Steven had just turned 6 months old.   He had recently discovered the freedom of being mobile and was attempting to follow his 3 year old sister Heather up the stairs.  He had almost mastered crawling up the first step when he slipped and fell, hitting his mouth on the linoleum floor of the kitchen.  The screaming brought his mother running who initially thought the baby must have split his head open because of the amount of blood that was everywhere.  As she cleaned the injury, she realized that the blood was coming from the baby's mouth.  After applying cold compresses for 15 minutes, the bleeding eventually stopped.  Five minutes later, the bleeding started up again.  She decided to call the pediatrician. 

The baby had stopped bleeding by the time the mother arrived at the pediatrician's office.   During a thorough checkup of the baby, the pediatrician noticed bruises on the legs and arms.   He noted that the baby had not been circumcised.  Upon examination of the injured gum area, bleeding started again.

The pediatrician asked the mother if there was any history of bleeding disorders on the maternal side of her family.  The mother was not sure, although she thought she may have had a great uncle who died when he was young of a blood disorder.  

Instructor's Note:

Review Module 5 of the Workbook:  Hemostasis and Coagulation.  Make sure to review objective 1 and answer the following questions:

 

1.  What 3 processes are involved to stop bleeding?

 

2.  What steps are required to form a platelet plug?

 

3.  What 3 pathways are involved in coagulation?

 

4.  What activates the extrinsic pathway?

 

5.  What activates the intrinsic pathway?

 

6.  What is the end result of the clotting cascade?

 

7.  Look at the chart on page 8-8 of your workbook.  Based on the names of the clotting factors, which are deficient in Hemophilia?  Which pathway is involved?