Hemostasis/Thrombosis   

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 ...

Thrombophilia testing, including JAK2 is negative. When would you stop anticoagulation?

If not, has your practice changed to use vWF replacement therapy more routinely for perioperative or acute bleeding management? Do you still perform D...

Are there specific guidelines for managing this patient population?

Are the INRs reliable? In what scenarios would you not recommend POC INR use for warfarin monitoring? Are these typically covered by insurance? Are t...

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

Do social or economic factors (i.e., relative cost of acquiring LMWH, the patient being injection averse) affect your decision to use DOACs? Do you s...

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

Additional risk factors could be family history of VTE or thrombophilia, such as antithrombin deficiency.

While follow up ultrasound is not usually recommended in provoked DVT, it often is done either for other reasons or by other physicians. Would this in...

Common thought is that FVIII may be used for differentiating coagulopathy in liver disease (normal to increased, from reduced clearance of VWF/FVIII) ...

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

Would you consider low dose indefinite anticoagulation in any scenario? Any difference in approach between hematological malignancy and solid tum...

No prior thrombosis; no family history of thrombosis. As per endocrine, the only useful therapy for the osteoporosis is estrogen. 

E.g. pulmonary embolism, portal vein thrombosis, cerebral venous sinus thrombosis

In the absence of concerning bleeding or thrombosis, family history of coagulopathy, current anticoagulant use, or malnutrition

Is thrombotic risk too significant? Patient failed OCPs.

I.e., what constitutes well-controlled cancer, IBD, nephrotic syndrome, etc. What other diseases do you put in this category (obesity, autoimmune dise...

How would the approach differ if the patient had a significant bleeding phenotype vs only minor bruising and mucosal bleeding?

FVL heterozygotes are often treated similarly to the general population. Aside from avoiding other VTE risk factors, are there situations where prophy...

Would you offer indefinite anticoagulation if the event is unprovoked and the patient has low bleeding risk? 

Provoked or unprovoked VTE: Do you use D-Dimer (or even repeat imaging to reassess residual clot) in any capacity to guide anticoagulation duration? E...

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

While this is a known risk factor for venous [Meijers et al NEJM 2000] and potentially arterial [Yang et al, Am J Clin Pathol 2006] thrombosis, it is ...

While thrombophilia testing is not routinely recommended prior to starting OCPs, how about after the development of a VTE?

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

What if this was "triple-negative" antiphospholipid syndrome?