Lecture 30 - Disorders of Secondary Hemostasis

Question 1

Disorders of Secondary Hemostasis are typically congenital. They cause ______ bleeding, unlike Primary which cause mucocutaneous bleeding. The most common of these disorders are the x-linked recessive disorders affecting Factor ____ and Factor ____.

Answer 1

Systemic bleeding

Factor VIII and Factor IX

Question 2

Hemophilia A is a deficiency in Factor ____, while hemophilia B is a deficiency in Factor ____.

Answer 2

VIII

IX

Question 3

Because Factor VIII concentrate is used to treat patients with Hemophilia ___, they can generate Alloantibodies to Factor VIII, which leads to increased systemic bleeding. Elderly people and women post-pregnancy face a similar issue, though it is rare, in which they produce Autoantibodies to Factor VIII –> this condition is termed Acquired Hemophilia ___.

Answer 3

Hemophilia A

Hemophilia A

Question 4

Lupus Anticoagulant (LAC) is a disorder in which patients produce an anti-_______ antibody. So, they’ll have an elevated APTT test, but no bleeding. Instead, these patients are at risk for arterial or venous _____, because the autoantibody in the chronic form of this disease can induce coagulation.

Answer 4

anti-Phospholipid

Thombosis

Question 5

When patients show an elevated APTT test with the other coag tests normal, their blood is mixed in a 1:1 ratio with normal blood, and the APTT test is rerun. If there is Correction with bleeding, it indicates Factor ___, ___, or XI deficiency. If there is NO correction and the patient is bleeding, it indicates ____ specific antibodies, whereas no correction WITHOUT bleeding indicates ____.

Answer 5

Factor VIII, IX, or XI

Factor-specific Abs

LAC

Question 6

Testing for Factor ___ is a good way to distinguish between Vit K deficiency bleeding from bleeding caused by Liver disease. Why is that?

Answer 6

Factor V

Factors II, VII, IX, and X are the only Vit K dependent ones, so Vit K deficiency would show normal levels of Factor V.