Screening 6

Question 1

What are the coagulation disorders we discussed?

Answer 1

• hemophilia

- disseminated intravascular coagulation (DIC)

Question 2

hemophilia is a bleeding disorder cause by a deficiency in

Answer 2

one of two blood clotting factors (proteins)

• factor VIII
• factor IX

Question 3

What is the root cause of hemophilia?

Answer 3

several different gene abnormalities can cause the disorder

Question 4

What is the main problem for people with hemophilia?

Answer 4

• people bleed unexpectedly or after minor injuries

- bleed longer, but not faster than normals

Question 5

What is the most common clinical manifestation of s/s for hemophiliacs?

Answer 5

acute hemarthroses

Question 6

What is the 2nd most common location of bleeds for hemophiliacs?

Answer 6

muscle bleeds

Question 7

Where are muscle bleeds often seen?

Answer 7

flexor groups

Question 8

With muscle bleeds, which are very important to distinguish between?

Answer 8

• iliopsoas bleed

- hip bleed

Question 9

trunk flexion: iliopsoas bleed

Answer 9

causes severe pain

Question 10

trunk flexion: hip bleed

Answer 10

causes mild pain

Question 11

hip rotation: iliopsoas bleed

Answer 11

causes mild pain

Question 12

hip rotation: hip bleed

Answer 12

causes severe pain

Question 13

For hemophiliacs, what will repeated muscle bleeds cause over time?

Answer 13

• fibrotic tissue
• contractures
• possibility of peripheral nerve lesions from compression

Question 14

Treatments for hemophilia

Answer 14

transfusions given to replace missing clotting factors

Question 15

Hemophilia tx: transfusions will have greater concentrations of:

Answer 15

The factor they’re deficient in

Question 16

Hemophilia: Why must you watch for an acute hemarthrosis?

Answer 16

Pseudotumor or bone erosion can occur

Question 17

What are the two forms of hemophilia?

Answer 17

• Hemophilia A

- Hemophilia B

Question 18

Which is the most common form of hemophilia?

Answer 18

• Hemophilia A

- accounts for 80% of all cases

Question 19

Hemophilia A is a deficiency of

Answer 19

clotting factor VIII

Question 20

Hemophilia B is a deficiency of

Answer 20

clotting factor IX

Question 21

Bleeding patterns and overall consequences: hemophilia A/B

Answer 21

both have similar bleeding patterns and overall consequences

Question 22

DIC =

Answer 22

disseminated intravascular coagulation

Question 23

What is DIC?

Answer 23

overactivation of clotting cascade with simultaneous and paradoxical

• clotting
• hemorrhaging

Question 24

With DIC, get widespread deposition of ____. Where does this happen?

Answer 24

• fibrin

- in circulation and in major organs

Question 25

Disseminated intravascular coagulation (DIC) is common after:

Answer 25

- shock - sepsis - OB/GYN complications - cancer - trauma

Question 26

What should you always take into account with a pt who has DIC?

Answer 26

- NO PT during bleeding episodes | - monitor lab values carefully to see when it's safe to mobilize

Question 27

Blood disorders overall: Guidelines for immediate medical attention

Answer 27

- Excessive or spontaneous bleeding | - Severe bruising previously seen or unreported

Question 28

Blood disorders overall: Guidelines for physician referral

Answer 28

- May be warranted with exercise prescription for client with known anemia - New episodes of joint or muscle pain in client with hemophilia

Question 29

Blood disorders overall: Clues when screening for hematologic disease

Answer 29

- previous hx of chemo/radiotherapy - chronic NSAID use - spontaneous bleeding of any kind - recent major surgery - rapid onset of dyspnea - chest pain - weakness - fatigue with palpitations associated with recent change in altitude - observed changes in hands and nail beds