Study Sets

Coagulation disorders

Compiled by: Ahmad Alkhasawneh

Recurrent thromboembolism in young female

A 39-year-old woman with past medical history of autoimmune disorder presenting to ED with acute onset shortness of breath. She was hypoxemic upon arrival, and CT scan showed pulmonary emboli. She was not on anticoagulant therapy on presentation. (Note: confirmatory tests can be obtained).

Uncontrolled bleeding in a newborn

2 weeks old male neonate presented with uncontrolled bleeding at circumcision site. Initial work up studies are shown.

Severe bleeding after delivery

30-year-old woman with recent delivery of her second baby 4 months ago, presents with large hematoma on her thigh. She does not recall any injury to the site. No significant history of bleeding or medication. Blood was drawn from left forearm.

Left arm deep vein thrombosis

A 27-year-old man presented with swelling in the left arm. Doppler ultrasound showed deep vein thrombosis. He has no history of recent travel, immobility, excessive bleeding or medication. Initial laboratory findings are shown.

Severe menorrhagia

A 14-year-old girl came to the pediatrician with complains menstrual period lasting for 6-7 days. She needs to get up 1-2 times during the night to change her pads. She stopped her basketball practice when she has her period because she soaks through her pads during practice. She is not receiving any medication.

Bruising after playing soccer

7-year-old boy with complains of multiple bruises on his legs and arms. Recently he started to play football with his friends and his mother noticed the bruises. After questioning mother, she remembers his son had nosebleeds a few times in the past, mainly at wintertime. It usually stopped after a short time and thought it was due to the dry air in the house. No medical care was needed. Boy is healthy, rarely has cold symptoms, and not on any medication.

Frequent bruising and hematoma

A 5 year-old girl (adopted) brought by her mother with frequent bruising and severe periorbital hematoma after laceration of left eyebrow. Mother tells the clinician that her daughter cut her left eyebrow with scissors 2 weeks ago. For 2-4 days, it looked as it was healing well and then it looked like fresh bleeding at the injury site. This cycle of healing and worsening repeated but the wound still does not seem healing.

Abnormal lab test

A 21-year-old female with no previous medical history was admitted with acute abdomen. Coagulation screening tests were ordered for impending urgent surgery for acute appendicitis.

Cerebral vein thrombosis in a young female patient

A female patient in her fourth decade presented with several months right sided headache associated with nausea. CT head showed extensive cerebral venous thrombosis. Patient was taking OCP at the time which was thought to be the provoking event. OCPs discontinued, patient was placed on anticoagulation.