General Internal Medicine

Thrombosis   

Questions discussed in this category


For ESRD patients with decreased Protein C activity level, the purported etiology may be a dialyzable substance in uremic plasma that interferes with ...

No DVT. AC started due to extensive size of initial LLE SVT, with continued SVT of contralateral RLE despite therapeutic anticoagulation with apixaban...

New data suggests monoclonal gammopathies can be associated with thrombotic events. Is your practice changing to include monoclonal gammopathy evaluat...

For example, would you consider this method in an ESRD/HD patient with antiphospholipid syndrome who had a major bleed requiring reversal of warfarin ...

Patient has bilateral common, internal, and external iliac and femoral DVT from obstruction by a large uterine mass that is likely malignant and is pl...

Labs with normal PT, but prolonged PTT (47 sec, ULN 40 sec) that does not correct on immediate mix. Lupus anticoagulant negative (DRVVT and hexagonal ...

Assume the patient does not have another indication for AC like VTE or AFib. Could this be suggestive of a hypercoagulable state?

Or do you generally prefer warfarin/non-DOAC agents? Do you consider trialing DOACs and testing anti-Xa DOAC levels to assess for absorption?

vWF and FVIII activities ~200% and were checked because of the patient's family history of "coagulopathy". Is there any utility in repeating the test...

How would you approach anticoagulation in this situation? Does the presence of thrombocytopenia or hemorrhagic splenic infarcts change your manag...

Do you do additional workup for venous obstruction or any other different testing/evaluation?

In the setting of requiring anticoagulation for atrial fibrillation and bioprosthetic valve, but also having severe vitamin K deficiency, would you st...

I.e. platelet count <30. Would your management change if HIT were only suspected rather than confirmed?  

What is the work up and what is the duration of anticoagulation if used?

Specifically, asymptomatic subsegmental PE diagnosed within a month from planned bilateral mastectomy for breast cancer. 

Significant history of autoimmune diseases and DVT in family, recent PE/DVT for a month

- Dialysis catheter used for hemodialysis- RIJ thrombus in dialysis catheter was incidentally found- Patient asymptomatic with no prior history of VTE...

Should we stop checking factor VIII levels as part of thrombosis workup?

For example, for outpatients or resource-limited settings with a moderate probability 4-T score (but low clinical suspicion), would you ever consider ...

e.g. in the setting of using prophylactic heparin in the past but now requiring therapeutic anticoagulation

Is there any difference between anticoagulants in this clinical context (e.g. anti-Xa inhibitors vs warfarin vs LMWH)?

Is there a preferred strategy of transfusional support versus reduced-dose anticoagulation during the duration of thrombocytopenia?


Papers discussed in this category


Blood Transfus, 2018 Oct 24

J Thromb Haemost, 2018 May 08

PLoS One, 2021 Apr 08

Expert Rev Hematol, 2019 Jul 05

J Thromb Thrombolysis,

Circulation, 2022 Nov 06

Circulation, 2022 Nov 06

J Thromb Haemost, 2021 Jul 14

Blood, 2020 Mar 19

Blood, 2014 Oct 15

Journal of medical case reports, 2014 Mar 04

British journal of haematology, 2024 Sep 02

JAMA network open, 2023 Aug 01

Blood, 2013 Jun 04

Annals of internal medicine, 2021 Nov 23

AJR Am J Roentgenol,

Blood advances, 2023 Jan 24

Thrombosis and haemostasis, 2018 Feb 12

The New England journal of medicine, 2020 Mar 28

Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists, 2018-04

Atherosclerosis, 2021 Nov 08