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Questions and Answers
Which of the following are examples of hereditary coagulation disorders?
Which of the following are examples of hereditary coagulation disorders?
What does DIC stand for?
What does DIC stand for?
Disseminated Intravascular Coagulation
Is DIC a disease entity?
Is DIC a disease entity?
False
What typically represents the most common sign of DIC?
What typically represents the most common sign of DIC?
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Vitamin K deficiency can lead to which of the following symptoms? (Select all that apply)
Vitamin K deficiency can lead to which of the following symptoms? (Select all that apply)
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Vitamin K is essential for the post-translational modification of factors II, VII, IX, and _____ and proteins C and S.
Vitamin K is essential for the post-translational modification of factors II, VII, IX, and _____ and proteins C and S.
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What is the primary consequence of severe liver disease on coagulation?
What is the primary consequence of severe liver disease on coagulation?
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Which clinical features are associated with acute DIC? (Select all that apply)
Which clinical features are associated with acute DIC? (Select all that apply)
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What is the abbreviation for the substances that can inhibit vitamin K?
What is the abbreviation for the substances that can inhibit vitamin K?
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Bleeding related to renal disease is typically severe.
Bleeding related to renal disease is typically severe.
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Match the following conditions with their related features:
Match the following conditions with their related features:
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Study Notes
Acquired Coagulation Disorders
- Acquired coagulation disorders can manifest as bleeding disorders secondary to other conditions.
- Disseminated Intravascular Coagulation (DIC) is a critical acquired bleeding disorder characterized by both clotting and hemorrhage.
Pathophysiology of DIC
- DIC often arises from the release of tissue factor (TF) into the bloodstream due to tissue damage or inflammation.
- Activated coagulation cascades lead to both thrombus formation and simultaneous depletion of clotting factors, causing bleeding.
Clinical Features of DIC
- Symptoms can be acute, presenting with rapid onset bleeding from multiple sites.
- Chronic DIC may develop over months, often asymptomatic until it worsens.
Signs and Symptoms of DIC
- Common signs include ecchymosis, petechiae, and purpura.
- Severe manifestations may involve dyspnea, chest pain, and hematuria.
Laboratory Findings in DIC
- Decreased platelet count and clotting factors.
- Prolonged prothrombin time (PT), activated partial thromboplastin time (aPTT), and thrombin time.
- Increased D-dimer and fibrin degradation products indicate ongoing coagulation and fibrinolysis.
Vitamin K Importance
- Vitamin K is essential for synthesizing coagulation factors II, VII, IX, and X, as well as proteins C and S.
- Fat-soluble vitamin K is obtained from dietary sources and synthesized by gut microbiota.
Hemorrhagic Disease of the Newborn (HDN)
- Vitamin K deficiency in infants can lead to HDN, causing intracranial bleeding and gastrointestinal hemorrhage.
- Early HDN arises from maternal ingestion of drugs that interfere with vitamin K metabolism.
- Classic HDN forms when prophylactic vitamin K is not administered at birth.
Symptoms of Vitamin K Deficiency
- Symptoms include easy bruising, nosebleeds, gum bleeding, and heavy menstrual cycles.
- In infants, severe deficiency risk includes intracranial hemorrhages.
Severe Liver Disease and Coagulation
- Severe liver disease compromises the synthesis of many coagulation factors, leading to bleeding risk.
- Liver diseases may not always show significant bleeding on standard coagulation tests, masking true hemostatic status.
Renal Disease and Bleeding Risk
- Chronic renal failure can lead to platelet dysfunction and increased bleeding risk.
- Nephrotic syndrome may result in the loss of clotting and regulatory proteins through urine, raising thrombosis risk.
First-line Tests for Acute Hemostatic Failure
- Specific tests are essential for investigating the underlying cause of acute bleeding conditions in patients presenting with hemostatic failure.
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