Bleeding Flashcards

(47 cards)

1
Q

pathophysiology of ITP

A

immune system makes antibodies against platelets… resulting in destruction of platelets

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2
Q

mechanism of rituximab

A

monoclonal antibody against B cells

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3
Q

management of ITP (4)

A
  • IVIG
  • steroids
  • Rituximab
  • Splenectomy
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4
Q

in ITP what complex on platelets are attacked?

A

GPIIb/IIIa complex

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5
Q

blood test findings in ITP

A
  • raised megakaryocytes in bone marrow

- antiplatelet autoantibodies

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6
Q

1st line trx ITP (2)

A
  • Oral corticosteroids

- IVIG

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7
Q

non immune causes of destruction of platelets

A
  • HUS

- TTP

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8
Q

medications that destroy platelets

A
  • Methotrexate
  • Isotretinoin
  • PPI
  • Antihistamines
  • Na Valporate
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9
Q

condition where tiny blood clots form throughout the small vessels of the body

A

TTP - thrombotic thromocytopenic purpura

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10
Q

deficiency in which protein in ITP?

A

ADAMTS13

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11
Q

role of ADAMTS13 usually?

A

this protein inactivates vWF & reduces platelet aggregation to vessel walls … therefore reducing clot formation

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12
Q

3 poss treatments for ITP

A
  • Rituximab
  • Steroids
  • Plasma exchange
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13
Q

4 symptoms/signs of ITP

A
  • florid purpura
  • fever
  • haemolytic anaemia
  • fluc cerebral dysfunction
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14
Q

name of the heparin induced antibodies that specifically target a protein on platelets?

A

anti-PF4

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15
Q

4 acquired coagulation disorders

A
  • liver dysfunction
  • anticoagulant medications
  • DIC
  • Vit K def
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16
Q

congenital coagulation disorders (2)

A
  • vWF disease

- Haemophilia A & B

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17
Q

what happens in platelet plug formation?

A

Platelets aggregate to form a platelet plug that temp seals the break in the vessel wall

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18
Q

3 tings released that i) enhance vascular spasm ii) cause more platelets to aggregate to area

A
  • Thromboxane A2
  • ADP
  • Serotonin
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19
Q

what activates platelet plug formation

20
Q

which pathway involves F7

A

extrinsic pathway

21
Q

what happens in extrinsic pathway?

A

TF + F7 –> TF-F7a

which activates FX + FIX

22
Q

Vitamin K dependant coagulation factors?

A

F2,7,9,10 and Protein C & S

23
Q

inheritance of Haemophilia A & B

A

X linked recessive

24
Q

F8 deficiency

A

Haemophilia A

25
Haemophilia B - deficiency of?
F9
26
what is Haemophilia B also known as?
Christmas disease
27
what is haemoarthrosis
spontaneous bleeding into joints
28
half life of F8
8 hours
29
management of acute episodes of bleeding in haemophilia?
- IV infusions (F8/9) - Desmopressin - Tranexamic acid
30
desmopressin affect on vWF
stimulated the release of von Willebrand Factor
31
most common inherited cause fo abnormal bleeding?
Von Willebrand disease
32
vWD inheritance?
type 1&2 = autosomal dominant type 3 = recessive
33
type 1 vWD caused by?
quantitative deficiency of vWF
34
type 3 vWD caused by?
complete deficiency of vWF
35
type 2a & b vWD caused by?
type 2a - reduced/abnormal vWF | type 2b - abnormal vWF
36
role of vWF (2)
- promotes platelet adhesion to damaged endothelium | - carrier molecule for F8
37
avoid desmopressin in which vWD
type 2b
38
which vWD can result in thrombocytopenia
Type 2b
39
what is virchows triad
3 factors thought to contirbute to thrombosis: - blood flow stasis - endothelial injury - hypercoagulability
40
mechanism of aspirin
irreversibly inhibits cyclo-oxygenase
41
mechanism of clopidogrel
blocks platelet aggregation and prolongs platelet survival by inhibiting the binding of ADP to its platelet receptor
42
differentials of unilateral swollen painful calf?
- DVT - Cellulitis - Ruptured bakers cyst - muscle haematoma
43
what is Homans sign?
calf tenderness worse on dorsiflexion of ankle
44
calf circumferences in DVT?
> 3 cm compared to unaffected leg when measured 10cm from tibial tuberosity
45
what is a PE called when SBP < 100 mmHg
Massive PE
46
PE ECG changes
- Sinus tachycardia | - S1Q3T3
47
management options for women with vWD with heavy periods (5)
- COCP - mirena coil - tranexamic acid - mefanamic acid - norethisterone