MC(C)
MCC of HUS
E. Coli 0157:H7
Most specific/best test for vWF
Ristocetin cofactor
How do you treat HIT
Stop heparin and switch to another anti coagulant
Bleeding and clotting everywhere
DIC
A male presents to the ER with spontaneous hemarthrosis of his knees. Labs show normal CBC, PTT prolonged, PT normal, and low factor VIII levels. This is your initial treatment.
DDAVP
MC inherited blood disorder
VWD
The lab diagnostic test you would you order if suspecting TTP
CBC, BMP/Chem 7, hemolysis labs
Blood product you would give to someone who is actively bleeding due to coagulation if liver
FFP; clotting factors
Male patient with a history of HIV comes to the clinic with a complaint of gums bleeding while brushing his teeth. His CBC shows normal WBC, Hgb, and thrombocytopenia. This is your diagnosis.
ITP
MC clinical presentation of Hemophilia A
Surgical bleeding (usually circumcision)
Initial prolonged PT, later on PTT prolonged, low factor II, VII, IX, X levels
Vit K deficiency
Reason for treating a TTP patient with a plasma exchange
healthy fibrinogen, albumin, immunoglobulin, vWF, electrolytes
Man presents with hemarthrosis
Patient complains of persistent heavy menses and recurring nosebleeds. Upon further evaluation, you notice pt has signs of dry bleeding. Labs look like this.
Normal CBC, normal coag panel, low vWF, low Ristocetin cofactor, low factor VIII
A prolonged PTT is most commonly due to...
Deficiency of Factor VIII (Hemophilia A) or Factor IX (Hemophilia B)
A 13 year old girl complains of very heavy menstruation, and bleeding from her gums when brushing her teeth. Her CBC is normal. This test is what you are most interested in next.
Ristocetin cofactor
Child presents with both wet and dry bleeding and pt mom states that he recently recovered from virus. This is your treatment.
You don’t, it resolves on its own
TTP clinical presentation
PENTAD
thrombocytopenia
hemolytic anemia
renal failure
fever
neuro findings
Woman who looks sick presents with fever and pallor and complains of SOB and fatigue. Upon further physical examination, you find signs of dry bleeding and pt is tachycardic. Labs show thrombocytopenia, anemia, and high retic. This is the most likely diagnosis.
TTP
MCC/MC type of hypercoagulability
Factor V Leiden
4 year old child presents with CC of abdominal pain, vomiting, and bloody diarrhea. Pt mom reports symptoms started after family BBQ this past weekend. Labs would appear like this. Explain why.
Thrombocytopenia, platelets stuck in kidney
Anemia, because of low Hgb due to RBC hemolysis
High retic, to compensate for hemolysis
Pt discharged from hospital and diagnosed with HIT. Describe bridge therapy.
Pt is discharged from hospital and started on SubQ LMWH for home therapy
started on Warfarin po along with LMWH
after 3-5 days, discontinue LMWH
po Warfarin only
MC platelet disorder. Describe pathophys.
ITP; immune system makes antibodies against platelets
A 52 yo woman is wheeled into the ER by her husband and she is visibly distressed and in agony. The man is screaming for help. The woman is losing consciousness and visibly erythematous. The husband said she was upstairs when he heard her fall and screaming she was in back pain after her steam shower. Upon examination she is febrile, fails her neuro exam, has bilateral tenderness in her lower back, and her eyes are bloodshot. CBC shows depleted hemoglobin, platelets, RBCs are low and reticulocyte count is high. Her BUN and SrCr are also elevated. Just as you were between two differential diagnoses, the patient begins to show left side paralysis. This is your most likely diagnosis.