Major Haemorrhage MCQs

A patient with 25% red blood cells in their blood is likely to experience light-headedness due to insufficient oxygen reaching the brain.

A major hemorrhage is characterized by a rapid loss of blood volume, typically more than 50% of the total blood volume within 2 hours.

A heart rate above 110 bpm and a systolic blood pressure below 90 mmHg are clinical indicators of a major hemorrhage.

The body responds to blood loss by activating baroreceptors which are located in the aortic arch and carotid arteries. These receptors signal the brain to initiate physiological responses like vasoconstriction and increased heart rate.

The intrinsic pathway of the clotting cascade is activated by direct damage to blood vessels. This triggers the coagulation cascade, leading to the formation of a fibrin clot.

Major hemorrhage triggers the sympathetic nervous system to increase heart rate and contractility and constrict blood vessels. This helps maintain blood pressure despite blood loss.

Major hemorrhage results in decreased cardiac output and increased systemic vascular resistance. This is due to the body's attempt to maintain blood pressure by constricting blood vessels and reducing blood flow.

Baroreceptors are located primarily in the aortic arch and carotid arteries, which are major blood vessels involved in blood pressure regulation.

The Extrinsic pathway is activated by damaged blood vessels. This triggers the coagulation cascade, leading to the formation of a blood clot.

Thrombin is a key enzyme in the clotting cascade. It converts fibrinogen into fibrin, which forms the meshwork of a blood clot. Without thrombin, this process cannot occur.

Citrate is an anticoagulant used in blood transfusions. It binds to calcium, which is essential for the clotting cascade. This prevents the formation of clots.

Major hemorrhage can lead to a rapid depletion of clotting factors, leading to a coagulopathy (a clotting disorder).

During a major hemorrhage, enzymes that promote blood clotting are rapidly used up. The body needs to use these enzymes to control bleeding.

Tranexamic acid is a medication used to inhibit the breakdown of blood clots. It should be administered within the first 3 hours to maximize its effectiveness in preventing further blood loss.

When oxygen is lost due to a major hemorrhage, the body switches to anaerobic respiration, producing lactic acid. This can lead to metabolic acidosis.

A major change in blood pH can affect enzyme function, potentially leading to organ dysfunction. This can also cause cardiac arrhythmias.

A condition where a patient loses a significant amount of blood, often rapidly.

The rapid loss of blood volume causes the body to compensate by increasing the heart rate to push more blood out, leading to a faster heartbeat.

Low blood pressure is a sign of major hemorrhage, as the body struggles to maintain adequate blood volume.

This helps to maintain oxygen levels and prevent tissue damage.

A type of surgery used to quickly stabilize patients with life-threatening injuries, often including severe bleeding.

This prevents further clotting, and is not indicated in major hemorrhages, where we want to promote clotting.

This is a way to measure how quickly blood is flowing through the capillaries. A longer time indicates a slower flow, which is a sign of poor circulation.

The oxygen-carrying red blood cells decrease, impacting oxygen delivery to the brain, leading to a feeling of lightheadedness.

A rapid sequence induction and intubation (mechanical ventilation) is urgently needed in major haemorrhage situations because rapid blood loss leads to a decrease in oxygen-rich blood, impacting respiratory function.

Hartmann's Solution or 0.9% NaCl is the preferred fluid replacement for active bleeding in the hospital setting, aiming to restore lost fluid volume.

Tranexamic Acid (TXA) IV is administered to help prevent excessive clotting during active bleeding, not to prevent clotting itself.

The lethal triad consists of: ACIDOSIS, COAGULOPATHY, and HYPOTHERMIA. It's a dangerous combination that can lead to death.

The priority of treatment in the lethal triad is early prevention of blood loss, as it's the primary driver of the triad's elements.

In the absence of group-specific blood, A Negative Red Blood Cells can be used as a safe alternative.

One pooled unit of Cryoprecipitate contains a higher concentration of fibrinogen compared to two units of Fresh Frozen Plasma (FFP).

Platelets must be the same blood group as the patient to ensure compatibility and prevent complications.

Peripheral vasoconstriction restricts blood flow to extremities, preventing oxygenated blood and clotting factors from reaching the injured area.

In major hemorrhage, fluid replacement aims to maintain adequate circulation and blood pressure, but excessive fluids can worsen bleeding.

The lethal triad in major hemorrhage refers to the combination of coagulopathy (clotting problems), metabolic acidosis (acid buildup), and hypothermia (low body temperature).

Cryoprecipitate is derived from fresh frozen plasma (FFP) and contains a concentrated amount of fibrinogen, a key clotting factor.

During massive transfusion, calcium is administered to counteract the effects of citrate, a component of stored blood products, which interferes with blood clotting.

The ODP's role in major hemorrhage includes managing blood products, warming the patient to maintain normothermia, and assisting with blood gas analysis to monitor the patient's condition.

Low calcium levels (hypocalcaemia) can weaken the heart muscle, leading to decreased contractility and potential heart failure.

During major hemorrhage, the main goal of treatment is to address the 'lethal triad' – coagulopathy, metabolic acidosis, and hypothermia – to prevent further complications and improve survival chances.