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diagnosis differential causes treatment algorithm bleeding rheumatology abnormal anemia blood bruising disorders intravascular prolonged pt systemic acquired activation bloodbank cerebritis
Causes of Abnormal PT and/or aPTT Prolonged Prothrombin Time (PT) 1. Acquired deficiency of FVII
Early liver disease ... Nonspecific inhibitors e.g ... to one factor e.g ... inhibitory drugs e.g ... #differential #hematology
Causes of Bleeding / Bruising - Differential Diagnosis Algorithm Thrombocytopenia - Quantitative Defect • Decreased Production •
Rare • Drugs (e.g ... ASA) • Renal Disease ... • Vasculitis Coagulation ... Von Willebrand's Disease ... Algorithm #Causes #Hematology
Summary of Coagulation Deficiencies Inherited: • Hemophilia A - Deficiency of Factor VIII • Hemophilia B -
Summary of Coagulation ... Malabsorption (e.g ... warfarin, DOACs (e.g ... Autoimmune disorders (e.g ... comparison #diagnosis #hematology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes Intravascular Hemolysis: • Mechanical Trauma (Microangiopathic hemolytic anemia):
intravascular coagulation ... (usually IgG) (e.g ... (usually IgM) (e.g ... deficiencies (e.g ... differential #diagnosis #hematology
Differential Diagnosis for a Prolonged PT and aPTT If the PT and the aPTT are both prolonged,
Pre-analytical cause (e.g ... inhibitory drugs (e.g ... specific inhibitor (e.g ... #differential #hematology ... #coagulation
Acquired von Willebrand Syndrome - Diagnosis and Management • Autoantibodies to vWF: Lymphoproliferative disorders (e.g. lymphoma,
von Willebrand Syndrome ... Lymphoproliferative disorders (e.g ... Myeloproliferative disorders (e.g ... thrombocythemia), Autoimmune disease ... #treatment #hematology
Disseminated Intravascular Coagulation (DIC) Overview Increased Clotting and Consumption of Clotting Factors Findings: • Bleeding • Recent history
• Prolonged PT/PTT ... • Severe Liver Disease ... INR < 2.3 - APTT ... causes #treatment #management ... #hematology
Hemophilia - Diagnosis and Management Diagnosis: • Consistent bleeding history (unless screening for disease in family members
Diagnosis and Management ... ) • aPTT is prolonged ... mixing study (aPTT ... hemophilia type (e.g ... #treatment #hematology
Nail Disorders secondary to Systemic Diseases Nail Fold Abnormality • SLE • Scleroderma • Dermatomyositis Koilonychia - Spoon-shaped
secondary to Systemic Diseases ... • Any systemic disease ... halt nail growth (e.g ... • Nephrotic syndrome ... Systemic #Secondary #dermatology
Causes of Thrombocytopenia and Platelet Disorders - Differential Diagnosis and Workup History: - Prior platelet count, family
cases: INR/PT, aPTT ... (liver disease, ... function test, ANA (e.g ... bypass), LFT (liver disease ... Causes #Workup #hematology
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