Bleeding & Thrombosis in Practice Flashcards Preview

Yr3 Haematology > Bleeding & Thrombosis in Practice > Flashcards

Flashcards in Bleeding & Thrombosis in Practice Deck (23)
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1

1) 20 month old boy attends A&E with dad
Refused to walk for 2 days (Walked unsupported for 4 months prior)
Right swollen and warm
Blood aspirated from knee

Most likely diagnosis?

Haemophilia

2

1) How would you determine which kind of haemophilia?

Coagulation factor 8/9 Assay

3

1) Factor VIII = 0% and IX = 73%
Which type of haemophilia is it?

Haemophilia A

4

1) How is haemophilia inherited?

X-linked

5

1) Mum says her dad had haemophilia A, she want's to know here odds of having another child with it?

1 in 4 (shes a carrier)

6

1) How do you treat the boy?

Recombinant Factor VIII
Atleast 3x per week

7

1) Which infections are a risk of Recombinant Factor VIII?

Hep B & C
HIV

8

1) Other than infections what's the major complication of Factor 8 concentrates?

Inhibitory antibody development

9

2) 24yr old female student presents with 4 days of easy bruising & small red spots on her ankles
Recently been off colour with flu-like symptoms
Previous tonsillectomy with no bleeding and on OCP.

Which of these symptoms are unlikely?
- Menorrhagia
- Epistaxis
- Buccal Bleeding
- Swollen hot painful leg

Swollen hot painful leg

The rest are possible bleeds from an acquired bleeding disorder

10

2) What is most likely to cause her symtpoms?

Thrombocytopenia

11

2) What could cause her thrombocytopenia?

AML
Aplastic Anaemia
ITP

12

2) She's bruising spontaneously, what's her likely platelet count?

10 or less

13

2) What underlying illness could cause ITP?

SLE
EBV
HIV
Lymphoma
(Also use of quinines)

14

3) 70yr old man with excessive bleeds after colectomy for cancer
Bleed from abdo wound but not his drain or line.
He's had surgery before without abnormal bleeds.
Whats the most likely cause?

LMWH prophylaxis

Not likely to be a bleeding disorder because its a single site

15

3) Why might that patient have been given LMWH prophylaxis?

For VTE because of his:
- Surgery
- Old Age
- Active Cancer

16

4) 65yr old man takes aspirin from h/o TIA.
How does it work?

Reduces platelet aggregation by inhibiting COX-1

17

4) Which of the following drugs are/aren't anti-platelets?
Clopidogrel
Dabigatran
Abciximab
Ticagrelor

Dabigatran is the only non anti-platelet. (its a DOAC)

C & T target binding of ATP to platelets, preventing activation of platelets

Abciximab inhibits platelet's receptors for fibrinogen (GP2b/3a)

18

5) 21yr old med student uses cOCP. Which of these is true:
- Increased stroke risk?
- Reduced pulm embolism risk?
- Bleeds more easily from injuries?
- Could have a fh of mother or sisters suffering PE?

Only the increased risk of Stroke

Actually have an increased PE risk

More likely to have a thrombosis than a bleed

Wouldn't prescribe OCP to someone with a 1st degree relative PE

19

5) Which of these could increase her risk of VTE?
- Hypercholesterolaemia
- Factor V Leiden
- Von Willebrand Factor Deficiency
- DM

Factor V Leiden

Hypercholesterolaemia & DM are arterial risk factors

vWF deficiency --> bleeding not thromboses

20

Which of these are risk factors for arterial thromboembolism?
- Smoking
- DM
- Factor V Leiden
- Atrial Fibrillation

All but Factor V leiden

21

Which of the follow are true of an arterial thrombus?
- Platelet rich
- Mostly on ruptured/ulcerated plagues
- Can --> PE
- Can --> Infarction

Is platelet rich
Is on plagues
Can cause infarction


Won't cause PE

22

Which of the following are true of DIC?
- Spontaneous disorder of coagulation
- typically --> DVT in lower limbs
- --> Tissue infarction due to microvacular thrombosis

Tissue infarction due to microvascular thrombosis

Can cause DVT but not common

Not Spontaneous

23

Which of these can DIC be a complication of:
- Metastatic cancer
- Normal Pregnancy
- Severe burns
- Septic Shock

Any apart from normal pregnancy

Can occur in non-normal pregnancy