Acquired Bleeding Disorders: Learning Objectives

Medical Importance

Patients with a wide variety of inherited and acquired bleeding disorders are encountered in nearly all subspecialties of medicine. Most of these disorders can now be identified with appropriate laboratory testing. Screening tests can rapidly distinguish platelet function defects, coagulation disorders and forms of excessive (systemic) fibrinolysis. Assays are also available for most of the components in these pathways, allowing identification of the specific defect in hemostasis. In many cases, the pathogenesis is now understood on a molecular level. With inherited hemorrhagic disorders, accurate diagnosis and understanding of the inheritance is necessary for genetic counseling and identification of family members at risk. Finally, specific therapy is now available for both prophylaxis and treatment of bleeding due to several of these disorders. 

Objectives

1. Be able to briefly describe the pathogenesis, diagnostic tests, and therapeutic approach to patients with the following acquired disorders who are actively bleeding:
• end stage liver disease
• acquired factor VIII inhibitor (auto‑antibody against FVIII)
• severe DIC due to acute promyelocytic leukemia
• vitamin K deficiency