Hematology and Oncology Book

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Bleeding Disorder

Aka: Bleeding Disorder, Bleeding Diathesis
  1. See Also
    1. Clotting Pathway
  2. Causes
    1. Coagulation Disorder
      1. See Coagulation Bleeding Disorders
      2. See Coagulopathy in Pregnancy
    2. Platelet Disorders
      1. See Platelet Bleeding Disorders
      2. See Thrombocytopenia
      3. See Drug Induced Platelet Dysfunction
    3. Vascular Disorders
      1. See Blood Vessel Wall Bleeding Disorders
  3. Signs: Abnormal Bleeding (multiple sites)
    1. Nasopharynx
      1. Epistaxis
      2. Bleeding gums
    2. Gastrointestinal
      1. Hematemesis
      2. Melana
    3. Gynecologic
      1. Menorrhagia
      2. Postpartum Hemorrhage
    4. Musculoskeletal
      1. Muscle hematomas
      2. Hemarthrosis
    5. Skin
      1. Purpura
      2. Petechiae
    6. Trauma
      1. Excessive bleeding from minor wounds
      2. Excessive bleeding following surgery or dental procedures
      3. Intracerebral bleeding event
  4. Labs: Initial
    1. Complete Blood Count with platelets
    2. Peripheral blood smear
    3. ProTime (PT) with INR
    4. Partial Thromboplastin Time (PTT)
  5. Labs: Based on initial testing
    1. Normal PT, PTT, and Platelet Count/morphology
      1. Obtain Platelet Function Closure Time (PFCT, Platelet Function Analyzer-100)
      2. PFCT Aggregation occurs with collagen/Epinephrine membrane only
        1. Drug Induced Platelet Dysfunction
      3. PFCT Aggregation occurs with both membranes (Epinephrine and ADP)
        1. Von Willebrand's Disease
    2. Partial Thromboblastin Time (PTT) abnormality
      1. PTT corrects with a PTT Mixing Study (mixed with normal blood)
        1. Obtain Factor VIII, Factor IX, and Factor XI assays
        2. Consider Von Willebrand's testing if low Factor VIII
      2. PTT does not correct with a PTT Mixing Study (mixed with normal blood)
        1. Obtain Lupus Anticoagulant
        2. Obtain Factor VIII Inhibitor
    3. ProTime (PT) or INR abnormal
      1. PT/INR corrects with Vitamin K Supplementation
        1. Replace Vitamin K as needed
        2. Assess for malnutrition and malabsorption causes of Vitamin K Deficiency
      2. PT/INR does not correct with Vitamin K Supplementation
        1. Obtain Factor VII assay
    4. ProTime (PT/INR) and Partial Thromboplastin Time Abnormal
      1. Comorbid advanced liver disease
      2. Disseminated Intravascular Coagulation (DIC)
      3. Anticoagulant use (Warfarin or Heparin)
    5. Platelet abnormality
      1. See Platelet Bleeding Disorders
      2. See Drug Induced Platelet Dysfunction
      3. See Thrombocytopenia
  6. References
    1. Allen (2002) Pediatr Clin North Am 49: 1239-56
    2. Ballas (2008) Am Fam Physician 77:1117-24

Bleeding tendency (C1458140)

Definition (MEDLINEPLUS)

Normally, if you get hurt, your body forms a blood clot to stop the bleeding. For blood to clot, your body needs cells called platelets and proteins known as clotting factors. If you have a bleeding disorder, you either do not have enough platelets or clotting factors or they don't work the way they should.

Bleeding disorders can be the result of other diseases, such as severe liver disease. They can also be inherited. Hemophilia is an inherited bleeding disorder. Bleeding disorders can also be a side effect of medicines.
Concepts Pathologic Function (T046)
SnomedCT 123329004, 78596001, 64779008, 248250000, 267562007
English BLEEDING DISORDER, BLEEDING TENDENCY, Bleeding diathesis (disorder), Bleeding Disorders, Bleeding tendencies, BLEEDING DIATHESIS, Bleeding diathesis, Bleeding disorder, Tendency to bleed, Tendency to bleed (observable entity), bleeding tendency, bleeding; diathesis, diathesis; bleeding, Bleeding disorders, Bleeding diathesis -RETIRED-, Bleeding tendency, Disability due to bleed disord, bleeding disorder
Italian Predisposizioni al sanguinamento, Predisposizione al sanguinamento
Dutch bloedingsneiging, diathese; hemorrhagie, hemorrhagie; diathese, bloedingsneigingen
French Syndrome hémorragique, Syndromes hémorragiques
German Blutungsneigung, Blutungsneigungen
Portuguese Tendência hemorrágica, Tendências hemorrágicas
Spanish Diátesis hemorrágica, diátesis hemorrágica (concepto no activo), diátesis hemorrágica - RETIRADO - (concepto no activo), diátesis hemorrágica - RETIRADO -, diátesis hemorrágica, tendencia al sangrado (entidad observable), tendencia al sangrado, tendencia hemorrágica, trastorno hemorrágico, Diátesis hemorrágicas
Japanese 出血傾向, ｼｭｯｹﾂｹｲｺｳ
Czech Krvácivé stavy, Krvácivý stav
Hungarian Vérzéshajlamok, vérzéses tendencia
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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