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diagnosis hematology coagulation differential causes disseminated intravascular management abnormal laboratory prolonged ptt algorithm anticoagulant anticoagulation apixaban bleeding bruising cardiology cascade
Causes of Abnormal PT and/or aPTT Prolonged Prothrombin Time (PT) 1. Acquired deficiency of FVII
Causes of Abnormal PT ... Prothrombin Time (PT ... typically prolong PT ... Prolonged PT and ... intravascular coagulation (DIC
Differential Diagnosis for a Prolonged PT and aPTT If the PT and the aPTT are both prolonged,
for a Prolonged PT ... and aPTT If the ... PT and the aPTT ... , FVII, FIX, FX ... intravascularcoagulation (DIC
Prothrombin Time (PT) and Partial Thromboplastin Time (PTT) Prothrombin Time (PT) - Often Elevated in: • Vitamin
Prothrombin Time (PT ... Prothrombin Time (PT ... warfarin) • Factor VII ... elevated in: • DIC ... thematttsai #PT
Disseminated Intravascular Coagulation (DIC) Overview Increased Clotting and Consumption of Clotting Factors Findings: • Bleeding • Recent history
• Prolonged PT ... /PTT • Low plasma ... levels of factors VII ... Fibrinogen: ↓ • PT ... INR < 2.3 - APTT
Bleeding and Bruising - Disorders of Hemostasis - Differential Diagnosis Framework == Quantitative or Qualitative defect in
== NORMAL PT ... evaluation of factor VII ... Inherited: • Factor VII ... Warfarin • Acute DIC ... disease • Acute DIC
ISTH Scoring System for Disseminated Intravascular Coagulation (DIC) Platelet count: • Expected: Low (or normal) • Elevation
Intravascular Coagulation (DIC ... platelet aggregation PT ... , aPTT: • Expected ... using INR use PT ... small vessels #DIC
Pancytopenia - Differential Diagnosis Algorithm • 12-13 g/dL, • ANC < 1800/uL, • platelet < 150,000/uL Initial
12-13 g/dL, • ANC ... iron studies, PT ... /aPTT Differential
Therefore, studies obtained at the initial presentation in the emergency department should evaluate for fibrinolysis with
prothrombin time (PT ... thromboplastin time (PTT ... decompensated DIC ... Diagnosis #Honc #DIC
The coagulation cascade is shown, separated into different phases with their endogenous and pharmacological inhibitors shown.
complexes with FVIIa ... TF-FVIIa also activates ... thrombin #clot #PT ... #PTT #diagnosis
Diabetic Myonecrosis (Diabetic Muscle Infarction) • Spontaneous ischemic necrosis of skeletal muscle (anterior thigh or calf)
Suspect in diabetic pt ... pain • Mean AIC
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