Signs and Symptoms Flashcards
What are the symptoms for a personal history of bleeding?
- Bruising: unexpected places, no injury, lumpy
- Surgical history, dental history (ask about family also), cuts and injuries
- Epistaxis: duration and frequency i.e. >30 mins
- GI tract: start at mouth and work down to anus
- Menses: duration, flooding/clots, no. of pads/tampons per period
- Urine: haematuria
What part of a FH would be signs of a clotting disorder?
- Known bleeding disorders
- Bleeding/abnormal bruising in family members, especially after surgery or dentistry
- If there is, get details of where tested, by whom and when
What does bruising in a child mean?
Any bruising/bleeding in a non-ambulant child must be considered non-accidental until proven otherwise, due to safety first policy.
What is Virchow’s triad?
- Stasis of blood flow
- Endothelial injury
- Hypercoagulability
What would be the examination findings for DVT?
- Warm, swollen leg
- Tenderness in calf > worse with dorsiflexion of ankle (Homan’s sign)
- Calf circumference greater than 3cm compared with unaffected leg - measure 10cm from tibial tuberosity on each leg and mark this
What are the typical symptoms for a PE?
- Sudden onset of pleuritic chest pain (worse on inspiration)
- SOB
- Haemoptysis
- Syncope
What are the signs of PE?
- Tachypnoea
- Tachyarrhythmia (commonest is AF)
- Possible signs of DVT
- Hypotension
- Pleural effusion
- Hypoxaemia
- Raised JVP
What are platelet disorder signs?
- Bruising
- Bleeding after dental/minor surgery
- Epistaxis
- Menorrhagia
What is the presentation of haemophilia A?
Depends on severity and it’s often early in life or after surgery/trauma - with bleeds into joints leading to crippling arthropathy and into muscles causing haematomas (increase pressure > nerve palsies and compartment syndrome).
It is diagnosed by increased APTT and decreased factor VIII assay.
