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Clotting Disorders

QuestionAnswer
Thrombocytopenia Low platelets (<150k). Sx: petechiae (<50k), spontaneous bleeding (<20k), fatal hemorrhage (<5k).
Clotting Cascade Sequence: injury, platelet plug, coagulation factors, fibrin mesh. Vitamin K essential.
Hemophilia A Patho Deficiency in Factor VIII. X-linked. Causes delayed bleeding, hemarthrosis, deep tissue bleeds.
Hemophilia B Patho Deficiency in Factor IX (Christmas disease). X-linked. Similar presentation to Hemophilia A.
Hemophilia Labs Prolonged aPTT, normal PT, normal platelets. Specific factor assays confirm.
Hemophilia Treatment Replace missing factor (VIII or IX). Desmopressin, cryoprecipitate, aminocaproic acid.
Hemophilia Nursing Prophylactic factor therapy, avoid trauma/contact sports, RICE for joints, monitor for compartment syndrome.
ITP Patho Autoimmune destruction of platelets. Leads to isolated thrombocytopenia, mucosal bleeding.
ITP Labs Isolated low platelet count. Large immature platelets on smear. Bone marrow biopsy shows normal/increased megakaryocytes.
ITP Treatment First-line: steroids. Then IVIG, thrombopoietin agonists (eltrombopag), splenectomy if chronic.
ITP Nursing Educate on steroid side effects, avoid NSAIDs/aspirin, neutropenic/bleeding precautions.
DIC Patho Systemic activation of clotting & fibrinolysis. Leads to microclots, factor depletion, then hemorrhage.
DIC Causes Sepsis, trauma, cancer, obstetric complications (placental abruption).
DIC Early Signs Cyanosis, dyspnea, ↓urine output, confusion, headache.
DIC Late Signs Petechiae, ecchymosis, bleeding from orifices, ARDS, PE, multi-organ failure.
DIC Labs ↑D-dimer, ↓fibrinogen, ↑PT/PTT/INR, ↓platelets.
DIC Treatment Treat underlying cause. Replace factors (FFP, cryoprecipitate), platelets, heparin, antifibrinolytics.
Factor VIII Meds Factor VIII concentrate, Desmopressin (stimulates release), Cryoprecipitate.
Factor IX Meds Factor IX concentrate, Factor VIIa (if inhibitor present).
Aminocaproic Acid Antifibrinolytic. Used in hemophilia & ITP to stabilize clots by inhibiting plasmin.
Created by: Wasurenboh
 

 



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