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hematology abnormal aptt prolonged algorithm arterial blanching bleeding bruise bruising chemistry dic ecchymosis embolism emergencies hemeonc hemorrhage hemostasis hepatology interpretation
Disseminated Intravascular Coagulation (DIC) Overview Increased Clotting and Consumption of Clotting Factors Findings: • Bleeding • Recent history
Disseminated Intravascular ... • Prolonged PT ... • Increased thrombin ... Subcutaneous dissecting hematoma ... #diagnosis #causes
Differential Diagnosis for a Prolonged PT and aPTT If the PT and the aPTT are both prolonged,
Differential Diagnosis ... drugs (e.g. direct thrombin ... hemorrhage • Disseminated ... #diagnosis #differential ... #hematology #coagulation
Causes of Abnormal PT and/or aPTT Prolonged Prothrombin Time (PT) 1. Acquired deficiency of FVII
Causes of Abnormal ... drugs e.g. direct thrombin ... Disseminated intravascular ... coagulation (DIC ... #diagnosis #differential
Causes of Post-Partum Hemorrhage - Differential Diagnosis Algorithm Blood Loss: >500mL post vaginal delivery OR >1000 mL
Causes of Post-Partum ... Diagnosis Algorithm ... Vaginal laceration / hematoma ... or percreta) Thrombin ... HELLP syndrome • Disseminated
Venous Thrombosis vs Arterial Thrombosis - Differential Diagnosis Framework VENOUS THROMBOSIS • Acquired Risk Factors: - >48 hours
Arterial Thrombosis - Differential ... Diagnosis Framework ... thrombocytopenia - Disseminated ... intravascular coagulation ... and other causes
Bleeding manifestations Petechiae are small, flat, red, discrete areas of skin bleeding that are typically <2
ecchymosis) is caused ... in endothelial cells ... to be normal, PT ... Diagnosis VWF ... VWF:RCo/VWF:Ag (differentiate
Bleeding and Bruising - Disorders of Hemostasis - Differential Diagnosis Framework == Quantitative or Qualitative defect in
of Hemostasis - Differential ... Diagnosis Framework ... liver failure, disseminated ... discern these causes ... warfarin, direct thrombin
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
• Albumin • Coagulation ... factors: PT/INR ... hemolysis, bleeding, hematoma ... liver #chemistry #diagnosis ... #differential #
Summary of Oncologic Emergencies Neutropenic fever: - Fever + ANC < 500 → start cefepime ± vancomycin (if
first) DIC (disseminated ... intravascular coagulation ... Treat underlying cause ... “big & sticky” cells ... Oncology #HemeOnc #Diagnosis
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