USMLE Forum Archives - USMLE Step 3 - hematology q..coagulopathy
hematology q..coagulopathy
zkadhem - 06-03-09 23:27
75 years old male patient underwent uncomplicated cholycystoctomy few days ago. The post operative time was smooth.Today he have multiple bruises on his body.
He has the following data:
PT/PTT ARE ELEVATED , BUT WAS NORMAL PREOP
Fibrinogen level is 550 (normal is 150-450 mg/dl).
D-Dimer level is 3.5 (normal is 0.4-2.2 mg/dl)
So, what is your diagnosis? and accordingly what is the treatment?
zkadhem - 06-03-09 23:27
75 years old male patient underwent uncomplicated cholycystoctomy few days ago. The post operative time was smooth.Today he have multiple bruises on his body.
He has the following data:
PT/PTT ARE ELEVATED , BUT WAS NORMAL PREOP
Fibrinogen level is 550 (normal is 150-450 mg/dl).
D-Dimer level is 3.5 (normal is 0.4-2.2 mg/dl)
So, what is your diagnosis? and accordingly what is the treatment?
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#1
Re: hematology q..coagulopathy shahprasun - 06-04-09 11:09 seems patient is in DIC . so treat accordingly with FFP and heparin but platelet count is to be checked also
#2
Re: hematology q..coagulopathy
zkadhem - 06-04-09 22:02 How it comes he has DIC and his fibrinogen level is high or normal?
#3
Re: hematology q..coagulopathy conym5 - 06-17-09 03:40 i nk its DIC,, fibrinogen levels are mildly elevated
may be its anesthesia induced
treatment IVF, FFP, heparin
#4
Re: hematology q..coagulopathy debbie - 06-17-09 11:29 It is DIC, i think.
It may be secondary to infection after the surgery. we need to trart him on antibiotics, ivf, ffp.
I don't think heparin would be good choice as he has bruises i mean bleeding predominance.
Zkadhem, i read somewhere, i don't know where that fibronogen will be low in chronic dic.
please correct me if i am wrong.
please tell the right ans.
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