A 40-year-old Caucasian male presents to the emergency room after being shot in the arm in a hunting accident. His shirt is soaked through with blood. He has a blood pressure of 65/40, a heart rate of 122, and his skin is pale, cool to the touch, and moist. This patient is most likely experiencing all of the following EXCEPT:
ADecreased sarcomere length in the myocardium
BIncreased stroke volume
CConfusion and irritability
DDecreased preload
EIncreased thromboxane A2
A 28-year-old man presents for severe abdominal pain and is diagnosed with appendicitis. He is taken for emergent appendectomy. During the procedure, the patient has massive and persistent bleeding requiring a blood transfusion. The preoperative laboratory studies showed a normal bleeding time, normal prothrombin time (PT), an INR of 1.0, and a normal platelet count. Postoperatively, when the patient is told about the complications during the surgery, he recalls that he forgot to mention that he has a family history of an unknown bleeding disorder. The postoperative laboratory tests reveal a prolonged partial thromboplastin time (PTT). Which of the following is the most likely diagnosis in this patient?
Avon Willebrand disease
BBernard-Soulier syndrome
CThrombotic thrombocytopenic purpura
DHemophilia A
EGlanzmann thrombasthenia
A 71-year-old woman is brought to the emergency department following a syncopal episode. Earlier in the day, the patient had multiple bowel movements that filled the toilet bowl with copious amounts of bright red blood. Minutes later, she felt dizzy and lightheaded and collapsed into her daughter's arms. The patient has a medical history of diabetes mellitus and hypertension. Her temperature is 99.0°F (37.2°C), blood pressure is 155/94 mmHg, pulse is 82/min, respirations are 15/min, and oxygen saturation is 99% on room air. The patient's exam is notable for fecal occult blood positivity on rectal exam; however, the patient is no longer having bloody bowel movements. The patient's lungs are clear to auscultation and her abdomen is soft and nontender. Labs are ordered as seen below. Hemoglobin: 7.1 g/dL Hematocrit: 25% Leukocyte count: 5,300/mm^3 with normal differential Platelet count: 182,500/mm^3 Two large bore IV's are placed and the patient is given normal saline. What is the best next step in management?
APacked red blood cells
BType and screen
CFresh frozen plasma
DCT abdomen
EColonoscopy
+ 7 more in the PDF
Browse all chapters