Key facts and checkpoints

• Purpura = petechiae + ecchymoses.

• Abnormal bleeding is basically the result of disorders of (1) the platelet, (2) the coagulation mechanism, or (3) the blood vessel.

• There is no substitute for a good history in the assessment of patients with bleeding disorders.

• An assessment of the personal and family histories is the first step in the identification of a bleeding disorder.

• When a patient complains of 'bruising easily' it is important to exclude thrombocytopenia due to bone marrow disease and clotting factor deficiencies such as haemophilia.

• The commonest cause of an acquired bleeding disorder is drug therapy, e.g. aspirin, NSAIDs, cytotoxics and oral anticoagulants.

• In general, bleeding secondary to platelet defects is spontaneous, associated with a petechial rash and occurs immediately after trauma or a cut wound. 1

• Laboratory assessment should be guided by the clinical impression.

• Bleeding caused by coagulation factor deficiency is usually traumatic and delayed, e.g. haemorrhage occurring 24 hours after a dental extraction in a haemophiliac.

• The routine screening tests for the investigation of patients with bleeding disorders can be normal despite the presence of a severe haemorrhagic state.

petechias ecchymosig purpura

Fig. 35.1 Purpuric rash (petechiae and ecchymoses)

Was this article helpful?

0 0
Dealing With Back Pain

Dealing With Back Pain

Deal With Your Pain, Lead A Wonderful Life An Live Like A 'Normal' Person. Before I really start telling you anything about me or finding out anything about you, I want you to know that I sympathize with you. Not only is it one of the most painful experiences to have backpain. Not only is it the number one excuse for employees not coming into work. But perhaps just as significantly, it is something that I suffered from for years.

Get My Free Ebook

Post a comment