Question 1

A patient has type 1 Von Willebrand disease (vWD). What treatment is generally effective to prevent and treat bleeding episodes in this patient?&#10;A) Coagulation factor&#10;B) Desmopressin&#10;C) Heparin&#10;D) Vitamin K

Accepted Answer

Desmopressin is effective in treating hemorrhage in patients with type 1 vWD by increasing the release of von Willebrand factor from endothelial cells. Coagulation factor replacement therapy is effective in treating bleeding episodes in severe vWD patients, while heparin and vitamin K have no role in the treatment or prevention of bleeding in vWD.

Question 2

A male patient has a history of recurrent epistaxis. Prior to a scheduled surgery, the provider asks about a family history of bleeding disorders. The patient reports no female relatives who had excessive bleeding episodes, but states that a maternal uncle and his maternal grandfather both had postsurgical complications related to bleeding. Based on this history, which diagnosis is possible?

A) Hemophilia
B) Thrombocytopenia
C) Thrombophilia
D) Von Willebrand disease

A

Accepted Answer

Hemophilia is a genetic disorder that impairs the body's ability to make blood clots, a process needed to stop bleeding. It is an X-linked recessive condition, which explains why the patient, his maternal uncle, and grandfather are affected, but no female relatives are reported to have excessive bleeding episodes. This pattern is consistent with the inheritance of hemophilia.

Question 3

A patient is noted to have prolonged bleeding after an intravenous needle is removed. A subsequent laboratory test reveals a prolonged activated partial thromboplastin (aPTT) time with a normal prothrombin time (PT). Based on this result, the provider may suspect alteration in function of which factor?

A) Factor V
B) Factor VII
C) Factor VIII
D) Factor X

C

Accepted Answer

Prolonged aPTT with normal PT indicates an alteration in the intrinsic pathway of coagulation, which involves factors XII, XI, IX, VIII, and X. Among these factors, factor VIII plays a crucial role in the intrinsic pathway, and its deficiency or dysfunction can result in prolonged aPTT. Factors V, VII, and X are primarily involved in the extrinsic pathway of coagulation, and their deficiency or dysfunction would result in prolonged PT rather than aPTT. Therefore, factor VIII is the best choice in this case.

Deck 217: Blood Coagulation Disorders