Haemorrhagic Disorders

• What is the purpose of administering alteplase in a patient?

  To break up the clot and restore blood supply
• What percentage of people recover to independence after thrombolysis?

  33%
• What is the risk of bleeding associated with thrombolysis?

  8% experience bleeding, 2% fatal
• What precautions should be taken for a child with a history of bleeding before tonsillectomy?

  Assess bleeding risk and treatment needs
• What are the key questions to ask regarding bleeding disorders?

  Is there a bleeding problem? Where is the defect?
• What factors should be considered in a bleeding history?

  • Onset of bleeding
  • Pattern and duration of bleeding
  • Severity of episodes
  • Treatments required
  • Symptoms of anemia
  • Previous blood transfusions
  • Medication history
  • Family history of bleeding
• What is primary haemostasis?

  Platelet plug formation
• What is secondary haemostasis?

  Activation of coagulation factors to form fibrin clot
• What are the types of skin bleeding mentioned?

  Purpura, petechiae, ecchymoses
• What are common types of mucosal bleeding?

  Epistaxis, blood blisters, gum bleeding
• What should be included in a physical examination for bleeding disorders?

  • Skin bleeding assessment
  • Signs of anemia
  • Joint examination
  • Lymph node, spleen, and liver examination
• How do disorders of primary and secondary haemostasis differ in terms of bleeding timing?

  • Primary: Immediate bleeding
  • Secondary: Delayed bleeding
• What screening tests are used for hemostasis?

  FBC, PT, APTT, bleeding time
• What are the types of platelet disorders?

  Quantitative and qualitative disorders
• What is thrombocytopenia?

  Decreased platelet count
• What are typical bleeding symptoms of quantitative platelet disorders?

  Skin purpura, mucocutaneous bleeding
• What is Idiopathic Thrombocytopenic Purpura (ITP)?

  Autoimmune disorder causing low platelets
• What lab results are typical in ITP?

  Platelets <100 x 10$^9$/l, normal Hb and WBC
• What is the treatment for ITP?

  Exclude causes and manage symptoms
• What are qualitative platelet disorders?

  • Adequate platelet count
  • Abnormal platelet function
  • Inherited and acquired types
• What is the pathogenesis of secondary haemostasis disorders?

  Decreased factor production and consumption
• What are the common symptoms of coagulation factor disorders?

  Lifelong bleeding tendency and joint bleeding
• What is the genetic cause of Haemophilia A and B?

  Genetic variant in factor 8 or 9
• What is the typical clinical presentation of Haemophilia?

  Spontaneous bleeding into muscles or joints
• What is the treatment for Haemophilia?

  Replacement therapy of deficient clotting factor
• What is the inheritance pattern of von Willebrand disease?

  Autosomal dominant inheritance
• What is von Willebrand disease (VWD)?

  Common inherited bleeding disorder
• What is the summary of bleeding disorders?

  • Abnormalities in blood vessels, platelets, factors
  • Disorders can be acquired or inherited
  • Clinical history guides laboratory investigations
  • Normal FBC and coagulation screens may require further tests
• What are the delays in diagnosis for women with VWD?

  16-year delay from symptom onset to diagnosis
• Who are the authors of the references provided?

  Rydz N, James PD, Lavin et al.
• What is the significance of the references listed?

  They provide guidelines and insights on bleeding disorders