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differential causes abnormal disseminated intravascular prolonged activation bleeding bruising hemophilia hemorrhage hemostasis isth laboratory macrophage mas obgyn obstetrics postpartum rheumatology
Disseminated Intravascular Coagulation (DIC) Overview Increased Clotting and Consumption of Clotting Factors Findings: • Bleeding • Recent history
• Prolonged PT ... Fibrinogen: ↓ • PT ... /INR: ↑ • PTT: ... INR < 2.3 - APTT ... #treatment #management
Causes of Abnormal PT and/or aPTT Prolonged Prothrombin Time (PT) 1. Acquired deficiency of FVII
Causes of Abnormal PT ... Prothrombin Time (PT ... (DIC) c. ... #Causes #diagnosis ... #differential #hematology
ISTH Scoring System for Disseminated Intravascular Coagulation (DIC) Platelet count: • Expected: Low (or normal) • Elevation
platelet aggregation PT ... , aPTT: • Expected ... using INR use PT ... ISTH #Scoring #diagnosis ... #hematology #laboratory
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 ... #Abnormal #PT ... #aPTT #Prolonged
Bleeding and Bruising - Disorders of Hemostasis - Differential Diagnosis Framework == Quantitative or Qualitative defect in
== NORMAL PT ... /ABNORMAL PTT: ... Perform a PTT mixing ... PTT suggests liver ... #Hematology
Hemophilia - Diagnosis and Management Diagnosis: • Consistent bleeding history (unless screening for disease in family members
established disease) • aPTT ... mixing study (aPTT ... mild cases) • PT ... #Management #treatment ... #hematology
Postpartum Hemorrhage - Differential Diagnosis and Management Uterine Atony (80%) - Most PPH Will respond to
• Oxytocin 40 IU ... epinephrine prn DIC ... CBC, fibrinogen, PT ... /PTT • Treat with ... unresponsive to usual treatment
Macrophage Activation Syndrome (MAS) Classified among the secondary or acquired forms of haemophagocytic lymphohistiocytosis (sHLH) What? A subset of
Hypofibrinogenemia • ↑ PT ... ↑ PTT • ↑ Fibrin ... Treatment: • Corticosteroids ... Activation #Syndrome #Diagnosis ... #Management #Hematology
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