Coagulation disorders (Overview)


Platelet Type Bleed Factor Type Bleed
Superficial bleeding:
Vagina, Gingiva, Petechia, Purpura, Epistaxis
Deep Bleed:
Heme-arthrosis, Echymosis
Platelet Count? Pt is Bleeding? Pt is Clotting?
Normal Low Hemophilia HIT Lupus anti-coagulant
Vit K defi. Uremic coagulopathy vWF def. Wiskot-Aldrich Syndrome ITP Delayed hemarthrosis
ONLY in Males
+ Hx of trauma

Lab:
PTT
normal PT

Tx:
Factor VIII or DDAVP
-Platelet count drop of >50 % of baseline
-Occurs 5 to 10 days after the initiation of heparin


Dx:
PF4-Ab

Tx: Argatroban

NO Bleeding
Pt is CLOTTIG

Dx:
Anti-phospholipid Ab
D-Dimer
PTT


 

  Tx:
Desmopressin
+
Dialysis
PTT
vWF
F VIII
plt production.

Recurrent infection

Eczema
 
Healthy
Post-infection
Isolated Plt. count
Normal size spleen
(Large spleen = NOT ITP)
Dx: Restociten Tx:
1. Plt < 30K = Prednisone

-  Uncontrolled Bleed:
  Plt transfusion

- Melena:
 IVIG

- Persistent/recurrent bleed
  Splenectomy
Tx: Desmopressin (DDAVP)