KEY CLOTTING DISORDERS

Question 1

Most common cause of inherited haemophilia?

Answer 1

Von Willebrand’s disease.

Question 2

Platelet disorders are typically characterised by what?

Answer 2

Easy bruising + spontaneous bleeding from small vessels.

Question 3

Coagulation disorders are typically characterised by what?

Answer 3

Bleeding after injury or surgery.

Question 4

The APTT test is a reflection of which clotting pathway?

Answer 4

The intrinsic pathway.

**Reflects intrinsic pathway and therefore function of platelets.

Question 5

Vitamin K is needed to synthesis which clotting factors?

Answer 5

II, VII, IX and X.

Question 6

Common presenting complaints of Von Willebrand disease?

Answer 6

Epistaxis
Easy bruising
Menorrhagia
Bleeding after minor trauma or surgery (e.g. tooth extraction).

Question 7

Most common inheritance pattern of Von Willebrand disease?

Answer 7

Autosomal dominant.

Question 8

Clotting profile (PT + APTT) results in Von Willebrand disease?

Answer 8

Prolonged APTT + PT.

Question 9

Other blood results seen in Von Willebrand disease?

Answer 9

Reduced VIII and reduced Von Willebrand factor.

Question 10

Deficiency in haemophilia A?

Answer 10

Factor VIII.

Question 11

Deficiency in haemophilia B?

Answer 11

Factor IX.

Question 12

Haemophilia inheritance pattern?

Answer 12

X-linked recessive.

Question 13

Feature of severe haemophilia?

Answer 13

Spontaneous bleeding into joints.

Question 14

Presentation of haemophilia in neonates?

Answer 14

Intracranial haemorrhage, haematomas + prolonged bleeding after circumcision.

Question 15

Clotting profile in haemophilia?

Answer 15

APTT prolonged.

PT normal.

Question 16

Most common inherited thrombophilia?

Answer 16

Activated protein C resistance (Factor V Leiden).

Question 17

What does thrombocytopenia mean?

Answer 17

Low levels of platelets.

Question 18

DIC arises due to what?

Answer 18

Systemic activation of coagulation, often as part of an inflammatory response.

Question 19

PT test assesses which clotting pathway?

Answer 19

Extrinsic and common pathways.

Question 20

Most common presenting complaints in Von Willebrand disease?

Answer 20

Menorrhagia, post-op bleeding, epistaxis.

Question 21

Most likely cause of bleeding + thrombosis in a young woman?

Answer 21

Anti-phospholipid 2 syndrome.

Question 22

Most common inherited thrombophilia?

Answer 22

Factor V Leiden.

Question 23

How long on LMWH in provoked VTE?

Answer 23

3 months.

Question 24

How long on LMWH for unprovoked VTE?

Answer 24

6 months.

Question 25

Treatment for anti-phospholipid syndrome in pregnancy?

Answer 25

Aspirin + LMWH.

Question 26

Management in a minor allergic reaction to a blood transfusion?

Answer 26

Stop transfusion temporarily and give anti-histamine.

Question 27

Management of anaphylaxis caused by a blood transfusion?

Answer 27

Terminate transfusion + give IM adrenaline.

Question 28

Blood clotting results in haemophilia?

Answer 28

Prolonged APTT.

PT, bleeding time and thrombin time all normal.

Question 29

Transfusions of packed red cells can cause what electrolyte abnormality?

Answer 29

Hyperkalaemia.

Question 30

Most common cause of isolated thrombocytopenia?

Answer 30

ITP.

Question 31

Grossly elevated APTT?

Answer 31

Haemophilia (B)

Question 32

Universal donor of FFP?

Answer 32

AB negative

Question 33

Pentad of symptoms and signs suggesting TTP?

Answer 33

Fever
Neurological signs
Thrombocytopenia
Haemolytic anaemia
Renal failure