Lecture 6: Bleeding Disorders Flashcards
causes of vascular and platelet dependent bleeding
- hereditary haemorrhagic telangiectasia
- Ehlers-Danlos syndrome
- due to scurvy, steroids, senility
general symptoms of vascular and platelet caused bleeding disorders
bleeding into mucous membranes and skin
general symptoms of coagulation disorders
bleeding into joints and soft tissue
what is thrombocytopenia
low platelet count, symptoms when <10
causes of thrombocytopenia
- rarely inherited
- mostly acquired from drug related causes
treatment for immune thrombocytopenia
- steroids
- iv immunoglobulins
- thromboietin agonists eg romiplostim
- immunosuppression eg rituximab
- splenectomy
what are acquired causes of platelet function disorders
- aspirin
- NSAIDs
what are the types of haemophilia
A: deficiency of factor VIII
B: deficiency of factor IX
both X-linked so affect males only
symptoms of haemophilia
- spontaneous bleeding into joints and muscle
- unexpected post-op bleeding
- chronic debilitating joint diseases
- generally not many symptoms until very very low levels
tests for coagulation disorders
- activated partial thromboplastin time
- prothrombin time
- thrombin time
- fibrinogen level
- clotting factor assays
- D-dimer levels
how to diagnose haemophilia
- prolonged APTT
- normal PT
- low factor VIII or IX
treatment of haemophilia
- infusions of recombinant factor VIII or IX
- prophylactic treatment
what is von Willebrands disease
- autosomal dominant
- von Willebran factor levels are low
- symptoms are musculocutaneous bleeds, nosebleeds and heavy periods
- treatment is DDAVP
acquired causes of coagulation disorders
- liver disease
- vitamin K deficiency
- disseminated intravascular coagulation
