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diagnosis hematology abnormal aptt emergencies oncologic oncology prolonged algorithm blanching bruise bruising cancer dic ecchymosis hematomas hemeonc hemostasis intravascular management
Disseminated Intravascular Coagulation (DIC) Overview Increased Clotting and Consumption of Clotting Factors Findings: • Bleeding • Recent history
Disseminated Intravascular ... • Prolonged PT ... • Increased thrombin ... Acral cyanosis • Hemorrhagic ... Fibrinogen: ↓ • PT
Differential Diagnosis for a Prolonged PT and aPTT If the PT and the aPTT are both prolonged,
Differential Diagnosis ... drugs (e.g. direct thrombin ... • Massive hemorrhage ... • Disseminated ... #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 ... Massive hemorrhage ... Disseminated intravascular ... #diagnosis #differential
Causes of Post-Partum Hemorrhage - Differential Diagnosis Algorithm Blood Loss: >500mL post vaginal delivery OR >1000 mL
Causes of Post-Partum ... Hemorrhage - Differential ... or percreta) Thrombin ... HELLP syndrome • Disseminated ... #PPH #Differential
Bleeding and Bruising - Disorders of Hemostasis - Differential Diagnosis Framework == Quantitative or Qualitative defect in
of Hemostasis - Differential ... inhibitor of a coagulation ... liver failure, disseminated ... discern these causes ... warfarin, direct thrombin
Oncologic Emergencies - Differential Diagnosis Framework HEMATOLOGIC ONCOLOGIC EMERGENCIES: Hyperviscosity Syndrome: • Spontaneous bleeding • Shortness of breath
Emergencies - Differential ... • Spontaneous bleeding ... "Sausage-like" hemorrhagic ... • Intracranial hemorrhage ... wall) Malignant Pericardial
Bleeding manifestations Petechiae are small, flat, red, discrete areas of skin bleeding that are typically <2
ecchymosis) is caused ... are typical of coagulation ... in endothelial cells ... to be normal, PT ... VWF:RCo/VWF:Ag (differentiate
Summary of Oncologic Emergencies Neutropenic fever: - Fever + ANC < 500 → start cefepime ± vancomycin (if
first) DIC (disseminated ... intravascular coagulation ... Simultaneous clotting and bleeding ... Treat underlying cause ... “big & sticky” cells
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