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2 Blood and Bleeding Disorders > Blood and Bleeding Disorders > Flashcards

Blood and Bleeding Disorders Flashcards

1
Q

What is haemotology?

A

involves the diagnosis and treatment of patients who have disorders of the blood and bone marrow

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2
Q

what are the functions of blood? 4

A

transport
immune system
homeostasis
coagulation

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3
Q

which cellular component of blood is vital for oxygen transport?

A

red blood cell / erythrocytes

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4
Q

which cellular component of blood is vital in the immune system?

A

white blood cells / leukocytes

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5
Q

which cellular component of blood is vital for clotting?

A

platelets

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6
Q

blood is composed of what 2 things?

A

plasma
cells

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7
Q

what does blood plasma contain? 6

A

proteins (clotting)
lipids
nutrients
hormones
electrolytes
water

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8
Q

blood is composed of what cells? 3

A

red blood cells - erythrocytes
white blood cells - leukocytes
platelets (clotting)

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9
Q

what is haematopoiesis?

A

production of the cellular components of blood

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10
Q

where does haematopoiesis occur?

A

in the red bone marrow in flat bones in adults
(ribs, sternum, vertebrae, iliac crest)

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11
Q

white blood cells - leucocytes are subdivided into what 5 categories?

A

lymphocytes
neutrophils
macrophages
eosinophils
basophils

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12
Q

what are the 3 haematological investigations

A

bone marrow biopsy
full blood count
blood film

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13
Q

what does a full blood count haematological investigation?

A

automated process that gives the number and size of cells in a blood sample

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14
Q

platelet count is normally between?

A

150-400 x 10^9 per litre

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15
Q

what is thrombocytopenia

A

platelet count <150

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16
Q

what is thrombocythaemia

A

platelet count >400

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17
Q

what’s another name for platelet?

A

thrombocyte

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18
Q

this image illustrates what process?

A

taking a bone marrow sample (biopsy) from the iliac crest

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19
Q

what is activated partial thromboplastin time? (APTT)

A

is the time (seconds) it takes for a patients plasma to clot after phospholipid, calcium and intrinsic pathway activator have been added to it.

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20
Q

activated partial thromboplastin time APTT tests which pathways? 2

A

the function of the intrinsic and common coagulation pathways

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21
Q

activated partial thromboplastin time detects deficiencies in? 5

A

factors
XII
XI
IX
VIII
factors in the common coagulation pathway

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22
Q

what is prothrombin time PT?

A

time (seconds) that it takes for blood to clot after addition of the activating enzyme thromboplastin

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23
Q

prothrombin time PT tests which pathways?

A

extrinsic and common coagulation pathway

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24
Q

prolonged prothrombin time PT can indicate what?

A

deficiencies or inhibitors of one or more of factors II, V, VII, X and fibrinogen

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25
Q

what is international normalised ratio?

A

reproducible version of prothrombin time

patients prothrombin time divided by a standardised normal prothrombin time

26
Q

international ratio (INR) tests what?

A

the effect of warfarin on the blood

27
Q

in health a normal international ratio INR is?

A

1.1 or below

28
Q

coagulation depends on what? 2

A

platelet number and function

coagulation cascade

29
Q

after vessel injury how does the platelet plug form and increase in size?

A

vasoconstriction reduces blood flow
platelet aggregation

activated platelets clump together, activating and attracting other platelets allowing the platelet plug to increase in size

30
Q

in the clotting cascade the intrinsic pathway is activated by?

A

internal damage to the vessel wall (exposure to endothelial collagen)

31
Q

in the clotting cascade the extrinsic pathway is activated by?

A

tissue factor / thromboplastin / factor III released by endothelial cells after external damage

32
Q

in the clotting cascade the intrinsic and extrinsic pathway merge to form?

A

common pathway

33
Q

in the clotting cascade results in? 3

A

conversion of fibrinogen to fibrin
stabilisation of the fibrin clot
formation of the blood clot

34
Q

what causes platelet problems?

A

deficiency

production problem

destruction

35
Q

how does liver disease affect blood coagulation

A

Site of production for all coagulation factors and precursor enzymes e.g. prothrombin

36
Q

the most common anti platelet drugs are? 3

A

Aspirin
Clopidogrel
Dipyridamole

37
Q

aspirin belongs to what drug group?

A

NSAIDs - non-steroid anti-inflammatory drugs

38
Q

the newer antiplatelet drugs are? 2

A

Ticregalor
Prasugrel

39
Q

platelet aggregation problems are managed by? 2

A

treating underlying causes
platelet transfusions

40
Q

coagulation cascade problems can be the result of what?

A

generalised deficiency
specific deficiency

41
Q

the ? is the site of production for all the ? ? and their ? except for ? ? ?

A

liver
coagulation factors
inhibitors
von Willebrand’s factor

42
Q

example of a generalised deficiency that can cause coagulation cascade problems

A

generalised protein deficiency from liver disease or severe malnutrition

43
Q

what are the two types of specific deficiency associated with coagulation cascade problems?

A

congenital (inherited)

drugs

44
Q

examples of specific congenital (inherited) deficiencies associated with coagulation cascade problems 2

A

haemophilia

von Willebrand’s disease

45
Q

examples of coagulation cascade problems associated with specific deficiencies drugs? 3

A

Warfarin and heparin

direct oral anticoagulants - DOACs

46
Q

haemophilia is inherited in an …?

A

X-linked recessive manner - males only

47
Q

what is deficient in haemophilia A?

A

coagulation factor VIII

48
Q

what is deficient in haemophilia B?

A

coagulation factor IX

49
Q

what happens in von Willebrands disease?

A

von Willebrand’s coagulation factor is either reduced in quantity or functionality

50
Q

von Willebrand’s disease is inherited in

A

a autosomal dominant manner
male and female affected

51
Q

von Willebrand’s disease affects

A

the function of platelets and factor VIII

52
Q

how is the risk from von Willebrand’s disease managed? 2

A

trauma avoidance

preparation for expected bleeding (operations)

53
Q

what is warfarin?

A

oral anticoagulant
Inhibits the activation of vitamin K -> reduction in the body stored of vitamin K -> reduced production of activating clotting factors

54
Q

do the drugs DOACs or Warfarin require INR testing?

A

only warfarin as its unstable and reacts with other medications

55
Q

examples of DOACs (direct oral anticoagulants)

A

apixaban
rivaroxaban
edoxaban
dabigatran

56
Q

the DOACs apixaban, rivaroxaban and edoxaban inhibit what?

A

factor Xa

57
Q

the DOAC dabigatran inhibits what?

A

thrombin

58
Q

what is heparin and low molecular weight heparins?

A

injectable anticoagulants used commonly in hospital after surgery to prevent blood clots - dialysis

59
Q

manifestations of coagulation problems

A

traumatic bleeding

mucosal bleeding

60
Q

what is purpura?

A

discolouration of the skin or mucous membranes due to haemorrhage from small blood vessels

61
Q

what is this type of purpura called?

A

petichiae

62
Q

what is this type of purpura called?

A

ecchymoses

2 Blood and Bleeding Disorders (1 decks)

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