Yesterday we met Lauren, a 34 year old who went to see her GP with easy bruising. She felt this was a new problem, although she mentioned her sister bruised easily.
We explored this a little further. Her sister had never had any surgery or dental extractions, and neither sister complained of menorrhagia.
Lauren was taking the oral contraceptive pill, which she had restarted a few weeks ago, after the birth of her second child four months ago.
Lauren had never had any surgery herself and said her delivery was normal, with no excessive blood loss that she was aware of.
The GP had taken some bloods and the results were as follows:
WCC 7 x10*9/l
Plts 248 x10*9
PT 12 secs (11-14
APTT 69 secs (29-39)
Fibrinogen 3.8 g/l
What do you make of this history and these results? What would you do next?
Please reply on twitter and please (PLEASE!) remember to include the hashtag #teamhaem in your responses. For those of you with more knowledge and experience, I would be grateful if you could help me explain some of the concepts and conditions to our less experienced team members.
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Remember we are an educational platform and not in a position of authority. All cases are fictional to protect patient identity.