pinpoint 1 - 2 mm non blanching red capillary bleeding sites in gravity dependent body areas or pressure points
purpura
like petechia but larger > 3 mm in diameter, non blanching
ecchymosis
bleeding deeper into the tissue layer, flat sheet usually >1 cm
hematoma
solid MASS of blood. significant swelling.
von willebrand disease: inheritance? incidence? how common?
autosomal dominant. incidence is 1/100, so it’s the most common hereditary bleeding disorder
acquired vs. hereditary: more common?
acquired bleeding disorders way more common than hereditary causes
von willebrand disease: present like?
a platelet or vascular defect: muco-cutaneous bleeding, nosebleeds, but usually mild or asymptomatic
3 other hereditary platelet disorders
bernard soulier syndrome. glanzmann’s thrombasthenia. platelet granule abnormalities or secretion defects
bernard soulier syndrome: deficiency of? so problem with?
glycoprotein Ib def = no platelet adhesion. seere bleeding.
glanzmann’s thrombasthenia: deficiency of? problem with?
glycoprotein 2b3a def = no platelet aggregation = seer bleeding
platelet granule abnormalities or secretion defects: problem with?
inability to recruit and activate other platelets to amplify platelet adhesion and aggregation
hereditary coagnulation factor disorders: which ones are X linked? autosomal? which factor?
Xlinked: hemophilia A = low 8. hemophilia B = low 9. autosomal recessive: hemophilia C = low 11
clinical presentation of coagulation factor disorders: severity? two things you see?
severity depends on how much residual factor. >5% mild (excess bleeding with trauma), 1-5% moderate (excess bleeding with minor injury), severe <1 % spontaneous bleeding. you see muscle hematomas and joint bleeds.
antiplatelet agents: do what? examples?
inhibit platelet function. aspirin/NSAIDS -| TXA2 generation, clopidogrel, abciximab
anticoagulants: do what? examples
coagulation factor function. warfarin, heparin, also have direct oral anticoagulants
DIC: stands for?
disseminated intravascular coagulopathy
DIC: def?
pathological process characterized by the widespread activation of the clotting cascade that results in the formation of blood clots in the small blood vessels throughout the body = you get bleeding and clotting at the same time
DIC: examples of triggers?
severe infection, trauma, cancer, pregnancy complications
DIC: what happens
tissue factor release = systemic activation of coagulation = numerous mini clots that can lead to organ failure, but also cause fibrinolysis and consumption of platelets and coag factor = bleeding
most important clinical “test”?
clinical history: bleeding history, past medical history, medications, family history.
laboratory evaluation for bleeding disorders?
baseline: CBC with differential, PT/INR, PTT, fibrinogen. then can do special investigations if abnormal baseline or positive bleeding history
