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 #400: ECMO

Podcast #400: ECMO

Author: Dylan Luyten, MD Educational Pearls: Extracorporeal membrane oxygenation (ECMO) is similar to bypass ECMO is being utilized routinely at some centers and even prehospital in cardiac arrest ...

2 Nov 20186min

Podcast #399: Hunting for pancreatitis

Podcast #399: Hunting for pancreatitis

Author: Michael Hunt, MD Educational Pearls: Alcohol and gallstones are most common causes of pancreatitis Diagnosis is not simply based on lipase alone - must have at least two the the three criteri...

31 Okt 20183min

Podcast #398:  Who is gonna fail your antibiotic plan?

Podcast #398: Who is gonna fail your antibiotic plan?

Author: Erik Verzemnieks, MD Educational Pearls: Recent study provides at least some evidence to help predict antibiotic failure for cellulitis, which is not necessarily straight forward Intuitive ri...

29 Okt 20181min

Podcast #397: Oh… Pharyngeal Trauma

Podcast #397: Oh… Pharyngeal Trauma

Author: Aaron Lessen, MD Educational Pearls: Injuries from penetrating pharyngeal trauma are often subtle on examination in children Potentially serious complications including carotid artery inju...

27 Okt 20183min

Podcast #396: Oncologic Emergencies

Podcast #396: Oncologic Emergencies

Author: Rachel Brady, MD Educational Pearls: Hypercalcemia of malignancy: Hypercalcemia of malignancy can present with lethargy, muscle weakness, hyperreflexia, altered mental status, cardiac dysrhyt...

24 Okt 20184min

Podcast #395:  Aspirin for everyone!

Podcast #395: Aspirin for everyone!

Author: Aaron Lessen, MD Educational Pearls: In patients without indications for aspirin, three recent studies looked at prevention of several end points in the elderly These showed no benefit in p...

22 Okt 20182min

Podcast #394: Myths of Medication Assisted Treatment

Podcast #394: Myths of Medication Assisted Treatment

Author: Katie Sprinkle, MD Educational Pearls: Medication Assisted Treatment (MAT) is the treatment of addiction with medications, commonly used for opioid use disorders A long held belief is MAT sim...

20 Okt 20185min

Podcast #393: Neonatal Vomiting

Podcast #393: Neonatal Vomiting

Author: Peter Bakes, MD Educational Pearls: Important historical information to elicit is the birth history, feeding habits, stooling habits, associated symptoms, presence of bile, and presence of ...

17 Okt 20185min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
jss
rss-rekommandert
liberal-halvtime
villmarksliv
rss-paradigmepodden
forskningno
sinnsyn
fjellsportpodden
pod-britannia
rss-nysgjerrige-norge
tidlose-historier
hva-er-greia-med
rss-lundqvist-podden
dekodet-2
tomprat-med-gunnar-tjomlid
vett-og-vitenskap-med-gaute-einevoll
nordnorsk-historie