Bleeding #2____________? - sarim

[ArchivalUser]

A 65 y/o caucasian male had undergone cardiac catheterization followed by aortic valve replacement for severe aortic stenosis and coronary artery bypass grafting for three vessel disease.His postoperative course was complicated by atrial fibrilation and an urinary tract infection.His other medical problems include HTN,diabetes and hypercholesterolemia.He is also receiving heparin,ciprofloxacin and amiodarone.Onpostoperative day five , he developed prolonged bleeding from the venipunture site. His lab:

Hb........................11.5
MCV......................88
Platelet ct..............50,000
Leukocyte ct..........75,00
seg.Neutrophils......68%
Bands...................1%
Eosinophils............1%
Lymphocytes.........24%
Monocytes.............6%
PT.........................12 sec (INR=1.0)
PTT........................65 sec

His preoperative labs were unremarkable.What is the most likely cause of these findings in this pt?

A-Thrombotic Thrombocytopenic purpura
B-Hemolytic Uremic syndrome
C-Ideopathic Thrombocytopenic purpura
D-Vitamin deficiency
E-Medication affect
F-Disseminated intravas. coagulation
G-Factor VIII defi
H-Factor IX defi
I-vW's disease

[ArchivalUser]

i got for heparin induced thrombocytopenia .. medication affect. E

[ArchivalUser]

eeeee...

[ArchivalUser]

ee

[ArchivalUser]

EEE

Cipro inhibit P450, leading to Heparin intoxication. Heparin will prolong PTT, but no affect platelets on regular dosage, but thrombocytopenia is a heparin side effect.

[ArchivalUser]

but heparin induced thrombocytopenia also named as:

C-Ideopathic Thrombocytopenic purpura.

or i am rong?

[ArchivalUser]

wht' s the ans sarim??

[ArchivalUser]

goforusmle; not it's not ..

[ArchivalUser]

correct is "E" ( Heparin Induced Thrombocytopenia)

@ariadna (Hola amiga) ---isn't that the HIT dose-independent? also does the Heparin use cyto-p450?

@goforusmle---ITP you would only see Thrombocytopenia and no affect on coagulation factors.It may be associated with SLE.