INHERITED BLEEDING DISORDERS Flashcards
inherited bleeding disorders can affect
- coagulation cascade
- platelets
- both
haemophilia
too little clot formed
thrombophilia
too much clot formed
factor VII def
haemophilia/ A
Factor IX def
christmas disease
Haemophilia B
reduced factor VII and reduced platelet aggregation
von willebrands disease
DDAVP
desmopressin
releases factor VIII to boost factor VII levels and clotting ability
tranexamic acid
inhibitor of fibrinolysis - keeps any clot that is formed
Haemophilia A and B affects who
sex linked recessive - males affected, females carriers
defect gene on X chromosome
management of haemophilia A
severe and mod - recomb factor VIII
mild and carriers - DDAVP/ tranexamic acid
management of haemophilia B
severe and mod - recomb factor IX
mild and carriers - recomb factor IX
Von wilebrand disease affects who
autosomal dominant
not transmitted on X chromosome
both sexes equally affected
mild types of VW
1 and 2 (dominant)
severe types of VW
type 3 (recessive)
management of VW
severe and mod - DDVAP
mild and carriers - oral tranexamic acid
special care required for what dental tx
LA
XLA
minor oral surg
perio surg
biopsies
safe LA
buccal infil
intraligamentary
intrapapillary
not safe LA
IAN block
lingual infil
post sup nerve block
Thrombophilia
increased risk of clots developing
thrombophilia risk
pulmonary thromboembolism
inherited hypercoagulation causes
protein C def
protein S def
factor V leiden
antithrombin III def
acquired hypercoagulation causes
antiphospholipid syndrome
oral contraceptives
surgery, trauma, cancer, pregnancy, immobilisation
thrombocytopenia
reduced platelet numbers
platelet count aim for dental tx
100x 10 9 / L
qualitative disorders
normal platelet number but abnormal function
thrombocythemia
increased platelet numbers
what do pts with thrombocythemia normally take
aspirin to prevent clots
