A 35-year-old patient is brought into the emergency department post motor vehicle crash. Stabilization of the patient in the trauma bay requires endotracheal intubation. The patient has a laceration on the femoral artery from shrapnel and seems to have lost large quantities of blood. The patient is transfused with 13 units of packed red blood cells. His vitals are T 96.5, HR 150, BP 90/40. Even with the direct pressure on the femoral artery, the patient continues to bleed. Results of labs drawn within the last hour are pending. Which of the following is most likely to stop the bleeding in this patient?
ANormal saline
BFresh frozen plasma and platelets
CWhole blood
DDextrose
ECryoprecipitate
An otherwise healthy 23-year-old man comes to the physician because of a 3-day history of mild persistent bleeding from the site of a tooth extraction. He has no prior history of medical procedures or surgeries and no history of easy bruising. He appears well. Vital signs are within normal limits. Laboratory studies show: Hemoglobin 12.4 g/dL Platelets 200,000/mm3 Serum Prothrombin time 25 seconds Partial thromboplastin time (activated) 35 seconds Deficiency of which of the following coagulation factors is the most likely cause of this patient’s condition?
AFactor II
BFactor XIII
CFactor X
DFactor VII
EFactor V
A 6-month-old male presents to the emergency department with his parents after his three-year-old brother hit him on the arm with a toy truck. His parents are concerned that the minor trauma caused an unusual amount of bruising. The patient has otherwise been developing well and meeting all his milestones. His parents report that he sleeps throughout the night and has just started to experiment with solid food. The patient’s older brother is in good health, but the patient’s mother reports that some members of her family have an unknown blood disorder. On physical exam, the patient is agitated and difficult to soothe. He has 2-3 inches of ecchymoses and swelling on the lateral aspect of the left forearm. The patient has a neurological exam within normal limits and pale skin with blue irises. An ophthalmologic evaluation is deferred. Which of the following is the best initial step?
AGenetic testing
BComplete blood count and coagulation panel
CEnsure the child's safety and alert the police
DPeripheral blood smear
EHemoglobin electrophoresis
+ 7 more in the PDF
Browse all chapters