Bleeding Disorders Quiz (BMS Learning Outcomes)
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Questions and Answers

What is the first physiological response to vascular injury in order to prevent blood loss?

  • Platelet aggregation
  • Formation of a fibrin plug
  • Vasoconstriction (correct)
  • Activation of the coagulation cascade

    • What condition is characterized by a reduction in platelet count below 150 x 10^9/L?

  • Hereditary haemorrhagic telangiectasia
  • Ehlers-Danlos Syndrome
  • Idiopathic Thrombocytopenia Purpura
  • Thrombocytopenia (correct)

    • Which of the following is a disease that may lead to acquired bleeding disorders due to severe infection?

  • Meningococcal infection (correct)
  • Idiopathic Thrombocytopenia Purpura
  • Ehlers-Danlos Syndrome
  • Vitamin C deficiency

    • What is a common characteristic of Acute Idiopathic Thrombocytopenia Purpura (ITP)?

    <p>It most commonly arises post-virally in children.</p> Signup and view all the answers

    Which vitamin deficiency can lead to impaired synthesis of blood-clotting factors?

    <p>Vitamin K</p> Signup and view all the answers

    In which bleeding disorder do the immune system mistakenly attack the body's own platelets?

    <p>Idiopathic Thrombocytopenia Purpura</p> Signup and view all the answers

    Which of the following platelets disorders is characterized by decreased or failed platelet production?

    <p>Thrombocytopenia</p> Signup and view all the answers

    What is a significant risk of liver disease concerning haemostasis?

    <p>Malabsorption of fat-soluble vitamins</p> Signup and view all the answers

    Which of the following is an inherited bleeding disorder classified under connective tissue disorders?

    <p>Ehlers-Danlos Syndrome</p> Signup and view all the answers

    What is the most common type of inherited coagulation disorder?

    <p>Haemophilia A</p> Signup and view all the answers

    Which statement about the treatment of Von Willebrand disease is accurate?

    <p>Desmopressin, tranexamic acid, and factor VIII are used for managing this disorder.</p> Signup and view all the answers

    Which condition is NOT a likely cause of post-operative bleeding in alcohol-dependent patients?

    <p>Increased alcohol metabolism leading to vitamin K overload</p> Signup and view all the answers

    What is the primary defect in Haemophilia B?

    <p>Deficiency of factor IX</p> Signup and view all the answers

    How does chronic renal failure primarily affect hemostasis?

    <p>It can impair platelet function and production.</p> Signup and view all the answers

    What is the role of Warfarin in anticoagulation therapy?

    <p>It blocks the action of vitamin K in clotting factor production.</p> Signup and view all the answers

    Which of the following best describes a distinguishing feature of Direct Oral Anticoagulants (DOACs)?

    <p>They directly inhibit factor Xa or thrombin.</p> Signup and view all the answers

    What is a significant effect of alcohol on bleeding risk?

    <p>It decreases the production of clotting factors.</p> Signup and view all the answers

    Which group of patients is at an increased risk of bleeding due to renal issues?

    <p>Patients with chronic renal failure</p> Signup and view all the answers

    What factor does not typically contribute to impaired hemostasis in liver disease?

    <p>Increased vascular tone</p> Signup and view all the answers

    Study Notes

    Haemostasis and Bleeding Disorders

    • Haemostasis is the physiological response preventing blood loss after injury. The process involves vasoconstriction, platelet activation, and coagulation cascade activation.

    Classifications of Bleeding Disorders

    • Disorders of Blood Vessels:

      • Inherited: Connective Tissue Disorders (e.g., Ehlers-Danlos Syndrome), Hereditary haemorrhagic telangiectasia (HHT)
      • Acquired: Severe infections (e.g., meningococcal, typhoid), drugs (e.g., sulphonamides), vitamin C deficiency, senile purpura

    • Disorders of Platelets:

      • Thrombocytopenia: Reduced platelet count (<150 x 10⁹/L). Causes include decreased production, destruction, or dysfunction.
        • Idiopathic Thrombocytopenic Purpura (ITP): Autoimmune disorder where immune system attacks platelets. Two forms:
          • Acute: Post-viral (e.g., chickenpox), self-limiting, common in children.
          • Chronic: Any age, symptoms persist from 6 months to lifelong.

    • Liver Disease:

      • The liver synthesizes clotting factors (I, II, VII, IX, X, XI).
      • Liver failure impairs vitamin K absorption (needed for clotting factor synthesis).
      • Prolonged Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) occur in chronic liver disease.
      • Post-operative bleeding risks in alcohol-dependent patients are due to decreased clotting factors, bone marrow suppression, malnutrition, and alcohol-enhanced effects of antiplatelet drugs.

    • Renal Disease:

      • Chronic renal failure impairs haemostasis due to decreased platelet production/adhesion, reduced platelet factor 3, vasodilation, and heparin use in haemodialysis.

    • Disorders of Coagulation:

      • Inherited:

        • Haemophilia A: Most common, X-linked recessive, Factor VIII deficiency. Symptoms: prolonged bleeding (nosebleeds, bleeding gums, easy bruising, joint pain).
        • Haemophilia B (Christmas Disease): Less common, X-linked recessive, Factor IX deficiency; similar symptoms to Haemophilia A
        • Von Willebrand Disease: Common hereditary coagulation abnormality, deficiency/dysfunction of von Willebrand Factor (vWF). vWF carries factor VIII and mediates platelet function. Presentation varies; treated with desmopressin, tranexamic acid, or factor VIII replacement.

      • Acquired: Liver disease, hematological malignancy, anticoagulant drugs (e.g., Warfarin, DOACs).

    Medical Conditions and Drug Therapies Affecting Bleeding Risk

    • Antiplatelet Drugs: Used to prevent blood clots in conditions like heart disease, stroke, and after stents. Examples include aspirin, clopidogrel, dipyridamole, ticagrelor, prasugrel.

    • Anticoagulant Drugs: Used to prevent blood clots in conditions like stroke, deep vein thrombosis, and atrial fibrillation.

      • Warfarin: Vitamin K antagonist, impairs synthesis of factors II, VII, IX, X. Monitored by INR; widely used, but with interactions.
      • Direct Oral Anticoagulants (DOACs): Rivaroxaban, apixaban, edoxaban, dabigatran. Directly inhibit specific clotting factors. Do not require regular INR monitoring (generally safer).
      • Injectable Anticoagulants (e.g., Heparin): Short half-life, used in hospitals, used in patients with deep vein thrombosis, and after surgery.

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    Description

    This quiz covers the essential concepts related to haemostasis and various bleeding disorders. Learn about the physiological mechanisms that prevent blood loss and explore the classifications of bleeding disorders, including inherited and acquired conditions. Test your knowledge on platelet disorders and their implications.

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