Bruising and Bleedign Flashcards
(55 cards)
_______ = petechiae + ecchymoses
Purpura
Abnormal bleeding is basically the result of disorders of 1 2 3
(1) the platelet, (2) the coagulation mechanism or (3) the blood vessel
The commonest cause of an acquired bleeding
disorder is______
drug therapy (e.g. aspirin, NSAIDs, cytotoxics and oral anticoagulants
The three major mechanisms of systemic bleeding disorders are (the Virchow triad):
1 coagulation deficiencies (reduction or inhibition
of circulatory coagulation factors)
2 platelet abnormalities: of platelet number or
function
3 vascular defects: of vascular endothelium
___________ disorders which are the
most common include von Willebrand disease
(vWD), thrombocytopenia and platelet function
disorders.
Primary haemostatic
Examples of disorders of secondary
haemostasis are disorders of _____
fibrin formation and
the haemophilias
_______ present as early bleeding
following trauma
Platelet abnormalities
______ present with
delayed bleeding after initial haemostasis is
achieved by normal platelets
Coagulation factor deficiencies
A normal response to previous coagulation
stresses (e.g. dental extraction, circumcision or
pregnancy) indicates an ________
acquired problem
Drugs and their responses
__________:
— prednisolone/other steroids
vascular purpura
Drugs and their responses
______________
— cytotoxic drugs — carbamazepine — gold — sodium valproate — heparin — ranitidine — sulphonamides
thrombocytopenia
Drugs and their responses
functional platelet abnormalities:
1
2
— aspirin
— NSAIDs
The initial choice of investigations depends upon the
bleeding pattern.
If coagulation defect suspected 1 2 3 4
- prothrombin time (PT), i.e. INR
- activated partial thromboplastin time (APTT)
- fibrinogen level
- thrombin time (TT)
The initial choice of investigations depends upon the
bleeding pattern.
If platelet pathology suspected:
1
2
3
- platelet count
- skin bleeding time (of doubtful value)
- platelet function analyser (PFA-100)
The initial choice of investigations depends upon the
bleeding pattern.
If inherited disorders suspected:
1
2
3
- factor VIII
- vW factor activity
- vW factor antigen
The _______ as a screening test
of haemostasis has been shown recently to be severely
limited by its lack of specificity and sensitivity
skin-bleeding time
Laboratory investigation checklist for the easy
bruiser
Full blood count Platelet count Prothrombin time (INR) Thrombin time (TT) Activated partial thromboplastin time
A common condition is ______________ which is a self-limiting disease usually
presenting on the second or third day of life because of a
deficiency of coagulation factors dependent on vitamin
K.
haemorrhagic disease of
the newborn,
What Tx has eliminated HDN
Vit K at birth
________is the commonest of the primary platelet
disorders in children. Both acute and chronic forms
have an immunological basis
Idiopathic (immune) thrombocytopenic purpura
ITP
Prognosis of ITP
Spontaneous remission within 4 to 6
weeks occurs with acute ITP in childhood
The commonest vascular defects in childhood are:
1
2
3
• anaphylactoid (Henoch–Schönlein) purpura
• infective states
• nutritional deficiency (usually inadequate dietary
vitamin C)
_______is the commonest vasculitis of children. It affects
small vessels, producing a leucocytoclastic vasculitis
with a classic triad of non-thrombocytopenic purpura,
large joint arthritis and abdominal pain
HSP
Distribution of HSP
over the lower limbs,
extending onto the buttocks, but it can
also involve the upper limbs, trunk and even the face
