Hello, med students. My name is Zach Olson, and thank you for downloading this special holiday episode of the EM Clerkship Podcast.

I hope you enjoyed my song last week. This week, we're doing another special holiday topic about Christmas disease.

Hemophilia B, factor nine deficiency, it's called.

Tintanalyas puts this in the chapter with the other big three bleeding disorders, factor eight deficiency, and von Willa Brain's disease.

Those are the big three bleeding disorders.

These aren't really that high yield except in trauma or active bleeding where it becomes

really, really important.

We won't be covering thrombocytopenia in this episode at all, but you remember that with

those platelet disorders, thrombocitopinia with the low platelets and von Willabrand's disease

when those platelets can't bind because the Von Willa brand factor is low.

You see lots of skin and mucosal bleeding when that initial early platelet plug takes too

long or can't form.

You get mucosal GI bleeding.

We mentioned in the vaginal bleeding episode that it can cause vaginal bleeding.

It can cause recurrent epistaxis, gingival bleeding, easy superficial skin bruising. When you see that type of stuff,

that's the platelets gone bad. On the flip side, delayed or deep bleeding, like into the joints

or into the brain or deep into the muscle,

that's more typical of those factor 8 and factor 9 hemophilias.

And remember that our objective today has nothing to do with diagnosing these.

You don't newly diagnose this in the ED unless you get like really lucky.

What you do need to know is how to fix these when a patient is bleeding and you find out on

history that they have one of these bleeding disorders.

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