The Clinical Problem Solvers

Episode 415 – Spaced Learning Series – Beyond The Coagulation Cascade

15 snips
Aug 27, 2025
Dive into the world of coagulation as the hosts tackle a complex case of a 70-year-old man facing unusual bleeding. They dissect the nuances of hemostasis, addressing the key roles of blood components and the implications of coagulopathy. Lab findings related to leukocytosis and kidney issues are explored, emphasizing accurate diagnoses. The challenges of amyloidosis and vascular health are discussed, shedding light on the intricate relationship between conditions and bleeding risks. An interdisciplinary approach to treatment highlights the complexities of managing such cases.
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ANECDOTE

Case Kickoff: Elderly Patient With Ongoing Bleeds

  • Mukund presents a 70-year-old man with persistent oozing chest wound and retroperitoneal hematoma requiring IR.
  • This short vignette launches a layered diagnostic hunt across hemostatic systems.
INSIGHT

Three Pillars Of Hemostasis

  • Hemostasis requires vessel integrity, platelets, and plasma proteins working together.
  • Small dysfunctions in platelets can affect both primary and secondary hemostasis.
ADVICE

Use Bleed Timing To Guide Testing

  • Use bleed pattern to distinguish platelet versus factor problems at the bedside.
  • Ask whether bleeding was immediate and mucocutaneous or delayed deep compartmental to guide testing.
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