Coagulopathy (main)
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Background
- Primary hemostasis: damage to endothelial basement membrane and formation of platelet plug
- Secondary hemostasis: coagulation cascade
Clinical Features
- Spontaneous bleeding
- Bleeding out of proportion
- Swollen joints
- Epistaxis
- Bleeding gums
- Menometrorrhagia
- Easy bruising/petechiae
- Hematuria
Differential Diagnosis
Coagulopathy
Platelet Related
- Too few
- Nonfunctional
Factor Related
- Acquired (Drug Related)
- Warfarin (Coumadin)
- Unfractionated heparin
- Low molecular weight heparin (i.e. enoxaparin (Lovenox), dalteparin)
- Factor Xa Inhibitors (e.g. rivaroxaban, apixaban, fondaparinux, edoxaban)
- Direct thrombin inhibitors (e.g. dabigatran, argatroban, bivalirudin)
- Illness induced
- Genetic
Increased Clotting
Management
- Bleeding Treatments
- Procedures in patients with coagulopathies
- Anticoagulant reversal (known medications)
- Anti-platelet agent reversal