Bleeding Disorders

Question 1

What are the 4 components of haemostasis?

Answer 1

Formation of the platelet plug
Formation of the fibrin clot
Fibrinolysis
Anticoagulant defences

Question 2

Is thrombocytopenia usually hereditary or acquired?

Answer 2

Acquired

Question 3

What pattern of inheritance is seen in VWF deficiency disorders?

Answer 3

Autosomal dominant

Has variable severity.

Question 4

What is the most common cause of primary haemostatic failure?

Answer 4

Thrombocytopenia

Question 5

What are the most common causes of thrombocytopenia?

Answer 5

Primary haemostatic failure

Question 6

What clotting factors are produced by vitamin K?

Answer 6

II, VII, IX and X.

Question 7

What occurs in disseminated intravascular coagulation (DIC)?

Answer 7

Massive activation of haemostasis due to tissue injury. It is to such an extent that clotting factors are used up.

Question 8

What causes haemophilia A?

Answer 8

Clotting factor 8 deficiency

Question 9

What causes haemophilia B?

Answer 9

Clotting factor 9 deficiency

Question 10

What causes single clotting factor deficiencies?

Answer 10

Genetic conditions - these are called haemophilia.

Question 11

What causes multiple blood clotting factor deficicencies?

Answer 11

Liver failure

Vitamin K deficiency/Warfarin overdose

Question 12

How is warfarin overdose treated?

Answer 12

Vitamin K

Question 13

How does DIC affect PT and APTT?

Answer 13

They are both prolonged.

Question 14

How is vitamin K attained through diet?

Answer 14

Leafy green vegetables.

Question 15

Why does obstructive jaundice cause vitamin K deficiency?

Answer 15

As bile salts are needed for absorption.

Question 16

What is haemorrhagic disease of the newborn?

Answer 16

Vitamin K deficiency due to a lack of dietary supplementation and a lack of bowel bacteria.

Question 17

Disseminated intravascular coagulation can be due to what?

Answer 17

Sepsis
Obstetric emergency
Malignancy
Hypovolaemic shock

Question 18

How is DIC treated?

Answer 18

By managing the underlying cause.

It is a rapidly progressive state.

Question 19

What pattern of inheritance is seen in haemophilia?

Answer 19

X-linked.

These means males are more likely to be affected.

Question 20

What form of haemophilia is more common?

Answer 20

Haemophilia A

Question 21

How does severe haemophilia present?

Answer 21

Recurrent haemarthrosis (recurrent bleeding into joints)
Recurrent soft tissue bleeds
Prolonged bleeding following procedures

Question 22

How does haemophilia affect APTT and PT?

Answer 22

Prolonged APTT (as this measures factor VIII and IX)
Normal PT

Question 23

Do patients with haemophilia have ‘target joints’?

Answer 23

Yes, these are joints which are more likely to develop within.

Can cause joint fusing.