Bleeding Disorders--Krafts Flashcards Preview

IHO Wk 6 > Bleeding Disorders--Krafts > Flashcards

Flashcards in Bleeding Disorders--Krafts Deck (40)
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1
Q

Platelet bleeding is characterized by…

A

spontaneous bleeding

petichaie

2
Q

Factor bleeding is characterized by…

A

big bleeds after trauma

esp. into deep joints

*lots of bleeding, not like petichae (like platelet bleeding)

3
Q

Petichiae are characteristic of…

A

platelet bleeding

4
Q

Big, joint space bleeding is characteristic of…

A

factor bleeding

5
Q

Type 1 vWD problem

A

decreased vWF

(75%)

6
Q

Type 2 vWD problem…

A

abnormal vWF

(25%)

7
Q

Type 3 vWD problem…

A

no vWF

(5%)

8
Q

Sx of vWD

A

mucosal bleeding

deep joint bleeding in severe cases

9
Q

vWD

Bleeding time

PTT

INR

[vWF]

Platelet aggregation studies

A

Bleeding time: prolonged

PTT: prolonged “corrects” w/ mixing study

INR: normal

[vWF]: normal, except type 2

Platelet aggregation studies: abnormal

10
Q

vWF binds which GP?

A

GPIb

11
Q

GPIa

GPIb

GPIIb/IIIa

A

GPIa: collagen

GPIb: vWF

GPIIb/IIIa: fibrinogen

12
Q

Tx of vWD

A

cryoprecipitate (contains vWF and VIII)

13
Q

Hemophilia inheritance pattern

A

X-linked recessive

14
Q

Most common factor deficiency

A

Hemophilia A

15
Q

Hemophilia A deficiency

A

Factor VIII

(levels decreased)

16
Q

Hemophilia A Sx

A

“Factor bleeding”

  • deep joint bleeding
  • prolonged bleeding after dental work

*rarely, mucosal hemorrhage

17
Q

Hemophilia A

INR, TT, platelet count, bleeding time

PTT

Factor VIII assays: abnormal

DNA studies: abnormal

A

INR, TT, platelet count, bleeding time: normal

PTT: prolonged (corrects with mixing study)

Factor VIII assays: abnormal

DNA studies: abnormal

18
Q

Tx of Hemophilia A

A

Factor VIII replacement

19
Q

Hemophilia B pathology

A

Factor IX deficiency

20
Q

Bernard-Soulier Syndrome

pathology

A

abnormal Ib (vWF receptor)

21
Q

Bernard-Soulier Syndrome

A

severe bleeding

big platelets

22
Q

Glanzmann Thrombasthenia

pathology

A

GPIIb/IIIa deficiency

no aggregation

23
Q

Gray platelet syndrome

pathology

A

no alpha granules

mild bleeding

24
Q

Delta granule deficiency

pathology

A

absent delta granules

may be part of another syndrome

25
Q

Why do you bleed in DIC?

A

use up all platelets

use all clotting factors

26
Q

What type of anemia is associated with DIC?

A

microangiopathic hemolytic anemia

27
Q

What sets off DIC?

A

initiation of coagulation

(it’s not a platelet problem)

28
Q

Big causes of DIC

A

malignancy

OB complications

sepsis

trauma

MOST cases acrynym

29
Q

DIC

INR, PTT, TT

FDPs

Fibrinogen

A

INR, PTT, TT: prolonged

FDPs: increased

Fibrinogen: decreased

30
Q

Idiopathic Thrombocytopenic Purpura

pathology

A

antiplatelet antibodies

GPIIb/IIIa or Ib

splenic macrophages eat platelets

31
Q

Chronic

vs

Acute

Idiopathic Thrombocytopenic Purpura

A

Chronic: big problem–bleeding into brain

Acute: abrupt, follows viral illness (usually children)

32
Q

Labs in idiopathic thrombocytopenic purpura

A

thrombocytopenia

many/bigger megas in BM

bigger platelets in smear

33
Q

TTP

pathology

A

ADAMTS13 deficiency

ADAMTS13 normally cleaves new, large vWF to less active bits

if they are not able to be cleaved, then you get a lot of platelet aggregation –> little clots everywhere

34
Q

TTP

pentad

A

MAHA

thrombocytopenia

fever

neurologic defects

renal failure

35
Q

Why do you get neurlogic defects in TTP?

A

many little clots that end up going to the brain

36
Q

Two things you will have in TTP

A

microangiopathic hemolytic anemia

thrombocytopenia

+ neurological deficits

37
Q

TTP Tx

A

acquired: plasmapheresis

hereditary: plasma infusions

38
Q

Hemolytic Uremic Syndrome

pathology

A

E. coli infections

  • most likely form toxin
  • endothelial damage (platelet activation)

*this is the reason that E. coli outbreak patients are hospitalized

39
Q

Hemolytic Uremic Syndrome

clinical findings

A

blood diarrhea

then renal failure

5% fatality rate

40
Q

Tx of hemolytic uremic syndrome

A

NOT ABX!!

supportive care

dialysis