Bleeding disorders Flashcards Preview

Phase 2a medicine > Bleeding disorders > Flashcards

Flashcards in Bleeding disorders Deck (17):
1

Over-anticoagulation
Cause

Warfarin

2

Over-anticoagulation
Treatment

Major bleeding from orifices - life-threatening:
- Stop warfarin
- Give Vit K by slow IV injection (antidote)
- FFP

INR > 8, no/minor bleeding:
- Stop warfarin
- Give Vit K by slow IV injection

Any other INR > target range:
- Stop warfarin
- Restart when INR < 5

3

Haemophilia A
Patho (3)

- X-linked recessive inheritance
- Factor VIII deficiency
- Impairs body's ability to make blood clots

4

Haemophilia A
Symptoms (2)

- Bleeds into joints -> crippling arthropathy
- Bleeds into muscle -> haematomas

5

Haemophilia A
Diagnosis (2)

- Raised APTT
- Reduced factor VIII plasma levels

6

Haemophilia A
Treatment (3)

- Avoid NSAIDs and IM injections
- DESMOPRESSIN - raises factor VIII
- IV infusion of recombinant factor VIII

7

Haemophilia B

'Christmas disease'
- Behaves clinically like Haemophilia A
- However, is due to factor IX deficiency
- Treat with factor IX concentrates

8

Von Willebrand's Disease
VW's roles in clotting

1. Brings platelets into contact with exposed sub-endo
2. Makes platelets bind to each other
3. Binds factor VIII, protecting it from destruction in circulation

Deficiency -> Defective platelet function and VIII deficiency

9

Von Willebrand's Disease
Clinical presentation

Bruising
Epistaxis
Menorrhagia
Increased bleeding post tooth extraction

10

Von Willebrand's Disease
Mild

(Types 1 and 2)
- Autosomal dominant inheritance
- Mucosal bleeding (GI and epistaxis)
- Prolonged bleeding after dental treatment/surgery

11

Von Willebrand's Disease
Severe

(Type 3)
- Recessive inheritance
- More severe bleeding and symptoms

12

Von Willebrand's Disease
Diagnosis

- Raised APTT and bleeding time
- Decreased factor VIII clotting activity
- Decreased vWf
- Normal INR and platelets

13

Von Willebrand's Disease
Treatment

- DESMOPRESSIN
- vWf-containing factor VIII concentrate

14

Vitamin K deficiency
Needed for

Vit K = needed for formation for active factors II, VII, IX and C

15

Vitamin K deficiency
Causes

- Malnutrition
- Malabsorption
- Warfarin treatment (inhibits Vit K synthesis)

16

Vitamin K deficiency
Diagnosis

Increased PT and APTT

17

Vitamin K deficiency
Treatment

Phytomenadione (vit K)