Bruising and Bleedign Flashcards
_______ = 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)
