Clotting Lab Results of this case? - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 08-09-2010
Kabutar111's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 414
Threads: 30
Thanked 87 Times in 70 Posts
Reputation: 97
Send a message via Skype™ to Kabutar111
Blood Clotting Lab Results of this case?

A 32-y-o man is brought to the emergency department 20 minutes after having a generalized tonic-clonic seizure. He has a 24-hour history of fever, headache, and intolerance of light. He is alert. His temperature is 40C (104F), pulse is 140/min, respirations are 24/min, and BP is 90/55 mm Hg. He appears acutely ill. Neurologic examination shows no focal findings. Intravenous fluids are administered, and there is persistent bleeding around the intravenous site.
Laboratory studies show:

PT 16 sec (INR=1.1)
PTT 33 sec
FDP increased
D-dimer increased

Which of the following changes is most likely in the blood coagulation process of this patient?

A) Decreased fibrinolysis
B) Decreased microvascular thrombus formation
C) Decreased thrombin production
D) Increased circulating clotting factors
E) Increased plasmin generation
F) Increased platelet count
__________________
There is no shortcut to SUCCESS ,and there is no excuse for FALIURE - by Kabutar111
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message



  #2  
Old 08-09-2010
USMLE Forums Guru
 
Steps History: ---
Posts: 487
Threads: 69
Thanked 297 Times in 134 Posts
Reputation: 317
Default

E) Increased plasmin generation
Reply With Quote Quick reply to this message
  #3  
Old 08-09-2010
Kabutar111's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 414
Threads: 30
Thanked 87 Times in 70 Posts
Reputation: 97
Send a message via Skype™ to Kabutar111
Default

Quote:
Originally Posted by khushboo View Post
E) Increased plasmin generation
can you please explain:sorry:
__________________
There is no shortcut to SUCCESS ,and there is no excuse for FALIURE - by Kabutar111
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
 
  #4  
Old 08-09-2010
USMLE Forums Guru
 
Steps History: ---
Posts: 487
Threads: 69
Thanked 297 Times in 134 Posts
Reputation: 317
Default

DIC is consuptive coagulopathy...as a result of wide spread injury to endothelial cells e.g. in septic shock...there is increased exposure of tissue factor leading to stimulation of extrinsic system which inturn stimulate intrinsic system too....resulting in coagulation in micro as well as macro vasculature...so..B) Decreased microvascular thrombus formation can not be choice...
during this massive coagulation clotting factors r used...ruls out D) Increased circulating clotting factors...
during cascade prothrombin is converted to thrombin....C) Decreased thrombin production can't be choice...n during this massive coagulation lots of platelets r also being used...decreasing their level...ruls out F) Increased platelet count....
thrombin that is formed during cascade n also activated factor 12 stimulate plasminogen coverting it to plasmin....E) Increased plasmin generation is correct choice...
Reply With Quote Quick reply to this message
The above post was thanked by:
lee-usmle (08-10-2010)
  #5  
Old 08-12-2010
Kabutar111's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 414
Threads: 30
Thanked 87 Times in 70 Posts
Reputation: 97
Send a message via Skype™ to Kabutar111
Default

what factor in the question help you decide that its DIC?thx :sorry:
Quote:
Originally Posted by khushboo View Post
DIC is consuptive coagulopathy...as a result of wide spread injury to endothelial cells e.g. in septic shock...there is increased exposure of tissue factor leading to stimulation of extrinsic system which inturn stimulate intrinsic system too....resulting in coagulation in micro as well as macro vasculature...so..B) Decreased microvascular thrombus formation can not be choice...
during this massive coagulation clotting factors r used...ruls out D) Increased circulating clotting factors...
during cascade prothrombin is converted to thrombin....C) Decreased thrombin production can't be choice...n during this massive coagulation lots of platelets r also being used...decreasing their level...ruls out F) Increased platelet count....
thrombin that is formed during cascade n also activated factor 12 stimulate plasminogen coverting it to plasmin....E) Increased plasmin generation is correct choice...
__________________
There is no shortcut to SUCCESS ,and there is no excuse for FALIURE - by Kabutar111
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
  #6  
Old 08-12-2010
USMLE Forums Guru
 
Steps History: ---
Posts: 487
Threads: 69
Thanked 297 Times in 134 Posts
Reputation: 317
Default

Key word here is persistant bleeding at iv site..n also hypotension, its due to blood loss...Neurological signs here is due to ischemia from occlusive thrombi..
There may be patachiae n ecchymosis from thrombocytopenia....
Reply With Quote Quick reply to this message



Reply

Tags
Hematology-, Pathology-, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Got my results Farqad USMLE Step 1 Forum 7 03-27-2017 07:03 PM
When do we get the results Peewee USMLE Step 1 Forum 10 09-05-2014 10:16 AM
Today is the CS Results! Tipene2010 USMLE Step 2 CS Forum 5 03-31-2010 01:15 PM
Just got the CS results Maximilian IMG Residency Match Forum 1 10-06-2009 10:13 AM
Time taken for Usmle results to come amaldameer USMLE Step 1 Forum 4 09-28-2009 04:44 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)