Bleeding Disorders for Dental Hygienists

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Questions and Answers

What is the primary physiological response initiated after a vascular injury?

Vasoconstriction (correct)

Formation of a fibrin plug

Coagulation cascade activation

Platelet activation

Which of the following is NOT a category of bleeding disorders?

Disorders of coagulation

Disorders of platelets

Disorders of inflammation (correct)

Disorders of blood vessels

What role do platelets play in haemostasis?

They provide structural integrity to blood vessels

They release anticoagulants to prevent clots

They facilitate the aggregation and formation of a plug (correct)

They help in the dissolution of fibrin

Which type of bleeding disorder is associated with connective tissue disorders?

Disorders of blood vessels Signup and view all the answers

What is the primary goal of understanding bleeding disorders for dental professionals?

To manage and identify risks related to oral health Signup and view all the answers

Which of the following statements about the coagulation cascade is incorrect?

It is initiated by the activation of platelets. Signup and view all the answers

When managing a patient with a bleeding disorder, what should dental professionals focus on?

A preventive approach to support long-term health Signup and view all the answers

What is the usual range for platelet count in healthy individuals?

150-450 x 10^9/L Signup and view all the answers

Which of the following is NOT a characteristic of Idiopathic Thrombocytopenia Purpura (ITP)?

It primarily affects only adults. Signup and view all the answers

What is a common cause of thrombocytopenia?

Decreased or failed platelet production Signup and view all the answers

Which of the following factors essential for blood clotting is produced by the liver?

Factor X Signup and view all the answers

Which condition is characterized by a deficiency in Vitamin K absorption?

Liver Disease Signup and view all the answers

Hereditary haemorrhagic telangiectasia (HHT) is mainly associated with which of the following manifestations?

Vascular malformations Signup and view all the answers

What might cause a destruction of circulating platelets?

Chemotherapy Signup and view all the answers

Which of the following is a potential cause of vitamin C deficiency?

Poor nutrition Signup and view all the answers

Which rare condition is associated with a disorder of platelets?

Bernard Soulier disease Signup and view all the answers

What physiological change can lead to post-operative bleeding in alcohol-dependent patients?

Decreased synthesis of clotting factors Signup and view all the answers

Which of the following is NOT a reason for impaired haemostasis in chronic renal failure?

Increased platelet factor 3 Signup and view all the answers

What is the most common type of inherited coagulation disorder?

Haemophilia A Signup and view all the answers

Which statement about Warfarin is correct?

It is a vitamin K antagonist. Signup and view all the answers

Haemophilia B is characterized by a deficiency of which clotting factor?

Factor IX Signup and view all the answers

Which of the following conditions can lead to acquired disorders of coagulation?

Liver disease Signup and view all the answers

Which treatment is often used for Von Willebrand Disease?

Desmopressin Signup and view all the answers

Which of the following anticoagulant drugs is a direct oral anticoagulant (DOAC)?

Rivaroxaban Signup and view all the answers

Which symptom is primarily associated with Haemophilia A?

Chronic nosebleeds Signup and view all the answers

Study Notes

Bleeding Disorders (Part 1)

The session aims to describe bleeding disorders for dental hygienists and therapists.
GDC learning outcomes include explaining general and systemic diseases, their relevance to oral health, and describing and applying relevant physiology to patient management.
Recognizing abnormalities of the oral cavity and the rest of the patient, and raising concerns where appropriate is crucial.
Identifying where patients' needs differ from the treatment plan and referring them accordingly is also emphasized.

Haemostasis

Haemostasis is the physiological response preventing significant blood loss after vascular injury.
The process involves three key events:
- Vascular system - injured vessels constrict.
- Platelet system - platelet activation and aggregation to form a plug.
- Coagulation cascade - activation to produce a fibrin plug.

Aggregation of Platelets

Platelet activation involves three stages:
- Adhesion: platelets stick to damaged blood vessels.
- Secretion: platelets release substances.
- Aggregation: platelets clump together.

The Coagulation Cascade

This cascade involves a complex series of reactions resulting in the formation of a fibrin clot.
Two main pathways exist:
- Intrinsic pathway - initiated by activation of clotting factors within the blood.
- Extrinsic pathway - initiated by tissue damage, leading to activation of clotting factors in the surrounding tissue.
- Final common pathway - where both pathways converge and ultimately result in the formation of a fibrin clot

Classification of Bleeding Disorders

Bleeding disorders are categorized into:
- Disorders of blood vessels.
- Disorders of platelets.
- Disorders of coagulation.

Disorders of Blood Vessels

Inherited disorders:
- Connective tissue disorders e.g., Ehlers Danlos syndrome
- Hereditary hemorrhagic telangiectasia (HHT).
Acquired disorders:
- Severe infections (e.g., meningococcal, typhoid).
- Medications (e.g., sulphonamides).
- Vitamin C deficiency, senile purpura.

Disorders of Platelets

Thrombocytopenia: a reduced platelet count (below 150 x 109/L). Causes:
- Decreased/failure of platelet production.
- Destruction of circulating platelets.
- Disorders of platelet function.
Idiopathic thrombocytopenic purpura (ITP): a rare autoimmune blood disorder affecting platelets. Two Forms:
- Acute ITP - often following viral infections in children.
- Chronic ITP - can occur at any age and symptoms can persist for months or years.

Disorders of Coagulation

Inherited:
- Haemophilia A - deficiency in Factor VIII.
- Haemophilia B - deficiency in Factor IX.
- Von Willebrand Disease - deficiency in von Willebrand Factor.
Acquired:
- Liver disease - reduced production of clotting factors.
- Haematological malignancies - impaired coagulation.
- Anticoagulant drugs.

Antiplatelet and Anticoagulant Drugs

Antiplatelet drugs are used to prevent blood clot formation in situations like ischemic heart disease and previous myocardial infarction. Aspirin, Clopidogrel, Dipyridamole, Ticagrelor, and Prasugrel are examples.
Anticoagulant drugs prevent blood clotting, and are used in conditions such as stroke, deep vein thrombosis, and pulmonary embolism. Warfarin, direct oral anticoagulants (DOACs), and Heparin are example drug classes.

Warfarin

A vitamin K antagonist that blocks enzymes needed to produce clotting factors.
Monitored using INR (international normalized ratio).

Direct Oral Anticoagulants (DOACs)

Rivaroxaban, Apixaban, Edoxaban inhibit Factor Xa.
Dabigatran directly inhibits thrombin.
Generally have a faster onset of action and fewer drug interactions compared to Warfarin.

Heparin

Short half-life, primarily used intravenously.
Used to prevent thrombosis in various situations such as after surgery, heart attack, and during dialysis.

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Description

This quiz covers the essential concepts of bleeding disorders relevant for dental hygienists and therapists. It focuses on the physiological mechanisms of haemostasis, including vascular response, platelet activation, and the coagulation cascade. Understanding these disorders is crucial for effective patient management in dental practice.