VWD Flashcards

1
Q

what is the function of VWF ?

A

binds and stabilizes factor 8
mediated platelet adhesion

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2
Q

what are the types of VWD ?

A

type 1 - mild quantitative defect
type 2 - qualitative defect
type 3 - severe quantitative defect

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3
Q

what effect does VWD have on PTT ?

A

factor 8 is in the intrinsic pathway so it affects the PTT by prolonging it
( isolated increase of PTT )

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4
Q

what is the ratio of Ag to Ac in VWD ?

A

type 1 - Ag=Ac
type 2 - Ag>Ac
type 3 - Ag=Ac

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5
Q

what is the treatment of each type of VWD ?

A

Type 1 - DDAVP, tranexamic acid
Type 2- DDAVP, Tranexamic acid concentrate
Type 3- concentrate

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6
Q

which type of VWD is the most common ?

A

type 1 is the most common

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7
Q

what is the most severe form of the disease ?

A

type 3

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8
Q

what is the clinical presentation of VWD ?

A

1- excessive mucocutaneous bleeding
2- which includes spontaneous bruising
recurrent epistaxis
3-bleeding from the gums after brushing teeth
4- menorrhagia in females

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9
Q

what are the tests for hemostasis ?

A

CBC and platelet count
PT and PTT
Fibrinogen

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10
Q

when can thrombocytopenia be seen in association with VWD ?

A

in type 2B VWD

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11
Q

what is the treatment for VWD ?

A

DDVAP
VWF concentrates or recombinant VWF

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12
Q

what is DIC ?

A

inappropriate stimulation of coagulation leading to thrombotic occlusion of blood vessels

( type of MAHA)

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13
Q

what are the triggers for DIC ?

A

major trauma or burns
severe sepsis or infection
solid tumors or haematological malignancies

( release of tissue factor into the circulation)

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14
Q

which haematological malignancy is highly associated with DIC ?

A

APL

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15
Q

when do we perform mixing study ?

A

after we find out that there is prolonged PTT

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16
Q

what are the lab findings associated with DIC ?

A

increase in aPTT
increase in PT
increase in TT
decrease in fibrinogen
decrease in platelets

17
Q

what are the clinical manifestations of DIC ?

A

petechiae
purpura
arterial line oozing
venipuncture site oozing

18
Q

what is seen on peripheral blood smear in DIC ?

A

scchistocytes

19
Q

when do we generally see schistocytes ?

A

MAHA
microangiopathic hemolytic anemias

20
Q

what are the two phases associated with DIC ?

A

early hypercoagulable state
clinical manifestation phasee

21
Q

what is the treatment of DIC ?

A

treatment of the underlying disorder
platelet transfusion
FFP

22
Q

what are the factors made by the liver that inhibit coagulation ?

A

antithrombin 3
protein C and protein S

23
Q

what is the management of hemostatic defects in liver disease ?

A

1- treatment of prolonged PT and PTT by given fresh frozen plasma
prothrombin complex concentrate
2- treatment of low fibrinogen

23
Q

what are thee vitamin K dependant factors ?

A

factor 2,7,9,10
protein C and protein S

24
Q

what are the causes of vitamin K deficiency ?

A

obstructive jaundice
chronic diarrhea
liver disease
hemorrhagic states in infants