Question

A 36-year-old woman presents to her general practitioner (GP) complaining of spontaneous bruising mainly on her legs. The bruising has been noticeable over the last 4–6 weeks. She cannot remember any episodes of trauma. Her platelet count is 40*109/L (normal platelet count 150-400 *109/L).

A. What is the possible cause of her spontaneous bruising without trauma?

B. What are the factors that prevent the intravascular clotting?

Answer 1

A. The woman has thrombocytopenia which is low platelets count in the blood.

Normally platelets forms plug at the sites of endothelial blood vessels injury and this occludes the injury site there by preventing the bleeding.

B. The normal factors that prevents the intravascular clotting are

1. Intact endothelial cell (only damaged endothelial cells will expose the collagen below it causing activation of clotting)

2. Prostaglandins like prostacyclin which inhibits platelets aggregation and prevents clotting.

3. Presence of circulating heparin which prevents clotting.

4. Presence of glycocalyx on the endothelium which prevents clotting

Hope this helps... Thank you!!!