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Haemophilia A

X-linked recessive condition, deficiency of factor VIII, prevalence 1 in 10,000 Range of possible mutations, 30% of cases due to sporadic mutation Low factor VIII levels predispose to bleeding – risk proportional to factor VIII level Mild disease (11-30 units/dl) risk after significant trauma/surgery Moderate disease (2-10 units) - minor trauma  
almostadoctor.com - free medical student revision notes
over 5 years ago
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48

von Willebrand's Disease

Most common inherited bleeding disorder (asymptomatic deficiencies 1%, symptomatic disease 100 per million) von Willeband factor (vWF) important in platelet adhesion and factor VIII transport Types of vWDType 1: decreased concentration of vWF, 80%, often autosomal dominantType 2: qualitative deficiency – AD or AR inheritance  
almostadoctor.com - free medical student revision notes
over 5 years ago
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Myelofibrosis

Marrow fibrosis and splenomegaly, de novo or following transformation of PV or ET Usually >50 years old Abnormal megkaryocytes produced in increased numbers. PDGF and TGFβ are released by megakaryocytes, stimulating fibrosis. Haematopoietic stem cells move to the spleen and liver Presentation: fatigue, weight loss, splenomegaly, splenic pain, portal hypertension, bleeding varices, ascites and hepatomegaly  
almostadoctor.com - free medical student revision notes
over 5 years ago
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Post Coital Bleeding

Causes InfectionChlamydia, gonorrhoea, trichomoniasis (rarer cause) Risk factors – ask about partners (number of partners, protection, Hx of sexually transmitted infection etc) Ask about other symptoms –discharge, pain Cervical / endometrial polyps  
almostadoctor.com - free medical student revision notes
over 5 years ago
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Hormonal Implants

Implant – aka Implanon Lasts 3 years 12% will have heavier bleeding, particularly in the first 6-12 months. This can be alleviated with: Tranexamic acid – 1g/6-8h for up to 4 days – an antifibrinolytic, can reduce menorrhagia by 50%  
almostadoctor.com - free medical student revision notes
over 5 years ago
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Antepartum Haemorrhage (APH)

 
almostadoctor.com - free medical student revision notes
over 5 years ago
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40

Goodpasture’s syndrome (anti-GBM antibody disease)

  This is a rare, genetic, autoimmune condition characterised by a combination of glomerulonephritis with alveolar hemorrhage in the presence of circulating anti-glomerular basement membrane (GBM) antibodies.  Circulating anti-GBM antibodies bind to basement membranes in the kidneys and lungs, fix complement and trigger a cell-mediated inflammatory response, causing glomerulonephritis and pulmonary capillaritis.    Specific predisposing factors include the following: Association with HLA-DR2  
almostadoctor.com - free medical student revision notes
over 5 years ago
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Comparison of Intracranial Haemorrhage

Comparison of Intracranial Haemorrhage Feature  
almostadoctor.com - free medical student revision notes
over 5 years ago
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Extradural Haemorrhage

Extradural Haemorrhage aka Epidural Haemorrhage Blood collects between the dura mater and the bone of the skull. The dura is stripped away from the skull – indicating a high pressure bleed. On CT and MRI, it has a classical lentiform (lens) shaped appearance.   Pathology  
almostadoctor.com - free medical student revision notes
over 5 years ago
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Subarachnoid Haemorrhage - SAH

This is bleeding into the subarachnoid space. The classical sign is a sudden onset intense headache (“feel like I’ve been hit on the back of the head Doc”).   The bleeding occurs as the result of rupture of aneurysm (80%) and AV malformations (15%). In the remainder of cases, no cause can be identified. Trauma is also a major cause, but is not considered true SAH.    
almostadoctor.com - free medical student revision notes
over 5 years ago
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1
29

Subdural Haemorrhage

A haemorrhage between the arachnoid and dura mater. It can be acute, chronic, or acute on chronic. Most cases are chronic, and occur in the elderly after mild trauma (e.g. a fall). Usually a venous bleed.   Epidemiology and aetiology Elderly Hypertension Falls (e.g. in epilepsy and alcohol abuse) Anticoagulant therapy   Pathology Vast majority due to trauma, but sometimes can be caused by ↑ICP and brain mets.  
almostadoctor.com - free medical student revision notes
over 5 years ago
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The Red Eye

There are many causes of a red eye. Below we have outlined the commonest and most important causes. Causes of a red eye: Conjunctivitis Corneal abrasions and ulcers Acute Iritis Scleritis Acute Glaucoma (separate notes available) Subconjunctival haemorrhage   Conjunctivitis  
almostadoctor.com - free medical student revision notes
over 5 years ago
Www.bmj
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Anticoagulation in atrial fibrillation

