Bleeding Disorders

Question 1

give an example of an acquired vascular abnormality

Answer 1

henoch-schonlein purpura

Question 2

thrombocytopenia - acquired

Answer 2

1. reduced production
2. increased destruction

Question 3

causes of peripheral platelet destruction

Answer 3

coagulopathy
- Disseminated Intravascular Coagulation

autoimmune
- Immune thrombocytopenic purpura (ITP)

hypersplenism

Question 4

platelet functional defects - acquired

Answer 4

drugs (e.g. aspirin, NSAIDs)
renal failure

Question 5

vWF deficiency - inheritance pattern

Answer 5

autosomal dominant

Question 6

is vWF generally mild or severe

Answer 6

mild

Question 7

what is the commonest cause of primary haemostatic failure

Answer 7

thrombocytopenia

Question 8

causes of thrombocytopenia

Answer 8

• marrow failure
• peripheral destruction

Question 9

multiple factor deficiencies

Answer 9

• liver failure
• vit K deficiency/warfarin therapy
• complex coagulopathy
  -disseminated intravascular coagulation

Question 10

where are coagulation factors synthesised

Answer 10

hepatocytes

Question 11

why does liver failure play a part in coagulation factor deficiencies

Answer 11

all coagulation factors are synthesised in hepatocytes

Question 12

where is vit K absorbed

Answer 12

upper intestine

Question 13

causes of vit K deficiency

Answer 13

Poor dietary intake
Malabsorption
Obstructive jaundice
Vitamin K antagonists (warfarin)
Haemorrhagic disease of the newborn

Question 14

causes of DIC

Answer 14

Sepsis
Obstetric emergencies
Malignancy
Hypovolaemic shock

Question 15

Treatment of DIC

Answer 15

Treat the underlying cause
Replacement therapy
-Platelet transfusions
-Plasma transfusions
-Fibrinogen replacement

Question 16

haemophilia inheritance pattern

Answer 16

x-linked

Question 17

what is haemophilia

Answer 17

An X-linked, hereditary disorder in which abnormally prolonged bleeding recurs episodically at one or a few sites on each occasion

Question 18

what coagulation factor is deficient in haemophilia A

Answer 18

factor VIII

Question 19

what coagulation factor is deficient in haemophilia B

Answer 19

factor IX

Question 20

clinical features of severe haemophilia

Answer 20

Recurrent Haemarthroses
Recurrent soft tissue bleeds
-bruising in toddlers
Prolonged bleeding after dental extractions, surgery and invasive procedures