Overview of Bleeding Disorders

Question 1

Describe the sxs of a primary hemostatic defect (clinical bleeding patterns)

Answer 1

• prolonged initial bleed
• bruising
• nose bleeds
• dental bleeding
• menorrhagia

Question 2

Describe the sxs of a secondary hemostatic defect (clinical bleeding patterns)

Answer 2

• delayed bleeding
• re-bleeding
• joint bleeds
• soft tissue/muscle bleeds
• extensive bruising

Question 3

Describe the etiology of thrombocytopenia

Answer 3

Question 4

Describe the etiology of immune thrombocytopenic purpura (ITP)

Answer 4

Question 5

Describe the presentation of immune thrombocytopenic purpura (ITP)

Answer 5

Question 6

Describe the labs/diagnostic testing for immune thrombocytopenic purpura (ITP)

Answer 6

Question 7

Describe the treatment for immune thrombocytopenic purpura (ITP)

Answer 7

Question 8

Describe two platelet surface glycoprotein defects

Answer 8

Question 9

Describe two platelet granule/secretion defects

Answer 9

Question 10

What can cause acquired platelet function defects

Answer 10

• drugs (ASA)
• bone marrow disorders (MDS)
• renal failure/uremia

Question 11

Describe the etiology of von Willebrand Disease

Answer 11

PRIMARY HEMOSTATIC DISORDER

Question 12

Describe the presentation of von willebrand disease

Answer 12

Question 13

Describe the labs/diagnostic testing for von willebrand disease

Answer 13

Question 14

Describe the treatment for Von Willebrand Disease

Answer 14

Question 15

Describe the etiology of hemophilia

Answer 15

Question 16

Describe the presentation of mild, moderate, to severe hemophilia

Answer 16

Question 17

Describe the lab testing for hemophilia

Answer 17

Question 18

Describe some causes of acquired secondary hemostatic disorders

Answer 18

• coag factor inhibitors
• vitamin K deficiency (gut flora, diet)
• liver disease

Question 19

Which coag factors are vitamin K dependent

Answer 19

• II
• VII
• IX
• X

(also protein C and S)

Question 20

How do liver related primary/secondary hemostatic defects present

Answer 20

• thrombocytopenia
• decreased synthesis of clotting factors
• dysfunctional fibrinogen
• excess fibrinolysis

Question 21

Describe the agents working in hemostatic balance

Answer 21

procoagulants
- endothelium
- platelets
- clotting factors
- fibrinolytic inhibitors

VS

anti-coagulants
- protein C
- protein S
- antithrombin
- plasmin