3 Bleeding Disorders

Types of bleeding disorders

1) Platelet disorders, 2) Coagulation factor deficiencies, 3) Vascular disorders

Thrombocytopenia

Low platelet count in the blood

Causes of thrombocytopenia

Decrease platelet production/survival, increased sequestration of platelets in spleen

Drug-induced thrombocytopenia

Type of thrombocytopenia caused by medications

Impaired platelet function

Bleeding in small vessels, characterized by petechiae and purpura

Bleeding sites in platelet disorders

Mucous membranes, commonly occurs in small vessels

Petechiae

Pinpoint purplish-red spots; seen almost exclusively in conditions of platelet deficiency

Purpura

Purple areas of bruising

Impaired platelet function causes

Inherited/acquired, drugs, disease, surgery, uremia

Von Willebrand disease (platelet disorder)

Von Willebrand factor needed to promote platelet adhesion; deficiency impairs platelet function

Uremia

Kidneys fail to filter waste products from the blood adequately

Bleeding from clotting factor deficiency

Typically occurs after injury or trauma; presents with large bruises, hematomas, and prolonged bleeding

Common bleeding sites in coagulation deficiencies

GI/urinary tract, and joints

Von Willebrand Disease types

Type 1 - partial deficiency (70% of cases), Type 2 - defective (25%), Type 3 absence/low level(autosomal recessive, rare and most severe)

Von Willebrand Disease defect

Defect in platelet function and coagulation

Von Willebrand Disease symptoms

Spontaneous bleeding, excessive menstrual flow, prolonged bleeding times

Hemophilia A

X-linked recessive disorder primarily affecting males; Factor VIII deficiency or defect

Hemophilia A mild to moderate

Bleeding due to lesion or trauma

Hemophilia A severe

Spontaneous and severe bleeding in GI tract, joints, soft tissues

Hemophilia A treatment

Avoid medications that cause bleeding; Factor VIII replacement

Antihemophilic factor - Why

Prevents blood loss from injury, surgery or to treat disorder

Antihemophilic factor - MOA

Replaces blood clotting factors that are genetically missing or low

Antihemophilic factor - ADE

Headache, flushing, chills, lethargy, NV, site reaction

Antihemophilic factor - CI

Allergy, factor IX with liver disease, lactation

Liver disease and coagulation

Liver responsible for production of many clotting factors, disease impairs coagulation

Vitamin K and coagulation

Needed to produce many clotting factors; deficiency may lead to clotting abnormalities

Vitamin K deficiency risk groups

Newborns (lack of established intestinal flora, given vitamin K injection at birth), impaired fat absorption, gallbladder disease