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diagnosis hematology differential causes abnormal aptt dic disseminated intravascular prolonged adjusted age anticoagulant anticoagulation apixaban arterial bleeding bruising cascade chemistry
Disseminated Intravascular Coagulation (DIC) Overview Increased Clotting and Consumption of Clotting Factors Findings: • Bleeding • Recent history
• Prolonged PT ... protein C and S Pathophysiology ... Fibrinogen: ↓ • PT ... significant fibrin clot ... treatment #management #hematology
The coagulation cascade is shown, separated into different phases with their endogenous and pharmacological inhibitors shown.
The coagulation ... platelet #thrombin #clot ... #PT #PTT #diagnosis ... #pathophysiology ... Rivaroxaban #Edoxaban #heparin
ISTH Scoring System for Disseminated Intravascular Coagulation (DIC) Platelet count: • Expected: Low (or normal) • Elevation
Intravascular Coagulation ... platelet aggregation PT ... using INR use PT ... thrombin to form clots ... Scoring #diagnosis #hematology
Causes of Abnormal PT and/or aPTT Prolonged Prothrombin Time (PT) 1. Acquired deficiency of FVII
unfractionated heparin ... cause e.g. heparin ... intravascular coagulation ... #differential #hematology ... #coagulation
Differential Diagnosis for a Prolonged PT and aPTT If the PT and the aPTT are both prolonged,
for a Prolonged PT ... Pre-analytical cause (e.g. heparin ... thrombin inhibitors, heparin ... #differential #hematology ... #coagulation
D-dimer Plasma D-dimer is a product of clot breakdown, released upon degradation of polymerized, crosslinked fibrin. Elevated
is a product of clot ... indicate that coagulation ... has formed, & clot ... Ddimer #dimer #pathophysiology ... #hematology #differential
Bleeding and Bruising - Disorders of Hemostasis - Differential Diagnosis Framework == Quantitative or Qualitative defect in
inhibitor of a coagulation ... == NORMAL PT ... Acquired: • Heparin ... intravascular coagulation ... Differential #Diagnosis #Hematology
Venous Thrombosis vs Arterial Thrombosis - Differential Diagnosis Framework VENOUS THROMBOSIS • Acquired Risk Factors: - >48 hours
cardiac valves (septic ... Hyperhomocysteinemia - Heparin-induced ... intravascular coagulation ... Venous #Arterial #pathophysiology ... #hematology #differential
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
• Albumin • Coagulation ... factors: PT/INR ... replaced by non-hepatic ... #differential #Hepatology
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