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(CASE 8) clotting and thrombosis - Coggle Diagram
(CASE 8) clotting and thrombosis
left school at 16
working in the family business (lack of physical activity)
obese in his 20s
at 33 he was 133kg, 1.75m (very obese)
lacked of diet
living with his parents (explain the unhealthy behavoiur)
l
breathless and collapsed
first diagnosed as a heart attack
pain in the chest
laid in bed for a week cause he strained his back
D-dimer test (was positive)
provisional diagnosis was pulmonary embolism secondary to deep vein thrombosis
full blood count, cardiac troponin, and clotting screen ( all tests were normal)
confirmed by CT pulmonary angiogram
chest x-ray was normal
engorged neck veins with prominent pulsation
physical examination showed tachypoea
normal breath sounds
ECG showed sinus tachycardia
Bp was 110/74 (normal)
enlarged right calf
blood sample results: normal co2 and pH, low oxygen
patient had two options: To receive daily subcutaneous injections of low molecular weight heparin (LMWH) and to start oral therapy at the same time with warfarin; or b) To receive direct oral anticoagulant (DOAC) therapy.
he choose to receive LMWH and warfarin therapy
the daily wafarin dos was adjusted to stabilise his INR
his prothrombin was measured and used to calculate his INR
INR value at 2.5
urged to lose weight
he developed sinsitis
he was given vitamin K
he took ibuprofen
follow ups to check his INR
after discharge told to attend the anticoagulant outpatient clinic
INR value was still close 2.5