madhurima
AIPPG Experienced Senior Member
Joined: 06 Nov 2008
Posts: 2534
85332 Credits
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 Posted: Mon Nov 02, 2009 2:16 pm Post subject: 45 yr old male is admitted with complaints of 2 episodes of |
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45 yr old male is admitted with complaints of 2 episodes of coffee colored vomitus. pt is a known alcoholic for 20 yrs and was diagnosed with cirrhosis 3 yrs back. pulse is 110/min, BP is 88/60 mm Hg, resp rate is 16/min. lab values show sr. albumin 2 mg%, bilirubin 4 mg%, PT 19 sec, aPTT 28 sec, Hb 11.5 g%, platelets 130,000/cu mm. which is the next best step in management?
A) whole blood transfusion
B) packed RBC
C) platelet infusion
D) FFP
E) cryoprecipitate
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madhurima
AIPPG Experienced Senior Member
Joined: 06 Nov 2008
Posts: 2534
85332 Credits
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| Posted: Mon Nov 02, 2009 2:16 pm Post subject: |
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Most important thing to deal here is patient is losing FACTORS. His PT is increased.
Albumin is low.
Again, if in options IV fluids was given.....answer would have been IVF.
But they are clever. They tricked us by not giving IV fluids, rather they gave other options.
After low BP, most important concern is patients PT. His Hb IS not so bad.
Guys no body dies because of anemia!
So, FFP, is the correct answer.......corrects PT, prevents Bleeding.
Whole blood is NOT GIVEN NOW A DAYS( exceptions very few).
PCV wud have been the right answer is patient had normal PT/ALBUMIN.
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