Question

create a short case study that reflects a disorder of primary hemostasis and and also create a summary table comparing common anticoagulants.

For the case study, create a case study. Include the following information:

Relevant patient history and clinical presentation

Laboratory tests and expected values

Prognosis and treatment plan

For the anticoagulant summary table, describe the activity of and the way each of the following can be measured: Aspirin, Unfractionated Heparin, Low Molecular Weight Heparin, Warfarin/Coumadin, and Direct Thrombin Inhibitors (DTIs).

Answer 1

1.Hemostasis is defined as the cessation of bleeding at a vascular injury site by the formation of a thrombus . A thrombus consists of two primary components :-

- platelet plug

- fibrin clot

Aggregation of platelets is called primary hemostasis.

Case study :-

Patient history - A 28 year old male met with a bike accident and got injured his knees and elbows . The person came to the emergency with bleeding knees and elbows and was unable to walk properly due to the injury .

Laboratory test and expected values :-

PT = 12.1 sec

INR = 1.1

APTT = 30 sec

Platelet = 45000 ,the patient is thrombocytopenic indication of primary hemostasis.

Other tests include :-

- platelet aggregation test

-bleeding time

- von williebrand factor

Treatment includes :-

Simulation of primary hemostasis

- Direct pressure

- Topical epinephrine

- cauterize

Treatment of hypovolemia :-

- colloids and crystalloid

- Whole blood transfusion

Identify and treat the cause :-

- vasculitis

- thrombocytopenia

- platelet function defect

Prognosis - prognosis is good if trwaent is taken at time ,if there is any delay in the treatment then there are chances of death due to bleeding caused hypovolemia.

2. The anticoagulant are :-

- Aspirin - is a NSAIDS , inhibit platelet aggregation and cause bleeding from the injured site .

- Unfractioned Infractions medicine - is used to treat bleeding

. Dose = 80U /kg bolus IV then continue voice cut it down .

- Low molecular weight heparin - it is derived from unfractioned bleeding from the injured sheet .

The dose of low molecular weight heparin. Is 100mg / ml.

- warfarin available in 5mg /vial injection and tablet 1 mg and 2 mg .

- DTI's direct throbbing inhibitors action is to delay bleeding by directly inhibiting the enzyme thrombin .