RT Book, Section
A1 Hillman, Robert S.
A1 Ault, Kenneth A.
A1 Leporrier, Michel
A1 Rinder, Henry M.
SR Print(0)
ID 1127768601
T1 EXTRINSIC AND COMMON PATHWAY COAGULOPATHIES
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=1127768601
RD 2024/04/19
AB CASE  HISTORY  •  Part  1A  71-year-old  woman  presents  with  1  day  of  headache  and  left-sided  weakness  after  complaining  for  several  days  of  dyspnea  and  confusion.  Her  history  is  notable  for  non-valvular  atrial  fibrillation  and  hypertension;  she  denies  any  prior  history  of  thrombosis  or  bleeding.  Her  medications  include  a  beta-blocker  and  warfarin  (coumadin).  Examination  is  notable  for  partial  left  hemiplegia;  ecchymoses  are  noted  over  both  forearms.  The  remainder  of  the  examination  demonstrates  rales  over  both  lung  bases,  an  irregularly  irregular  heart  rhythm,  and  a  heave  at  the  left  sternal  border.CBC:  Hemoglobin/hematocrit  -  12  g/dL/35%MCV  -  89  fL  MCH  -  30  pg  MCHC  -  27  g/dLRDW-CV  -  10%  WBC  count  6,500/μLPlatelet  count  -  225,000/μLPT  =  55.1  seconds  (<14  seconds)INR  =  7.1  (<1.3)PTT  =  39  seconds  (22–35  seconds)QuestionsDo  the  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?