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Bleeding Disorders - Coggle Diagram
Bleeding Disorders
Congenital Bleeding Disorders
Hemophilia A
Etiology: Factor VIII Deficiency
Rx: Desmopressin (Stimulates release of preformed VIII from endothelial cells)
Hemophilia B
Etiology: Factor IX Deficiency
Hemophilia C
Etiology: Factor XI Deficiency
Rare, only in Ashkenazi Jewish heritage
Rx: If symptomatic, plasma infusions
Dx: Prolonged PTT that corrects in mixing studies
Dx: Confirm with assay of individual actors
Von Willebrand Disease
Most common hereditary bleeding disorder
Etiology: Due to deficient or ineffective carrier protein for factor VIII
Dx: Reduced ristocetin cofactor activity
Type 1 VWF (Most common)
Rx: Desmopressin
Type 2 VWF (abnormal function)
Rx: Do NOT give desmopressin as it induces platelet aggregation
Type 3 VWF (severe deficiency)
Rx: VWF concentrates, antifibrinolytic therapy (aminocaproic acid, transexamic acid) after surgery / menorrhagia
Acquired Bleeding Disorders
Coagulopathy of Liver Disease
Order a Factor VIII to differentiate between this and DIC
Vitamin K Deficiency
Can be found in those with poor biliary or pancreatic function
Etiology: Cofactor for protein C and S
Acquired von Willebrand Disease
Etiology: High circulatory shear stress
Acquired Hemophilia
50% from pregnancy and postpartum state, malignancy, autoimmune disorder, medications
DIC
Etiology: Endothelial injury or circulating procoagulants cause disseminated microvascular thrombi
Dx: Thrombocytopenia, prolonged PT, PTT, INR, hypofibrinogenemia, D-dimer elevation
Rx: Platelet transfusion, cryoprecipitate, fresh frozen plasma.