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Coagulation cascade and anticoagulants 

Satyendra Dhar MD, @DharSaty

#coagulation #coumadin #heparin #warfarin #apaxiban #pradaxa #xarelto #DOAC #vWF
Coagulation cascade and anticoagulants ... coagulation #coumadin #heparin ... xarelto #DOAC #vWF #thrombin ... #ptt #pt
How to Evaluate an Abnormal APTT
Step 1: Is the PT or APTT Artifactually Prolonged?
Step 2: Is
Step 1: Is the PT ... Patient Receiving Anticoagulants ... K Antagonists, Heparin ... , or Direct Thrombin ... prolonged #diagnosis #hematology
The coagulation cascade is shown, separated into different phases with their endogenous and pharmacological inhibitors shown.
at the site of injury ... #clot #PT #PTT ... diagnosis #models #hematology ... anticoagulation #anticoagulant ... Rivaroxaban #Edoxaban #heparin
Effect of Anticoagulants on Coagulation Tests
PT / INR, aPTT, Anti-Xa Activity, Activated Clotting Time, Thrombin Time,
Effect of Anticoagulants ... Coagulation Tests PT ... Clotting Time, Thrombin ... Time, Ecarin Clotting ... EricsMedicalLectures/ #Anticoagulants
Causes of Abnormal PT and/or aPTT
Prolonged Prothrombin Time (PT)
1. Acquired deficiency of FVII
unfractionated heparin ... - Other anticoagulants ... drugs e.g. direct thrombin ... inhibitors, heparin ... #differential #hematology
Bleeding and Bruising - Disorders of Hemostasis - Differential Diagnosis Framework

== Quantitative or Qualitative defect in
Acquired: • Heparin ... deficiency • Anticoagulants ... warfarin, direct thrombin ... deficiency • Anticoagulant ... Differential #Diagnosis #Hematology
This 24M presented with acute onset CP/SOB, hypoxia, HR 150s. What's the diagnosis? Treatment options? Hint:
Thrombus in transit ... Pt had extensive ... Started on heparin ... Echocardiogram #A4C ... PulmonaryEmbolism #Thrombus
Summary of Coagulation Deficiencies
Inherited:
 • Hemophilia A - Deficiency of Factor VIII
 • Hemophilia B -
, CF, IBD) • Anticoagulant ... Medications - Heparin ... inhibitors, direct thrombin ... comparison #diagnosis #hematology
Disseminated Intravascular Coagulation (DIC) Overview

Increased Clotting and Consumption of Clotting Factors

Findings:
 • Bleeding
 • Recent history
• Prolonged PT ... • Increased thrombin ... Fibrinogen: ↓ • PT ... Reduction of pro/anticoagulants ... treatment #management #hematology
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 ... drugs (e.g. direct thrombin ... inhibitors, heparin ... #differential #hematology