lecture 4 Flashcards
(24 cards)
Name three common inherited bleeding disorders.
Von Willebrand disease, haemophilia A (factor VIII deficiency), and haemophilia B (factor IX deficiency).
What is the most common inherited bleeding disorder?
Von Willebrand disease.
What are two primary features of haemophilia?
Joint bleeding (haemarthrosis) and soft tissue haematomas.
List three common acquired causes of abnormal bleeding.
Liver disease, disseminated intravascular coagulation (DIC), and anticoagulant use.
How does liver disease contribute to bleeding?
Reduced synthesis of clotting factors, impaired platelet production, and increased fibrinolysis.
What should be assessed when taking a bleeding history
Current and previous bleeding, haemostatic challenges (e.g., surgery), medication, alcohol use, and family history.
What bleeding patterns suggest a primary haemostasis defect?
Mucocutaneous bleeding such as petechiae, epistaxis, and heavy menstrual bleeding.
What bleeding patterns suggest a coagulation defect?
Deep tissue bleeding, such as haemarthrosis or soft tissue haematomas.
What are the first-line laboratory tests for bleeding disorders?
PT, APTT, fibrinogen level, platelet count, and FBC.
How does tranexamic acid work?
It blocks plasmin activation, reducing fibrinolysis.
When is fresh frozen plasma (FFP) used in bleeding management
In severe liver disease, massive haemorrhage, or DIC to replace clotting factors.
What is the purpose of cryoprecipitate in bleeding treatment?
To correct low fibrinogen levels in significant bleeding.
What are the main indications for platelet transfusion?
Bone marrow failure, trauma, DIC, or surgery with platelet counts <50 x10⁹/L.
What is desmopressin (DDAVP), and when is it used?
A drug that releases endogenous von Willebrand factor and factor VIII, used in mild haemophilia A and von Willebrand disease
What is the first step in managing anticoagulant-related bleeding?
Stop the anticoagulant drug.
What is the reversal agent for warfarin in life-threatening bleeding?
Vitamin K and prothrombin complex concentrate (PCC).
What is the reversal agent for dabigatran?
Idarucizumab.
How is severe bleeding caused by Xa inhibitors managed?
With andexanet alpha or supportive measures.
What is the role of tranexamic acid in anticoagulant-related bleeding
It helps reduce bleeding by inhibiting fibrinolysis.
What are common laboratory findings in disseminated intravascular coagulation (DIC)?
Prolonged PT/APTT, low platelet count, low fibrinogen, and elevated D-dimer.
Why is vitamin K deficiency a cause of bleeding?
It impairs synthesis of vitamin K-dependent clotting factors (II, VII, IX, X).
What are key clinical features of von Willebrand disease
Mucocutaneous bleeding, menorrhagia, and prolonged bleeding after trauma or surgery
What type of bleeding is commonly associated with platelet dysfunction?
Superficial bleeding, such as petechiae and easy bruising.
What factor deficiency is associated with haemophilia A?
Factor VIII deficiency.
