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haematology > Bleeding Disorders > Flashcards

Bleeding Disorders Flashcards

1
Q

Disseminated intravascular coagulation

A

Excessive and inappropriate activation of the haemostatic system

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2
Q

Causes of Disseminated intravascular coagulation (4)

A

Sepsis, obstetric emergencies, malignancy and Hypovolaemic shock

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3
Q

What may be seen on blood film in Disseminated intravascular coagulation

A

Fragmented RBCs

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4
Q

What happens to PT, APTT and TT in Disseminated intravascular coagulation

A

Very prolonged

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5
Q

What happens to fibrinogen levels in Disseminated intravascular coagulation

A

Reduced

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6
Q

Is D dimer positive or negative in Disseminated intravascular coagulation

A

Positive

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7
Q

FBC results in Disseminated intravascular coagulation

A

Severe thrombocytopenia

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8
Q

Clinical sign of Disseminated intravascular coagulation

A

Bleeding from the mouth, nose and venepuncture sites, easy bruising

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9
Q

What is haemophilia

A

Condition which affects bloods ability to clot causing prolonged bleeding

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10
Q

What is the inheritance of haemophilia

A

X linked recessive

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11
Q

What is deficient in haemophilia A

A

Factor VII

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12
Q

What is deficient in haemophilia B

A

Factor IX

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13
Q

What is more common, haemophilia A or B

A

A

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14
Q

What is a consequence of haemophilia

A

Bleeding into the joints

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15
Q

Clinical presentation of mild haemophilia

A

Bleeding associated with an injury or surgery

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16
Q

Clinical features of severe haemophilia (3)

A

Recurrent haemarthrosis
Recurrent bruising
Prolonged bleeding after procedures

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17
Q

Test result indicating haemophilia

A

Isolated prolonged APTT

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18
Q

Management of haemophilia

A

Replace clotting factors

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19
Q

Complication of the treatment of haemophilia

A

Formation of antibodies against the clotting factor meaning the treatment is ineffective

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20
Q

Management of acute episodes of bleeding in haemophilia

A

Infusion of clotting factor
Desmopressin to stimulate VWF
antifibrinolytics

21
Q

Give an example of an antifibrinolytic

A

Tranexamic acid

22
Q

Von willebrands disease

A

A deficiency or abnormality of VWF

23
Q

Where is the VWF gene located

A

Chromosome 12

24
Q

Consequence of low VWF

A

Impaired platelet adhesion to the subendothelium

25
Q

Consequence of reduced VWF on other clotting factors

A

Causes factor VII deficiency as it is not protected from premature degradation

26
Q

Clinical presentations of Von willebrands disease

A

Nosebleeds , menorrhagia etc.

27
Q

Epistaxis

A

Nose bleed

28
Q

Menorrhagia

A

Heavy or prolonged periods

29
Q

Thrombotic thrombocytopenic purpura

A

Formation of small blood clots throughout the body

30
Q

What causes Thrombotic thrombocytopenic purpura

A

Deficiency of metalloproteinase ADAMTS13

31
Q

Clinical presentation of Thrombotic thrombocytopenic purpura (5)

A

Fever
Haemolytic anaemia
Thrombocytopenia
Acute renal failure
Neurological symptoms

32
Q

Blood film in Thrombotic thrombocytopenic purpura

A

Schistocytes and elevated reticulocyte count

33
Q

Urinalysis result in Thrombotic thrombocytopenic purpura

A

Proteinuria and microscopic haematuria

34
Q

Management of Thrombotic thrombocytopenic purpura

A

IV plasma exchange

35
Q

Second line management in patients with Thrombotic thrombocytopenic purpura

A

Splenectomy

36
Q

Massive haemorrhage

A

Bleeding with signs of shock , already required prompt transfusion

37
Q

What can cause haemorrhage

A

Traumatic bleeding
Infection

38
Q

What can we give to patients to replace fibrinogen

A

Cryoprecipitate

39
Q

Role of tranexamic acid

A

Reduces or prevents excessive bleeding by inhibiting the break down of blood clots

40
Q

Causes of secondary ITP

A

Anti phospholipid antibody syndrome
SLE
viral infections (cytomegalovirus, varicella-zoster, hepatitis C, HIV)
h.pylori infection
Meds
Lymphoproliferative disorders

41
Q

What causes immune thrombocytopenic purpura

A

Type 2 hypersensitivity reaction - production of antibodies that target and destroy platelets

42
Q

ITP

A

Immune thrombocytopenic purpura

43
Q

When does ITP usually present

A

Children under 10

44
Q

Usual history in ITP

A

History of recent viral illness

45
Q

Symptoms of ITP

A

Bleeding, bruising and petechial or purpurin rash

46
Q

Investigation for ITP

A

Full blood count

47
Q

Positive result that indicates ITP

A

Isolated thrombocytopenia

48
Q

Usual management of patients with ITP

A

Monitoring until platelets return to normal

49
Q

Management of severe thrombocytopenia

A

Prednisolone
IV immunoglobulins
Blood transfusions if required

haematology (11 decks)

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