lec 9 : Bleeding Disorders

Question 1

Thrombasthenia

Thrombocytopathia

Answer 1

Weak Platelet Function

Question 2

Thrombocytopenia

Answer 2

Decreased Platelet Count

Question 3

Normal platelet count is…………………….

Answer 3

150,000 - 410,000/µL (mm3).

Question 4

Bleeding occurs when number of platelets falls below

…………………………………

Answer 4

50,000/µL.

Question 5

Lethal platelet count …………………

Answer 5

< 10,000/ µl

Question 6

Idiopathic thrombocytopenic purpura due to

Answer 6

♣ Autoimmune disease

→ platelets are destructed by antibodies

Question 7

Secondary thrombocytopenic purpura due to

Answer 7

♣ Hypersplenism

♣ Severe destruction of BM

Question 8

Causes OF Thrombasthenia

Answer 8

Prolonged use of aspirin
→ ↓ platelet aggregation
Renal failure
Deficiency of Von Willebrand factor
→ defective platelet adhesion

Question 9

Bleeding due to Abnormal Coagulation

Answer 9

Coagulation tests (PT and/or aPTT) are prolonged
according to the cause
Bleeding time is norma

Question 10

……………………→ depress the clotting system

Answer 10

•Liver diseases

Question 11

…………………………..→ ↓ clotting factors II, VII, IX & X

Answer 11

•Vitamin K deficiency

Question 12

•In liver diseases & vitamin K deficiency

Both PT and aPTT are………………….

Answer 12

prolonged

Question 13

In early liver diseases & mild vitamin K deficiency

Answer 13

PT is prolonged

aPTT is normal

Question 14

Causes of Vitamin K Deficiency

Answer 14

Liver disease
→ Failure of the liver to secrete bile
Failure of absorption
Deficient intestinal bacteria
Anticoagulant drugs 
e.g. coumarin derivatives (Warferin) 
→ prevent u?liza?on of vitamin K by liver
Causes of Vitamin K Deficiency
Failure of absorption
• Obstruction of the bile ducts 
(Obstructive jaundice) 
No bile reaches the intestine.
• Chronic diarrhea
• In GI disease as a result of poor absorption of fats
Deficient intestinal bacteria 
• Prolonged use of antibiotics 
• Newly born infant

Question 15

Congenital deficiency of factors VIII, IX , XI

Answer 15

Hemophilia

Question 16

Congenital deficiency of factor V

Answer 16

Parahemophilia

Question 17

Depletion of fibrinogen

Answer 17

Afibrinogenemia

Question 18

↓ prothrombin synthesis by liver

= usually in vitamin K deficiency

Answer 18

Hypoprothrombinemia

Question 19

Hemophilia

Answer 19

•An inherited sex-linked anomaly
•Transmitted by females with no symptoms to males
who manifest signs of disease
•Symptoms usually begin early in life
•Slight injury → severe hemorrhage
•Prolonged aPTT and normal PT

Question 20

Hemophilia A
(Classical hemophilia)
•It is due to deficiency of factor…………………….
•Represents ………………of hemophilic patients

Answer 20

VIII , 85%

Question 21

Hemophilia B
(Christmas disease)
•It is due to factor……………….. deficiency

Answer 21

IX

Question 22

Hemophilia C

•It is due to factor ……………deficiency

Answer 22

XI

Question 23

Prothrombin time (PT) 
evaluates .............................

Answer 23

extrinsic pathway

Factors VII, X, V, II,I

Question 24

Activated partial thromboplastin time (aPTT)

evaluates ………………………

Answer 24

intrinsic pathway 
(Factors XII, XI, IX, VIII, X, V, II,I)

Question 25

•Factor V Leiden is resistant to the action of …………

Answer 25

APC

Question 26

A patient has vitamin K deficiency. Which of the following would be expected for a
patient with this deficiency?

Answer 26

Prolonged prothrombin time (PT)

Question 27

Hemophilia B is a reduction in which one of the following?

Answer 27

Factor IX and so affects the intrinsic pathway