Patient Information: First Name: Vanessa Last name: Vanderbilt Date of Birth: 01
ID: 127218 • Letter: P
Question
Patient Information:
First Name: Vanessa
Last name: Vanderbilt
Date of Birth: 01/29/2003
Gender: Female
Ethnicity: British
Patient History:
Bruises easily
Gums bleed when brushing teeth
Nosebleeds – occurring often and for prolonged lengths of time
Blood in urine and stool sample from last visit
Anemic
Family History:
Mother anemic
Brother presents with same symptoms above
Misdiagnosed last year with hemophilia
Father bruises easily as well and is anemic
Symptoms Today:
Excessive Menstruation
Excessive Cramping
Fatigue
Shortness of breath
Patient Information:
First Name: Brittney
Last name: Fletcher
Date of Birth: 10/13/2006
Gender: Female
Ethnicity: Irish
Patient History:
Bruises easily
Heavy menstruation paired with extensive cramping
Excessive fatigue since menstruation began
Anemic (low blood cell count)
Blood present in both urine and stool
Recurrent nosebleeds
Family History:
Mother diagnosed with heart disease
Complications with bleeding times during surgery reported
Sister presents with same symptoms above
Misdiagnosed last year with thrombocytopenia
Father is anemic
Symptoms Today:
Laceration on forearm from falling out of tree house
Bleeding persisted for prolonged period of time
Directions: Based on the information in your case study you must diagnose the patients and research the answers to the questions below. Clarification – the symptoms on the case studies are just that, symptoms. They are not the diagnosis. If the case study lists sarcoma as a symptom, sarcoma is not the diagnosis.
1. What is your diagnosis of these patients? Make sure to explain the disease in simple terms.
2. What key information from the patients’ file led you to believe this was the proper diagnosis?
Explanation / Answer
According to the given case file of the two patients, the diagnosis of their symptoms is bleeding disorders.
The patients show all the symptoms of bleeding disorders.
Definition: The condition which impacts the clotting ability of the blood is known as bleeding disorder. The process of blood clotting is also known as coagulation.
The body has an ability to clot the blood naturally in case of any injury; this is a natural process to prevent the blood loss.
But when the body lack this ability due to some abnormal conditions, it leads to bleeding disorders.
The bleeding can be internal and external and in case of internal bleeding (as it is not visible until diagnosed) can lead to massive blood loos. External bleeding shows signs of massive abnormal blood loss from the body.
In both the cases, proper diagnosis and treatment is necessary, if not it can lead to fatal conditions.
Causes of bleeding disorders:
If the blood lacks clotting factors (proteins) and blood cells known as platelets, then the process of clotting is inhibited. In case of injury the blood cells (platelets) combine and form a layer on the injured area, then the clotting proteins come together to form a fibrin clot. This forms the sheath over the injury and prevents the blood from over flowing.
This process is inhibited if:
There is low red blood cell count.
There is a deficiency in vitamin k
Infections or side effects caused due to any medications.
Bleeding disorders are of different types based on the type of origin, some maybe inherited and some maybe be acquired. The types of bleeding disorders are many but the most commonly occurred ones are mentioned here:
Hemophilia: It can be A and B types, it occurs when there are low levels of clotting factors. It can be fatal if not diagnosed and treated properly.
The other type of disorder is von Willebrand’s disease; it is an inherited disorder where the blood lacks the factor which is responsible for clotting.
Symptoms:
The basic symptoms of bleeding disorders can be
Unexplained and easy bleeding.
Excessive bleeding during menstruation.
Frequent bleeds from nose
Excessive blood loss through small injuries
Internal organs bleeding
Diagnosis and Treatment:
A proper diagnosis for any disease is very important as the further steps of action are based of the diagnosis. Apart from the noticeable symptoms, bleeding disorders can be diagnosed by:
A complete blood count (CBC) - this measures the amount of red and white blood cells count.
A platelet aggregation test- this will identify the level of platelets function in coagulating.
A bleeding time- this observes and identifies the time taken for the blood to clot.
Bleeding disorders can be treated based on the type and origin (acquired and inherited) of those. The most common treatments are provided by giving iron supplements, by blood transfusion and other interventions based on the requirement and severity. For example, nasal sprays can be prescribed to the patient having nose bleeding.
2. The symptoms and information given in the file which led to determine if the diagnosis was proper is:
Bleeding gums, nose bleeds, visibility of blood traces in urine and stool, history of anaemia (both to the patient and family- inherited), family history of similar symptoms, excessive blood loss during menstruation, and fatigue.
With these symptoms it clearly led to identify that the diagnosis is proper for bleeding disorders.