Question

A 77-year-old female is brought to the emergency room after falling twice at her daug hter's home. The tub, where she slipped while rising from the shower chair. She fell a second time hter's home to visit friends two hours later. Her daughter, who is present, states presently a large hematoma on the first fall was in the bath when leaving her daug that her mother hit her head on the side of the house, and there is right side of her skull. The daughter states that her mother has been fatigued over the past two weeks and began t aking an herbal remedy suggested by a friend. The daughter also st her arthritis "acting up." When the mother is further question capsules to her daily medicines to help lower her cholesterol levels. The garlic is not on the list of home rnedications. ates that her mother had complained about ed, she states that she added garlic Past medical history: Osteoarthritis Atrial Fibrillation Hypertension Hyperlipidemia Home Medications: Aspirin 81 mg orally daily Furosemide (Lasix) 40 mg orally daily Metolazone (Zaroxolyn) 5 mg orally daily e .Potassium (K-Dur) orally 20 mg daily Metoprolol succinate (Toprol XL) 50 mg orally daily Rosuvastin calcium (Crestor) 10 mg orally daily Warfarin (Coumadin) 5 mg orally daily Now add: Garlic 2 capsules every morning

Answer 1

1. INR is International normalized ratio . It is used to measure the patient's level of anticoagulation when being treated with anticoagulant . The normal INR value is less than 1.3 . The medication taken by the patient that affects the INR value is warfarin which is a anticoagulant ,it increases the clotting time.

2. Platelet aggregation is the test to check how well the platelets clump together to form a clot and stops bleeding . Platelets are the blood cells which forms clots by sticking together . The medication that affect the platelet aggregation is aspirin . Aspirin is an antiplatelet and prevents platelet from clubbing together and cause bleeding.

3. Prothombin time is the blood test done to check how the ti me taken by the blood to form a clot. When we bleed a series of blood activities take place this is called the coagulation cascade. The PT test looks at special proteins (called coagulation factors) that are involved in this event, and measures their ability to help blood clot. The medication that affects the PT is warfarin . Warfarin is an anticoagulant or blood thinning agent which increases the PT and increases the risk of bleeding.

4. Subdural hematoma is the collection of blood between the brain and outermost covering .

Pathophysiology of subdural hematoma i:-

Major cause is head injury , in this case also patient had head injury . Other causes are use of anticoagulants ,seizure disorders ,CSF shunt etc . All these lead to bleeding in the brain and results in hematoma formation . It depends on the site where the clot is formed Luke in this case it's subdural ,other areas are epidural , sure arachnoid ,intracerebral etc

The medications warfarir( anticoagulant ) and aspirin ( antiplatelet ) played an important role in patients hematoma and it increased the INR to 5 .