Bleeding and Clotting Disorders Flashcards Preview

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Flashcards in Bleeding and Clotting Disorders Deck (29)
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1

What are some possible problems when dealing with coagulopathy?

Bleeding
Clot formation
Both bleeding and clot formation

2

What types of issues will you see with bleeding?

Immediate or delayed

3

If you have immediate bleeding due to a platelet problem (van Willebrand problem) what could be the causes?

Low number (platelet count)
Poor function (bleeding time)

4

What are clinical findings of immediate (primary) hemostasis defects? *

Mucosal and subcutaneous bleeding (Petechiae, purpura, ecchymoses)
Spontaneous bleeding (platelet count less than 20 or 30 or non-functioning platelets)

5

What is the main treatment for a low number of platelets?

Transfusion of platelets
Replace von Willebran factor (factor VIII and fibrinogen)

6

What medications could be used in the instance of poor platelet function?

Aspirin (irreversibly)

7

What types of issues will you see with delayed bleeding?

Intrinsic factor PTT
Extrinsic pathway PT (INR)

8

What are the clinical findings of delayed secondary defects?

Hematoma and hemarthroses

9

If there is an abnormal PT (INR)?

Extrinsic pathways affected
Vit K dependent factors depleted
Liver disease
Warfarin (Coumadin)

10

If there is an abnormal PTT?

Intrinsic pathways affected
Inhibited by heparin

11

If there an abnormal PTT and PT/INR?

Common pathway

12

In a 1:1 mixing study, what could normalized test results mean? Non-normalized?

Factor deficiency, factor inhibitor

13

What is the treatment for a elevated PT/PTT?

Immediate, fresh frozen plasma (FFP) medicine to clot blood

14

For vitamin k dependent factor deficiency what should be done?

Vit K 10 units IV only
Vit K orally
Need to synth factors

15

If there is a bleeding and clotting disorder what could occur?

Disseminated intravascular coagulopathy (DIC)
- Inc thrombin a clot formed

16

What is the main product of fibrinolysis due to DIC?

D-dimer +

17

What are some areas of clot formation?

Arterial, microcircular
Venous
Either

18

What is arterial clotting disorder induced by?

Platelets

19

What could arterial clotting lead to?

Myocardial infarction, CVA.stroke, peripheral arterial disease

20

What is the platelet count for essential thrombocytosis?

450-999

21

What would you see in microcirculation clotting disorders?

Thrombotic thrombocytopenic purpura (TTP)

22

What is the the treatment for TTP/HELLP?

Glucocorticoidsteroid for immunosuppression
Immediate: fresh frozen plasma
(to replace the vWF)

23

What is HELLP?

Hypertension, elevated liver enzymes and low platelets (in pregnancy)

24

If you have arterial or venous or both in clotting, what can you expect?

Heparin-induced thrombocytopenia (HIT)
Antiphospholipid antibody syndrome *
Hyperhomocysteinemia

25

Describe Antiphospholipid antibody syndrome *

Thrombosis, fetal loss
Lupus anticoagulant antibody

26

What could occur in a venous clotting disorder?

Deep vein thrombosis
Pulmonary emboli

27

How are venous clotting disorders treated?

Heparin/LMWH short term
Warfarin

28

What is factor V leiden due to?

Venous clotting disorders

29

Factor V leiden

Pts with recurrent VTE, most common hereditary cause
Antithrombin (AT) III deficiency
Protein C and S deficiency