Hemophilia Chapter 10 Flashcards
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Questions and Answers

What does the coagulation cascade chart represent?

  • A visual representation of all blood coagulation factors
  • A diagram showing coagulation pathways
  • A step-by-step flow of coagulation processes
  • All of the above (correct)
  • What mutation is associated with Hemophilia A?

    F8 gene

    What is the mode of inheritance for Hemophilia A?

    X-linked recessive

    What gene is mutated in Hemophilia B?

    <p>F9 gene</p> Signup and view all the answers

    What mode of inheritance exists for Hemophilia B?

    <p>X-linked recessive</p> Signup and view all the answers

    Define variable expressivity.

    <p>The expression of the disease is variable among those who are affected.</p> Signup and view all the answers

    Describe the clinical findings for severe Hemophilia.

    <p>Less than 1% normal factor activity with spontaneous joint and muscle bleeding.</p> Signup and view all the answers

    What are the initial lab findings for a F8 and F9 mutation?

    <p>Prolonged APTT, normal PT, normal bleeding time, normal fibrinogen levels.</p> Signup and view all the answers

    What joints are most commonly affected by severe hemophilia?

    <p>Knees, ankles, elbows</p> Signup and view all the answers

    What is a De novo mutation?

    <p>Mutations that occur for the first time in one family member and are not inherited.</p> Signup and view all the answers

    What does APTT measurement evaluate?

    <p>The intrinsic pathway of the coagulation cascade.</p> Signup and view all the answers

    What is the PT measurement used for?

    <p>Evaluate the extrinsic pathway</p> Signup and view all the answers

    Neither PT nor APTT can differentiate between factor deficiencies or the presence of specific factor inhibitors.

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

    Low to normal clotting activity in these screening tests completely rules out the presence of hemophilia A.

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

    What should all bleeding disorders be screened with?

    <p>APTT measurement, PT measurement, bleeding time measurement, platelet count.</p> Signup and view all the answers

    What can be done to increase the levels of factors 8 and 9?

    <p>Estrogens, oral contraceptives, epinephrine, desmopressin acetate, vigorous exercise.</p> Signup and view all the answers

    What is the best screening test for platelet function disorder?

    <p>Bleeding time.</p> Signup and view all the answers

    Mutations in mild to moderate hemophilia tend to be which type?

    <p>All of the above</p> Signup and view all the answers

    Hemophilia affected males will transmit the mutation to all their __________ but to none of their __________.

    <p>daughters, sons</p> Signup and view all the answers

    Study Notes

    Hemophilia Overview

    • Hemophilia is classified into two main types: Hemophilia A (mutation of the F8 gene) and Hemophilia B (mutation of the F9 gene).
    • Both types exhibit X-linked recessive inheritance patterns, primarily affecting males.

    Hemophilia A

    • Caused by mutations in the F8 gene, leading to impaired production of coagulation Factor VIII.
    • Factor VIII is crucial for proper blood coagulation.
    • Severity classifications:
      • Severe: < 1% normal factor activity; spontaneous joint and muscle bleeding occurs.
      • Moderate: 1-5% normal factor activity; bleeding from minor trauma and postoperative.
      • Mild: 5-40% normal factor activity; bleeding occurs post-operatively or after mild trauma, no spontaneous bleeding.

    Hemophilia B

    • Caused by mutations in the F9 gene, resulting in insufficient levels of coagulation Factor IX.
    • Also characterized by X-linked recessive inheritance.

    Variable Expressivity

    • Refers to the varying expression of disease symptoms among affected individuals, demonstrating different levels of severity.

    Laboratory Findings

    • Initial lab findings for both Hemophilia A and B include:
      • Prolonged activated partial thromboplastin time (APTT).
      • Normal prothrombin time (PT), bleeding time, and fibrinogen levels.
    • APTT is part of the intrinsic pathway of the coagulation cascade.

    Genetic Transmission

    • Hemophilia is not inherited from father to son because males transmit only Y chromosomes to male offspring.
    • Commonly affected joints in severe hemophilia include knees, ankles, and elbows.

    De Novo Mutations

    • Alterations that occur for the first time in a family member, not inherited.
    • Key for understanding unique cases of hemophilia.

    Screening and Monitoring

    • APTT is most sensitive for detecting moderate to severe hemophilia.
    • APTT is also useful for monitoring heparin therapy and detecting clotting inhibitors.
    • Prothrombin time (PT) measures the extrinsic pathway, useful for liver function and monitoring long-term anticoagulant therapy.

    Testing and Counseling

    • Essential screenings for bleeding disorders include APTT, PT, bleeding time, and platelet count.
    • Specific coagulation factors are assessed based on initial screening results.

    Management & Treatment

    • Treatments to increase levels of factors VIII and IX include:
      • Hormonal treatments (estrogens, oral contraceptives).
      • Epinephrine and desmopressin acetate, the latter enhancing factor VIII levels.
      • Vigorous exercise can aid in management.

    Platelet Function Testing

    • Bleeding time is the best screening test for platelet function disorders, prolonged in von Willebrand's disease and qualitative platelet disorders.

    Mutation Types in Hemophilia

    • Mild to moderate disease often linked to point or missense mutations.
    • Severe disease typically associated with deletion mutations that respond poorly to therapy.
    • Males with hemophilia pass the mutation to all daughters but none of their sons.

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    Description

    Explore key concepts and definitions related to Hemophilia in this comprehensive flashcard quiz. Understand the coagulation cascade, mutations involved in Hemophilia A and B, and their inheritance patterns. Perfect for studying or reinforcing knowledge on this important topic.

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