Questions and Answers
What distinguishes acute haemorrhage from chronic haemorrhage?
Acute haemorrhage involves a rapid loss of blood and can lead to hypovolaemic shock, while chronic haemorrhage occurs over a prolonged period and may cause anaemia.
Identify two common causes of surgical haemorrhage.
Two common causes of surgical haemorrhage are surgical trauma and gastrointestinal bleeding.
Explain the physiologic response to haemorrhage aimed at maintaining circulatory volume.
The physiological response involves prioritizing blood flow to vital organs like the heart and brain while reducing perfusion to less critical areas.
What is the role of vasoconstriction in stopping bleeding?
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Differentiate between primary and secondary haemorrhage.
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What are two major risks associated with untreated chronic haemorrhage?
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What are the three types of haemorrhage based on the bleeding vessel?
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Define primary haemorrhage and when it occurs.
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Describe how chronic peptic ulcers contribute to chronic haemorrhage.
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What is the significance of coagulation abnormalities in non-surgical haemorrhage?
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What distinguishes secondary haemorrhage from other types?
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How does reactionary haemorrhage differ from primary haemorrhage?
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Explain the difference between revealed and concealed haemorrhage.
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What complications can arise from a secondary haemorrhage after surgery?
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Identify two aetiological factors that could contribute to haemorrhagic diathesis.
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What type of bleeding characterizes venous haemorrhage?
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What is the main difference between primary and secondary haemorrhage?
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How is acute haemorrhage classified based on blood volume loss?
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What clinical signs indicate tachycardia due to blood loss?
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What role does hypothermia play in the context of haemorrhage?
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What is the significance of capillary refill time in assessing blood loss?
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How does the type of injury affect the estimation of blood loss?
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What is oliguria, and how is it related to renal perfusion in haemorrhage?
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Explain how compensatory mechanisms maintain blood pressure during mild blood loss.
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Study Notes
Types of Hemorrhage
- Concealed hemorrhage occurs internally and is invisible, affecting body cavities (e.g., haemoperitoneum, haemothorax) or interstitial tissues (e.g., around fractures).
- Revealed hemorrhage is external and visible, occurring via skin wounds or body orifices (e.g., epistaxis, haematemesis).
Acute vs. Chronic Hemorrhage
- Acute hemorrhage involves a significant loss of blood in a short time, leading to hypovolaemic shock; common causes include trauma and gastrointestinal bleeding.
- Chronic hemorrhage is slower blood loss that, if untreated, causes anemia; typical sources include chronic peptic ulcers and malignancies.
Surgical vs. Non-Surgical Hemorrhage
- Surgical hemorrhage can be managed through surgical operations or non-surgical methods like angioembolization.
- Non-surgical hemorrhage arises from coagulopathy and requires correction of coagulation issues rather than direct intervention.
Physiologic Response to Hemorrhage
- Two goals: stop bleeding and maintain circulatory volume for vital organs (heart, brain) at the expense of less critical tissues (skin, muscles).
- Mechanisms to stop bleeding include vasoconstriction, platelet plug formation, and activation of coagulation pathways.
Signs of Hemorrhage
- Pale appearance and tiredness; cold, clammy extremities; collapsed veins; slow capillary refill time.
- Mental status may vary; pulse and blood pressure can remain normal with mild loss (<500 ml) but tachycardia occurs with more significant loss.
- Progressive blood loss leads to hypotension and thready pulse, with further symptoms including tachypnea, air hunger, and hypothermia.
- Oliguria results from reduced renal perfusion.
Classification of Blood Loss
- Adult blood volume averages 5 liters, classified as:
- Class 1: <15% blood volume lost
- Class 2: 15-30% blood volume lost
- Class 3: 30-40% blood volume lost
- Class 4: >40% blood volume lost
- Estimation of blood loss relies on clinical presentation and injury type.
Types of Hemorrhage Based on Blood Vessel
- Arterial hemorrhage presents as bright red jets correlated with pulse.
- Venous hemorrhage shows dark red steady flow, potentially severe if large veins are involved.
- Capillary hemorrhage appears as bright red ooze from a broad area.
Timing of Hemorrhage
- Primary hemorrhage occurs at injury or surgery.
- Reactionary hemorrhage arises within 24 hours, often due to slippage of ligature or clot dislodgment.
- Secondary hemorrhage occurs 7-14 days post-trauma or surgery, often caused by infections or necrosis, which can be life-threatening if it involves large vessels.
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Description
Explore the various types of hemorrhage, including concealed and revealed varieties, as well as acute and chronic hemorrhages. Understand the differences between surgical and non-surgical management strategies and the physiological responses to blood loss. This quiz will test your knowledge on critical concepts related to hemorrhage treatment.