An 80 year old man presents for evaluation prior to laparoscopic hernia



Yüklə 7,23 Mb.
tarix09.02.2017
ölçüsü7,23 Mb.
#8226





  • An 80 year old man presents for

  • evaluation prior to laparoscopic hernia

  • repair

    • Known severe aortic stenosis (no angina, syncope, CHF)
      • No prior history of abnormal bleeding, or clotting disorder
    • Bp 120/70 HR 90 sinus
    • III/VI mid peaking crescendo-decrescendo murmur of aortic stenosis heard in aortic area and radiating to carotids and precordium
    • Stool heme positive


Echo: Severe aortic stenosis, normal left ventricular function

  • Echo: Severe aortic stenosis, normal left ventricular function

    • No change from echo performed one year ago
  • Hbg 7.5

    • Hbg was 14.0 six months ago, microcytic hypochromic
  • Colonoscopy





Which of the following, in addition to the finding noted at colonoscopy, best explains the cause of his anemia?

  • Which of the following, in addition to the finding noted at colonoscopy, best explains the cause of his anemia?

  • A. Acquired disorder impairing platelet adhesion

  • B. Inherited disorder impairing platelet adhesion

  • C. Acquired disorder of thrombin generation

  • D. Inherited disorder of thrombin generation







  • Gigantic multimeric protein

  • Mediates adhesion of platelets to sites of vascular damage

  • Large multimers cleaved by plasma metalloprotease under conditions of high shear stress

  • Absence of large multimers of vWF cause bleeding from gastrointestinal angiodysplasia









Which of the following, in addition to the finding noted at colonoscopy, best explains the cause of his anemia?

  • Which of the following, in addition to the finding noted at colonoscopy, best explains the cause of his anemia?

  • A. Acquired disorder impairing platelet adhesion

  • B. Inherited disorder impairing platelet adhesion

  • C. Acquired disorder of thrombin generation

  • D. Inherited disorder of thrombin generation





Yüklə 7,23 Mb.

Dostları ilə paylaş:




Verilənlər bazası müəlliflik hüququ ilə müdafiə olunur ©azkurs.org 2024
rəhbərliyinə müraciət

gir | qeydiyyatdan keç
    Ana səhifə


yükləyin