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Bleeding Disorders (Disseminated Intravascular Coagulation (Aetiology…
Bleeding Disorders
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Haemophilia A
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Treatment
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In minor bleeding, put pressure and elevate site
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Von Willebrand's Disease
Functions of vWF
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To bind factor VIII, protecting it from destruction in the circulation
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Types
Type 1: 60-80%, low levels of vWF, autosomal dominant, mucosal bleeding, prolonged bleeding after dental surgery
Type 2: 20-30%, abnormal vWF, autosomal dominant
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Type 3: 1-5%, undetectable vWF levels, autosomal recessive, low factor VIII, severe bleeding
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Bleeding Physiology
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Vascular and platelet disorders lead to prolonged bleeding from cuts, bleeding into the skin and bleeding from mucous membranes
After injury, there are three processes that halt bleeding: vasoconstriction, gap-plugging by platelets and coagulation cascade
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Definitions
Activated Partial Thromboplastin Time = Tests the intrinsic system of coagulation. Tests for abnormalities in factors I, II, V, VIII, IX, X, XI, XII
Thrombin Time = Thrombin is added to plasma to convert fibrinogen to fibrin. Thrombin time is the time taken for blood to form a clot in plasma of a blood sample containing an anticoagulant and an excess of thrombin
Prothrombin Time = Measures how long it takes for blood to clot. Expressed as INR (international normalized ratio). Tests for abnormalities in factor I, II, V, VII, X
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Over-Anticoagulation
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Major bleeding: intracranial, intraperitoneal, intraocular, muscular compartment syndrome
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Vitamin K Deficiency
Deficiency is caused by malnutrition, malabsorption and warfarin (warfarin is a vitamin K synthesis inhibitor)
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Vitamin K is needed for formation of factors II, VII, IX and C
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