To prepare for operating on a patient with a bleeding

Discussion in 'MRCS Forum' started by Lona., Dec 9, 2007.

  1. Lona.

    Lona. Guest

    To prepare for operating on a patient with a bleeding history diagnosed as von Willebrand’s disease (recessive), you would give -
    a- High-purity factor VIII:C concentrates
    b- Low-molecular-weight dextran
    c- Fresh frozen plasma (FFP)
    d- Cryoprecipitate
    e- Whole blood
  2. Lona.

    Lona. Guest

    Answer: d. (Schwartz, 7/e, pp 78-84) von Willebrand disease is similar to true hemophilia in frequently of occurrence. It is being diagnosed more commonly today because of more reliable assays for factor VIII. This autosomal dominant disorder (recessive transmission can occur) is characterized by a diminution in factor VIII:C (procoagulant) activity. The reduction in activity is not as great as in classic hemophilia, and the clinical manifestations are more subtle. These manifestations are often overlooked until an episode of trauma or surgery makes them apparent. Treatment requires correcting the bleeding time and providing factor VIII R:WF (the von Willbrand factor). Only cryoprecipitate is reliably effective. High-purity factor VIII:C concentrates, effective in hemophilia, lack the von Willbrand factor and are consequently underdependable.

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