lecture 4

Question 1

Name three common inherited bleeding disorders.

Answer 1

Von Willebrand disease, haemophilia A (factor VIII deficiency), and haemophilia B (factor IX deficiency).

Question 2

What is the most common inherited bleeding disorder?

Answer 2

Von Willebrand disease.

Question 3

What are two primary features of haemophilia?

Answer 3

Joint bleeding (haemarthrosis) and soft tissue haematomas.

Question 4

List three common acquired causes of abnormal bleeding.

Answer 4

Liver disease, disseminated intravascular coagulation (DIC), and anticoagulant use.

Question 5

How does liver disease contribute to bleeding?

Answer 5

Reduced synthesis of clotting factors, impaired platelet production, and increased fibrinolysis.

Question 6

What should be assessed when taking a bleeding history

Answer 6

Current and previous bleeding, haemostatic challenges (e.g., surgery), medication, alcohol use, and family history.

Question 7

What bleeding patterns suggest a primary haemostasis defect?

Answer 7

Mucocutaneous bleeding such as petechiae, epistaxis, and heavy menstrual bleeding.

Question 8

What bleeding patterns suggest a coagulation defect?

Answer 8

Deep tissue bleeding, such as haemarthrosis or soft tissue haematomas.

Question 9

What are the first-line laboratory tests for bleeding disorders?

Answer 9

PT, APTT, fibrinogen level, platelet count, and FBC.

Question 10

How does tranexamic acid work?

Answer 10

It blocks plasmin activation, reducing fibrinolysis.

Question 11

When is fresh frozen plasma (FFP) used in bleeding management

Answer 11

In severe liver disease, massive haemorrhage, or DIC to replace clotting factors.

Question 12

What is the purpose of cryoprecipitate in bleeding treatment?

Answer 12

To correct low fibrinogen levels in significant bleeding.

Question 13

What are the main indications for platelet transfusion?

Answer 13

Bone marrow failure, trauma, DIC, or surgery with platelet counts <50 x10⁹/L.

Question 14

What is desmopressin (DDAVP), and when is it used?

Answer 14

A drug that releases endogenous von Willebrand factor and factor VIII, used in mild haemophilia A and von Willebrand disease

Question 15

What is the first step in managing anticoagulant-related bleeding?

Answer 15

Stop the anticoagulant drug.

Question 16

What is the reversal agent for warfarin in life-threatening bleeding?

Answer 16

Vitamin K and prothrombin complex concentrate (PCC).

Question 17

What is the reversal agent for dabigatran?

Answer 17

Idarucizumab.

Question 18

How is severe bleeding caused by Xa inhibitors managed?

Answer 18

With andexanet alpha or supportive measures.

Question 19

What is the role of tranexamic acid in anticoagulant-related bleeding

Answer 19

It helps reduce bleeding by inhibiting fibrinolysis.

Question 20

What are common laboratory findings in disseminated intravascular coagulation (DIC)?

Answer 20

Prolonged PT/APTT, low platelet count, low fibrinogen, and elevated D-dimer.

Question 21

Why is vitamin K deficiency a cause of bleeding?

Answer 21

It impairs synthesis of vitamin K-dependent clotting factors (II, VII, IX, X).

Question 22

What are key clinical features of von Willebrand disease

Answer 22

Mucocutaneous bleeding, menorrhagia, and prolonged bleeding after trauma or surgery

Question 23

What type of bleeding is commonly associated with platelet dysfunction?

Answer 23

Superficial bleeding, such as petechiae and easy bruising.

Question 24

What factor deficiency is associated with haemophilia A?

Answer 24

Factor VIII deficiency.