Thrombotic Disorders

Question 1

Examples of congenital and acquired vascular defects

Answer 1

Congenital: Osler-Weber-Rendu syndrome, CT disorders e.g. EDS
Acquired: senile purpura, infection (meningococcal, measles), steroids, scurvy, HCP

Question 2

Haemolytic Uraemic Syndrome pathophysiology, presentation and management

Answer 2

Microangiopathic haemolytic anaemia - fibrin strands in renal vasculature cause mechanical destruction of passing RBCs - thrombocytopenia and AKI
Caused by e. coli
Presentation: abdo pain, bloody diarrhoes, AKI, proteinuria
Rx: dialysis for AKI

Question 3

Causes of DIC

Answer 3

Malignancy, sepsis, trauma, obstetric events

Question 4

Presentation and pathophysiology of DIC

Answer 4

Bruising or bleeding everywhere due to systemic activation of pathways leading to and regulating coagulation which can result in generation of fibrin clots that may cause organ failure with concominant consumption or platelets and coagulation factors that may result in clinical bleeding

Question 5

Ix and Rx in DIC

Answer 5

Low platelets, long APTT, raised fibrin degradation products, schistocytes

Treat cause, replace platelets if needed, cryoprecipitate to replace fibrinogen, FFP to replace coagulation factors, activated protein C