RT Book, Section
A1 Hillman, Robert S.
A1 Ault, Kenneth A.
A1 Leporrier, Michel
A1 Rinder, Henry M.
SR Print(0)
ID 1127768536
T1 HEMOPHILIA AND OTHER INTRINSIC PATHWAY DEFECTS
T2 Hematology in Clinical Practice, 5e
YR 2016
FD 2016
PB McGraw-Hill Medical
PP New York, NY
SN 9780071626996
LK accessbiomedicalscience.mhmedical.com/content.aspx?aid=1127768536
RD 2024/04/20
AB CASE  HISTORY  •  Part  1A  66-year-old  man  presents  with  a  complaint  of  bruising  and  severe  pain  in  the  right  arm  and  forearm  after  painting  a  wall  yesterday.  His  history  is  notable  for  osteoarthritis,  hypertension,  and  non–insulin-dependent  diabetes  mellitus;  he  denies  any  prior  history  of  bleeding.  His  medications  include  hydrochlorothiazide  and  glyburide  (a  sulfonylurea),  and  he  took  ibuprofen  for  the  pain  last  night.  Examination  is  notable  for  large  ecchymoses  over  the  right  shoulder  and  triceps,  with  swelling  and  tenderness  of  the  right  forearm  and  wrist.  The  remainder  of  the  examination  is  benign.Table  Graphic  Jump  Location|Download  (.pdf)|PrintCBC:  Hemoglobin/hematocrit  -  13  g/dL/39%MCV  -  94  fL  MCH  -  29  pg  MCHC  -  28  g/dLRDW-CV  -  11%  WBC  count  -  13,500/μLDifferential:Neutrophils  -  45%Lymphocytes  -  50%Monocytes  -  5%Platelet  count  -  300,000/μLPT  =  12.1  seconds  (<14  seconds)INR  =  1.0  (<1.3)PTT  =  77  seconds  (22–35  seconds)QuestionsDo  the  CBC  and  screening  coagulation  test  results  point  to  a  specific  cause  for  a  bleeding  tendency  in  this  patient?Are  additional  studies  warranted  for  diagnosis  or  determining  therapy?