Podcast 647: INR and Liver Failure

Podcast 647: INR and Liver Failure

Contributor: Erik Verzemnieks, MD

Educational Pearls:

  • INR measures the clotting cascade including factors II, VII, IX, and X
  • Coumadin most commonly elevates the INR, and it is used to monitor the anticoagulant's effectiveness
  • Liver failure can cause a similar elevation in the INR due to lack of synthesis of factors II, VII, IX, X
  • An elevated INR in liver failure does not mean that the patient is anticoagulated, at increased risk for bleeding, or is at less risk of forming a clot
  • There is more commonly an increased risk of clot formation due to lack of production of protein C and S, which are natural anticoagulants
  • Lack of production of proteins C and S have a larger effect and lead to typically a net clotting risk
  • Levels of these can be indirectly measured through albumin
  • Portal venous thrombosis is one of the most common examples of this phenomenon

References

Harrison MF. The Misunderstood Coagulopathy of Liver Disease: A Review for the Acute Setting. West J Emerg Med. 2018;19(5):863-871. doi:10.5811/westjem.2018.7.37893

Summarized by John Spartz, MS3 | Edited by Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at www.emergencymedicalminute.com/cme-courses/ and create an account.

Donate to EMM today!

Episoder(1147)

Podcast # 424: Hunting for Measles

Podcast # 424: Hunting for Measles

Author: Mike Hunt, MD Educational Pearls: Measles is highly contagious and successfully infects 90% of those at risk exposed to the virus. 10 day prodrome where patients are asymptomatic. 3 day perio...

16 Jan 20194min

Podcast # 423: Blunt Cardiac Injuries

Podcast # 423: Blunt Cardiac Injuries

Author: Mike Hunt, MD Educational Pearls: Blunt cardiac injuries most commonly occur in motor vehicle collisions, auto-pedestrian collisions, and from sports injuries The more anterior right ventri...

14 Jan 20194min

Podcast # 422: ED Opioid Prescription Trends

Podcast # 422: ED Opioid Prescription Trends

Author: Jared Scott, MD Educational Pearls: From 1996 to 2012, the total quantity of opioids prescribed increased 647% for non-cancer pain Office based prescriptions accounted for 84% of the total ...

11 Jan 20194min

Podcast # 421: Sweet DKA Pearls

Podcast # 421: Sweet DKA Pearls

Author: Gretchen Hinson, MD Educational Pearls:   Diabetic ketoacidosis patients are subject to electrolyte derangements Potassium should be monitored closely: K 3.3 K > 5.3 = delay potassium repl...

9 Jan 20194min

Podcast # 420: CT Contrast and the Kidneys

Podcast # 420: CT Contrast and the Kidneys

Author: Don Stader, MD Educational Pearls: Recent meta-analysis has demonstrated that there is no significant risk for kidney injury from CT contrast Most kidney injury seen after contrast CTs wer...

7 Jan 20192min

Podcast # 419: Etripamil

Podcast # 419: Etripamil

Author: Don Stader, MD Educational Pearls: Etripamil is an intranasal calcium channel blocker in development for use in SVT A recent study showed that etripamil has an SVT conversion rate of arou...

20 Des 20183min

Podcast # 418: Vertebral Artery Dissection

Podcast # 418: Vertebral Artery Dissection

Author: Don Stader, MD Educational Pearls: Vertebral artery dissection (VAD) contributes to just 2% of strokes overall but ~25% of strokes for patients VAD is associated with minor trauma (chiroprac...

17 Des 20183min

Podcast # 417: Water Balance

Podcast # 417: Water Balance

Author: Katie Sprinkle, MD Educational Pearls: Hyponatremia results when patients over hydrate and dilute their sodium with too much free water Symptoms of hyponatremia can mimic symptoms of dehydrat...

15 Des 20183min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
rss-rekommandert
jss
liberal-halvtime
villmarksliv
rss-paradigmepodden
forskningno
sinnsyn
fjellsportpodden
pod-britannia
nevropodden
rss-nysgjerrige-norge
tidlose-historier
hva-er-greia-med
diagnose
rss-overskuddsliv
smart-forklart
rss-lundqvist-podden