Ugh. That was fast! Today was our first assessment of the year in the form of an 8AM double-header quiz in pathology and immunology. Could have gone better. But studying yesterday, I realized that pathology is going to be much much better than several of the classes we took last year. It took a year but we're finally learning about disease, which is more readily applicable to patient care. Now maybe I'll be readier for the next quiz...
TIL: To identify a clotting factors deficiency, you mix the patient's blood with normal blood. Normal blood contains all of the clotting factors so this "mixing study" will normalize the clotting time for the patient's blood. To figure out which precise factor is deficient requires a bit more work. Now, you mix the patient's blood with a samples each lacking one of the factors. Any combination that brought at least some of each clotting factors will also normalize, but when you find a combination where both parts of the mixture are deficient in the same factor, the clotting tune will remain abnormal, thus identifying the deficient clotting factor.
Disseminated intravascular coagulation (DIC) sucks. This is a condition brought about by a whole slew of etiologies and whatever you do to treat it will make it worse. DIC causes a widespread activation of the coagulation cascade, resulting in small blood clots blocking small arteries and capillaries throughout the body. The clot storm is so severe though that it uses up all of the clotting machinery resulting in widespread bleeding elsewhere in the body. If you treat the clotting with anticoagulant meds, the patient will bleed out; if you treat the bleeding with clotting factors they'll thrombose, likely leading to an embolism. Yay! The treatment is to try to fix the underlying condition but between 10 and 50% of patients with DIC will die from the condition.
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