Atrial fibrillation increases the risk of stroke, which is a leading cause of death and disability worldwide. The use of oral anticoagulation in patients with atrial fibrillation at moderate or high risk of stroke, estimated by established criteria, improves outcomes. However, to ensure that the benefits exceed the risks of bleeding, appropriate patient selection is essential. Vitamin K antagonism has been the mainstay of treatment; however, newer drugs with novel mechanisms are also available. These novel oral anticoagulants (direct thrombin inhibitors and factor Xa inhibitors) obviate many of warfarin’s shortcomings, and they have demonstrated safety and efficacy in large randomized trials of patients with non-valvular atrial fibrillation. However, the management of patients taking warfarin or novel agents remains a clinical challenge. There are several important considerations when selecting anticoagulant therapy for patients with atrial fibrillation. This review will discuss the rationale for anticoagulation in patients with atrial fibrillation; risk stratification for treatment; available agents; the appropriate implementation of these agents; and additional, specific clinical considerations for treatment.  
bmj.com
over 5 years ago
Www.bmj
1
19

Anticoagulation in atrial fibrillation

Atrial fibrillation increases the risk of stroke, which is a leading cause of death and disability worldwide. The use of oral anticoagulation in patients with atrial fibrillation at moderate or high risk of stroke, estimated by established criteria, improves outcomes. However, to ensure that the benefits exceed the risks of bleeding, appropriate patient selection is essential. Vitamin K antagonism has been the mainstay of treatment; however, newer drugs with novel mechanisms are also available. These novel oral anticoagulants (direct thrombin inhibitors and factor Xa inhibitors) obviate many of warfarin’s shortcomings, and they have demonstrated safety and efficacy in large randomized trials of patients with non-valvular atrial fibrillation. However, the management of patients taking warfarin or novel agents remains a clinical challenge. There are several important considerations when selecting anticoagulant therapy for patients with atrial fibrillation. This review will discuss the rationale for anticoagulation in patients with atrial fibrillation; risk stratification for treatment; available agents; the appropriate implementation of these agents; and additional, specific clinical considerations for treatment.  
bmj.com
over 5 years ago
Www.bmj
1
18

Anticoagulation in atrial fibrillation

Atrial fibrillation increases the risk of stroke, which is a leading cause of death and disability worldwide. The use of oral anticoagulation in patients with atrial fibrillation at moderate or high risk of stroke, estimated by established criteria, improves outcomes. However, to ensure that the benefits exceed the risks of bleeding, appropriate patient selection is essential. Vitamin K antagonism has been the mainstay of treatment; however, newer drugs with novel mechanisms are also available. These novel oral anticoagulants (direct thrombin inhibitors and factor Xa inhibitors) obviate many of warfarin’s shortcomings, and they have demonstrated safety and efficacy in large randomized trials of patients with non-valvular atrial fibrillation. However, the management of patients taking warfarin or novel agents remains a clinical challenge. There are several important considerations when selecting anticoagulant therapy for patients with atrial fibrillation. This review will discuss the rationale for anticoagulation in patients with atrial fibrillation; risk stratification for treatment; available agents; the appropriate implementation of these agents; and additional, specific clinical considerations for treatment.  
bmj.com
over 5 years ago
Www.bmj
3
131

Anticoagulation in atrial fibrillation

Atrial fibrillation increases the risk of stroke, which is a leading cause of death and disability worldwide. The use of oral anticoagulation in patients with atrial fibrillation at moderate or high risk of stroke, estimated by established criteria, improves outcomes. However, to ensure that the benefits exceed the risks of bleeding, appropriate patient selection is essential. Vitamin K antagonism has been the mainstay of treatment; however, newer drugs with novel mechanisms are also available. These novel oral anticoagulants (direct thrombin inhibitors and factor Xa inhibitors) obviate many of warfarin’s shortcomings, and they have demonstrated safety and efficacy in large randomized trials of patients with non-valvular atrial fibrillation. However, the management of patients taking warfarin or novel agents remains a clinical challenge. There are several important considerations when selecting anticoagulant therapy for patients with atrial fibrillation. This review will discuss the rationale for anticoagulation in patients with atrial fibrillation; risk stratification for treatment; available agents; the appropriate implementation of these agents; and additional, specific clinical considerations for treatment.  
bmj.com
over 5 years ago
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Epistaxis

 
almostadoctor.com - free medical student revision notes
over 5 years ago
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Carvedilol for primary prophylaxis of variceal bleeding in cirrhotic patients

Stream Carvedilol for primary prophylaxis of variceal bleeding in cirrhotic patients by BMJ talk medicine from desktop or your mobile device  
SoundCloud
over 5 years ago
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Management of subarachnoid hemorrhage with intracerebral hematoma

Stream Management of subarachnoid hemorrhage with intracerebral hematoma by BMJ talk medicine from desktop or your mobile device  
SoundCloud
over 5 years ago
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Carvedilol for primary prophylaxis of variceal bleeding in cirrhotic patients

Stream Carvedilol for primary prophylaxis of variceal bleeding in cirrhotic patients by BMJ talk medicine from desktop or your mobile device  
SoundCloud
about 5 years ago