RT Book, Section
A1 Hillman, Robert S.
A1 Ault, Kenneth A.
A1 Leporrier, Michel
A1 Rinder, Henry M.
SR Print(0)
ID 1127768420
T1 PLATELET DYSFUNCTION AND VON WILLEBRAND DISEASE
T2 Hematology in Clinical Practice, 5e
YR 2016
FD 2016
PB McGraw-Hill Medical
PP New York, NY
SN 9780071626996
LK hemonc.mhmedical.com/content.aspx?aid=1127768420
RD 2024/04/20
AB CASE  HISTORY  •  Part  1A  76-year-old  man  presents  with  a  complaint  of  headache,  which  began  several  hours  after  a  fall  and  has  steadily  worsened.  His  history  is  notable  for  hypertension  and  coronary  artery  disease,  status  post-bypass  grafting  4  years  prior.  He  denies  any  history  of  bleeding  or  thrombosis  other  than  his  previous  coronary  symptoms.  Medications  include  a  cholesterol-lowering  agent,  beta-blocker,  and  a  daily  aspirin.  Examination  is  notable  for  a  tender  bruise  over  the  left  occipital  region.  The  remainder  of  the  examination  is  benign.CBC:  Hemoglobin/hematocrit  -  13  g/dL/39%MCV  -  94  fL  MCH  -  31  pg  MCHC  -  32  g/dLRDW-CV  -  11%  White  blood  cell  count  -  8,500/μLPlatelet  count  -  310,000/μLBLOOD  SMEAR  MORPHOLOGYNormocytic,  normochromic  with  no  aniso-  or  poikilocytosis  or  polychromasia.  White  blood  cells  are  normal  and  platelets  are  numerous  with  normal  morphology.PT  =  12.6  seconds  (<14  seconds)INR  =  1.1  (<1.3)PTT  =  31  seconds  (22–35  seconds)QuestionsGiven  the  risk  of  an  intracranial  hemorrhage,  do  these  laboratory  results  rule  out  a  coagulopathy?What  other  test(s)  might  be  in  order?