Tag Archives: Heparin

Case 74 – part 3

We have our 3rd and final case of the week! A 40 year old man who has a vasculitis ,who has been requiring plasma exchange, needs to have a new line put in for exchange. The renal team are concerned … Continue reading

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Case 70 – part 3 – summary

For our last short case this week we looked at a 50 year old gentleman who developed a subdural following an assault. He had been diagnosed with a provoked DVT 1 week prior following knee surgury and had been loaded … Continue reading

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Case 70 – part 3 – the beginning

And for our last case, a 50 year old gentleman has attended A&E following an assault. A CT head has shown a subdural and the neurosurgeons want to take him to theatre. The patient had a knee replacement about 4 … Continue reading

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Case 70 – part 1 – summary

So our patient was a 75 year old male who has a PMH of NIDDM, HTN, AF and a previous bioprosthetic AV replacement. He is anticoagulated for AF with a CHADS2 score of 3 – which is an annual stroke … Continue reading

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Case 70 – part 1 – the beginning

Welcome to our cases this week. This week we will do 3 short cases looking at anticoagulation and perioperative management around elective and emergency surgery. Our first case is a patient who is being seen pre operatively. The patient needs … Continue reading

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Case 39 – summary

.The final part of our case was dedicated to discussing what tests, if any, should be requested on a patient presenting with an unprovoked VTE (uVTE). Clearly there are many other topics in the field of ‘clots and cancer’ that … Continue reading

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Case 39 – update 2

In the last few days we have established that the 74 year old man with a confirmed DEEP vein thrombosis (in the superficial femoral vein – see this link for discussion of this misnomer: http://jama.jamanetwork.com/article.aspx?articleid=389874). He has had significant indigestion … Continue reading

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Case 39 – update 1

One of the team has written a fantastic summary of differentials and points to consider in the history and examination: thanks olitodd1984! Please see his comments below: Rule out infection– in the history ask about fevers, sweats, rigors, loss of appetite. On … Continue reading

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Case 39 – the beginning

Welcome to case 39, a short case exploring DVT/PE management. Sound dull? Well, we’re going to show you why it’s not just a DVT. This case is particularly aimed at: General medics Surgeons Medical students Nursing students Acute medicine practitioners … Continue reading

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Case 37 part 2 – summary

The key to this mini case was the history. The patient had had numerous previous operations without problems. Therefore inherited bleeding disorder is unlikely. The clotting screen had previously been normal so an acquired problem is what we’re dealing with. … Continue reading

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Case 37 part 2 – update 1

Here are some results that may help: PT 14s (11-14s) APTT 56s (33-40s) Fibrinogen (Clauss) 6.9g/L (1.5-4.5g/L) Thrombin time 38s (15-19) Questions What has happened here? Please reply to us (@teamhaem) on Twitter and always include #teamhaem to allow others … Continue reading

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Case 37 part 2 – the beginning

The APTT can be rather sneaky at times! In part one of this case we saw how the APTT can be prolonged in factor deficiencies. You are working in a small hospital and the surgical team request fresh frozen plasma for … Continue reading

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Case 1 – summary

Thank you for your comments about anticoagulation management in HIT. Argatroban and danaparoid would be appropriate anticoagulants to use in this setting. Lepirudin is no longer available, having been recently withdrawn from Europe. Fondaparinux would not be suitable at this … Continue reading

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Case 1 – update 1

Welcome back team. Thanks for your comments so far. On reviewing the case notes you find out the following: Mr X has had simple valve replacement but developed acute kidney injury and has been on CVVH for six days now … Continue reading

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