Internal Medicine

Hemostasis

Questions discussed in this category

For mild to moderate hemophilia B, do you routinely screen for inhibitors?

Assume the patient has infrequent bleeding events every few years, with use of FIX replacement for acute bleeds only.

How do you treat factor XI deficient patients with surgery or trauma related bleeding?

Is there a factor XI goal that you target? Would you consider FVIIa products instead?

For an asymptomatic patient discovered during workup for elevated PT/PTT to have mild prothrombin deficiency, would you suggest any preoperative prophylaxis?

Level >60%. No family or surgical h/o of bleeding but heavy postpartum bleeding.

2 Answers available

How do you interpret a low VWF activity/antigen ratio, when both activity and antigen levels are above 50%?

E.g. Normal F8, VWF activity ~50%, VWF antigen ~100%, ratio 0.5 sent in a patient with positive bleeding history Is there any clinical significance t...

1 Answer available

Would you use PCC for clotting factor repletion in acute life threatening hemorrhage in a patient with elevated INR from coagulopathy of liver disease?

2 Answers available

When do you stop trying to eradicate an acquired factor VIII inhibitor?

Patient with high titer acquired FVIII inhibitor with no causative etiology. Bleeding is well-controlled on emicizumab, but inhibitor has failed...

3 Answers available

In patients with severe hemophilia A on emicizumab for prophylaxis, in case of noncompliance leading to a lapse of more than 2-3 months off therapy, do you reload with emicizumab?

1 Answer available

What is the preferred immunosuppressive modality for patients with an acquired factor 8 inhibitor?

1 Answer available

What is your recommended management algorithm for bleeding associated with an acquired factor VIII inhibitor?

1 Answer available

How would you manage VTE in a patient with bleeding disorder such as hemophilia?

Have you used anticoagulants other than coumadin? Or is that the only appropriate agent given monitoring is based on PT/INR?

1 Answer available

How would you manage a patient with acquired von Willebrand disease who requires DAPT for arterial disease?

1 Answer available

Should platelet transfusions be considered for anti-platelet agent reversal in patients with major bleeding?

1 Answer available

Is there a role for anti-fibrinolytic agents in patients with hyperfibrinolytic disseminated intravascular coagulation?

The use of anti-fibrinolytics is typically contraindicated in DIC, but does it have benefit in DIC states characterized by hyperfibrinolysis?

1 Answer available

What additional testing, if any, should be performed for an adolescent patient with heavy menstrual bleeding and a negative von Willebrand disease evaluation?

1 Answer available

What is the best way to monitor intraoperative heparin use in a patient with factor XII deficiency?

In a patient with severe factor XII deficiency with a baseline prolonged PTT, what is the best method to monitor their ACT or heparin levels when on c...

1 Answer available

Do you account for the effect of coffee on platelet aggregation studies?

1 Answer available

How do you evaluate an isolated prolonged aPTT in patients?

Especially in a patient without hemophilia or thrombosis history?

1 Answer available

Are patients with bleeding disorders receiving plasma-derived products at increased risk of acquiring COVID-19?

1 Answer available

Should patients with bleeding disorders increase their home supplies of clotting factors foreseeing a possible shortage of product availability due to COVID-19?

1 Answer available