04-10-2007, 11:24 PM
A 21-year-old woman presents with a history of ulcerative colitis and insulin-dependent diabetes mellitus. She is admitted for a diabetic foot ulcer and is started on cefotetan. On the day of admission, her colitis flares up, and she has seven episodes of diarrhea. She stops eating, fearing that food may exacerbate her symptoms. She also develops a headache for which she takes acetaminophen every four hours. Four days after the admission, she starts having a nosebleed, which stops with nasal packing. The following day, while ambulating, the patient trips and falls against a chair, resulting in a bruise that develops into a large hematoma. She denies easy bruising or excessive bleeding during dental procedures in the past.
Laboratory studies show the following results:
WBC 6,200/mm3; hemoglobin 9.6 mg/dL; hematocrit 27.5%, platelets 300,000/mm3. Bleeding time 3 minutes (normal); PT 18 seconds; INR 1.5; PTT 42 seconds; albumin 3.5g/dL; total bilirubin 1.2 mg/dL; alkaline phosphatase 95 U/L; ALT 32 U/L; AST 2 5 U/L; ESR 70 mm/h.
What would be the most appropriate in treating this hemostatic disorder?
(A) Desmopressin acetate
(B) Vitamin K
© Factor VIII
(D) Fresh frozen plasma
(E) Aminocaproic acid
Laboratory studies show the following results:
WBC 6,200/mm3; hemoglobin 9.6 mg/dL; hematocrit 27.5%, platelets 300,000/mm3. Bleeding time 3 minutes (normal); PT 18 seconds; INR 1.5; PTT 42 seconds; albumin 3.5g/dL; total bilirubin 1.2 mg/dL; alkaline phosphatase 95 U/L; ALT 32 U/L; AST 2 5 U/L; ESR 70 mm/h.
What would be the most appropriate in treating this hemostatic disorder?
(A) Desmopressin acetate
(B) Vitamin K
© Factor VIII
(D) Fresh frozen plasma
(E) Aminocaproic acid
