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diagnosis hematology differential clinical causes pathophysiology abnormal anticoagulation aptt cascade clots dic disseminated echocardiogram electrical electrocution embolism heparin intransit intravascular
Coagulation cascade and anticoagulants Satyendra Dhar MD, @DharSaty #coagulation #coumadin #heparin #warfarin #apaxiban #pradaxa #xarelto #DOAC #vWF
Coagulation cascade ... @DharSaty #coagulation ... xarelto #DOAC #vWF #thrombin ... #ptt #pt
ISTH Scoring System for Disseminated Intravascular Coagulation (DIC) Platelet count: • Expected: Low (or normal) • Elevation
Intravascular Coagulation ... platelet aggregation PT ... consumption of coagulation ... using INR use PT ... Intravascular #Coagulation
The coagulation cascade is shown, separated into different phases with their endogenous and pharmacological inhibitors shown.
The coagulation ... at the site of injury ... Thrombin, then primes ... #Coagulation #Cascade ... #clot #PT #PTT
Effect of Anticoagulants on Coagulation Tests PT / INR, aPTT, Anti-Xa Activity, Activated Clotting Time, Thrombin Time,
Anticoagulants on Coagulation ... Tests PT / INR, ... Clotting Time, Thrombin
Causes of Abnormal PT and/or aPTT Prolonged Prothrombin Time (PT) 1. Acquired deficiency of FVII
Causes of Abnormal PT ... Congenital intrinsic coagulation ... drugs e.g. direct thrombin ... intravascular coagulation ... differential #hematology #coagulation
Disseminated Intravascular Coagulation (DIC) Overview Increased Clotting and Consumption of Clotting Factors Findings: • Bleeding • Recent history
Intravascular Coagulation ... • Prolonged PT ... • Increased thrombin ... is simultaneous coagulation ... Fibrinogen: ↓ • PT
This 24M presented with acute onset CP/SOB, hypoxia, HR 150s. What's the diagnosis? Treatment options? Hint:
Thrombus in transit ... Pt had extensive ... Echocardiogram #A4C ... PulmonaryEmbolism #Thrombus
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 Venous Thrombosis vs Arterial Thrombosis - Differential Diagnosis Framework VENOUS THROMBOSIS • Acquired Risk Factors: - >48 hours
- Aortic mural thrombus ... Cardiac: - Atrial thrombus ... Left ventricular thrombus ... intravascular coagulation ... Vasculitis • Injury
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 ... drugs (e.g. direct thrombin ... #Abnormal #PT ... differential #hematology #coagulation
Bleeding and Bruising - Disorders of Hemostasis - Differential Diagnosis Framework == Quantitative or Qualitative defect in
inhibitor of a coagulation ... == NORMAL PT ... level NORMAL PT ... intravascular coagulation ... warfarin, direct thrombin
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