3: Bleeding disorders Flashcards Preview

Haematology Week 2 2018/19 > 3: Bleeding disorders > Flashcards

Flashcards in 3: Bleeding disorders Deck (53)
Loading flashcards...
1

What are some causes of problems with secondary haemostasis?

Single factor deficiencies - Haemophilia A & B

Multiple factor deficiencies - Vitamin K deficiency, liver disease, DIC

note that DIC is a cause of problems with both primary and secondary haemostasis (because it drains platelets AND clotting factors)

2

What are some causes of problems with primary haemostasis?

VASCULAR: less available collagen (ageing), Vit C deficiency, steroids, Henoch Schonlein purpura (vasculitis)

PLATELETS: bone marrow suppression, renal failure, autoimmune thrombocytic purpura, DIC, hypersplenism

VON WILLEBRAND DISEASE

3

What is a

reduced

increased

number of platelets called?

Reduced platelets - thrombocytopaenia

Increased platelets - thrombocytosis

4

Which drugs reduce the function of platelets?

Anti-platelets e.g aspirin, clopidogrel, ticagrelor

NSAIDs

5

What is Von Willebrand's disease?

vWF deficiency

6

Von Willebrand's disease is more commonly diagnosed in (men / women).

Why?

women

menorrhagia presents early

7

Which vasculitis, seen in children, causes abnormal bleeding?

HSP

8

Where should you look for a purpuric rash first?

Why?

Lower limbs

Oncotic pressure (gravity) pushes blood out of capillaries into compartments of lower limb

9

Where should you look for haemorrhages in a patient with abnormal bleeding?

Skin

Mouth

Eyes

10

What are some acquired causes of thrombocytopaenia?

Bone marrow pathology e.g malignancy

DIC (widespread clotting uses up all your platelets and clotting factors)

Autoimmune disease (autoimmune thrombocytopaenic purpura)

Renal failure (uraemia causes platelet destruction)

11

What are autoimmune diseases causing

a) vessel dysfunction

b) platelet destruction

causing abnormal bleeding?

a) HSP (vasculitis)

b) ATP

12

Why can hypersplenism cause platelet destruction?

Overactive haemolysis

13

Which drugs are designed to cause platelet dysfunction?

How do they work?

Anti-platelets e.g aspirin, clopidogrel, ticagrelor

Block thromboxane A2

14

Why does renal failure cause platelet dysfunction?

Build up of toxins e.g urea

15

What is the mode of inheritance of Von Willebrand's disease?

Autosomal dominant

16

Apart from promoting platelet aggregation, what does vWF do?

Carries Factor XIII around

So deficiency also impacts coagulation

17

Low levels of circulating ___ is the most common reason for failure of haemostasis.

platelets

i.e thrombocytopaenia

18

What is prothrombin also known as?

Factor II

just to make things more confusing

19

In which condition are clotting factors and platelets used up to the point that they are deficient?

DIC

20

Where are clotting factors produced?

Liver

21

Problems with which organ impact coagulation?

Liver

where clotting factors are produced

22

Which vitamin is required to produce clotting factors?

Vitamin K

23

Which clotting factors are deficient in

Haemophilia A

Haemophilia B?

Haemophilia A - VIII

Haemophilia B - IX

24

Which clotting factors require Vitamin K to be activated?

II, VII, IX and X

25

Which clotting factors are inhibited by warfarin therapy?

II, VII, IX and X

26

Which clotting time is used to measure warfarin response?

Which clotting factors does warfarin inhibit?

What is required to produce these factors in the liver?

PT

II, VII, IX and X

Vitamin K

27

Clotting factors are deficient in ___ failure.

liver failure

28

___ _ deficiency causes abnormal bleeding.

Vitamin K

required for production of factors II, VII, IX and X in the liver

29

Where is Vitamin K absorbed?

Small intestine

30

What is required for Vitamin K to be absorbed in the small intestine?

Bile salts