Based on these results, does the patient have a coagulopathy?

The platelet count, prothrombin time (PT), and partial thromboplastin time (PTT) are all normal, ruling out thrombocytopenia or a factor deficiency, but this is not surprising given the patient's age and lack of bleeding history or liver disease. Neither cholesterol-lowering agents nor betablockers are strong inhibitors of platelet function, but daily aspirin use can significantly inhibit platelet function through its blockade of cyclooxygenase-dependent activation. Furthermore, von Wille brand disease, a common inherited platelet functional defect, must be considered in any patient with uncontrolled bleeding after trauma or with surgery. To look at these possibilities, a PFA screening test is ordered, the results of which are as follows: PFA collagen/ADP closure time = 95 seconds (80-1 20 seconds} PFA collagen/epinephrine closure time (I I 0- 1 80 seconds) 245 seconds In addition, a computed tomography (CT) scan of the head with contrast demonstrates a subdural hematoma. The neurosurgeon recommends immediate surgery, but because of the aspirin use and the PFA result, the neurosurgeon requests a consult for medical management of bleeding risk prior to the operation.

Questions

• Based on these results, does the patient have a coagulopathy?

• If so, does he require immediate treatment prior to surgery?

find the cost of your paper

Based on smear morphology and the red blood cell indices (mean cell volume [MCV], mean cell hemoglobin [MCH], mean corpuscular hemoglobin concentration [MCHC]), the patient has a severe microcytic, hypochromic anemia most likely caused by iron deficiency (see Chapter 5).

Based on smear morphology and the red blood cell indices (mean cell volume [MCV], mean cell hemoglobin [MCH], mean corpuscular hemoglobin concentration [MCHC]), the patient has a severe microcytic, hypochromic….

Given the diagnosis of HHT, how should this patient be managed?

The patient's history and physical examination (telangiectasia involving the lips, tongue, and palms) are consistent with a diagnosis of hereditary hemorrhagic telangiectasia (HHT). Three diagnostic criteria are met: multiple telangiectases,….

As this patient with HHT grows older, her bleeding tendency will likely become progressively more difficult to manage.

As this patient with HHT grows older, her bleeding tendency will likely become progressively more difficult to manage. If she were premenopausal, oral contraceptives would be an option, but in….