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 # 344: Foley troubleshooting

Podcast # 344: Foley troubleshooting

Author: Aaron Lessen, MD. Educational Pearls: When foley is stuck, balloon may not have deflated. Make sure balloon is not in the urethra, which can block drainage. Cut off the port as it may b...

22 Jun 20183min

Podcast # 343: Snake Bites

Podcast # 343: Snake Bites

Educational Pearls: Snake bites commonly occur between April and October. Rattlesnake bites are the most common. Venom contains proteins/enzymes that cause local inflammation, coagulopathy, and...

20 Jun 20186min

Podcast # 342: Scombroid

Podcast # 342: Scombroid

Author: Jared Scott, MD Educational Pearls: Scombroid is a type of food poisoning associated with dark fish (i.e. tuna, salmon, mackerel) that mimics anaphylaxis. Occurs through conversion of histi...

18 Jun 20184min

Podcast # 341: Tenecteplase vs. Alteplase

Podcast # 341: Tenecteplase vs. Alteplase

Author: Rachel Beham, PharmD Educational Pearls: Tenecteplase is more specific for fibrin and has a longer half-life than alteplase. In setting of ischemic stroke, tenecteplase before thrombectomy ...

13 Jun 20183min

Podcast # 340: Drowning

Podcast # 340: Drowning

Author: Chris Holmes, MD Educational Pearls: Epidemiology: 80% male, ages 1-4 at greatest risk, African-American > Caucasian. Freshwater and ocean water may have more bacteria than pool water. ...

11 Jun 20185min

Podcast # 339: Ectopic Pregnancy Risk Factors

Podcast # 339: Ectopic Pregnancy Risk Factors

Author: Jared Scott, MD Educational Pearls: Data is mixed, but some studies show 1-2% of pregnancies are ectopic. Risk factors for ectopic pregnancies include: pelvic inflammatory disease, prior ec...

8 Jun 20185min

Podcast # 338: Mononucleosis predictors

Podcast # 338: Mononucleosis predictors

Author: Chris Holmes, MD Educational Pearls: Symptoms commonly seen with mononucleosis are palatal petechiae, posterior cervical lymphadenopathy, inguinal/axillary lymphadenopathy, splenomegaly, and/...

6 Jun 20182min

Podcast # 337: Airway Burn Inhalation

Podcast # 337: Airway Burn Inhalation

Author: John Winkler, MD Educational Pearls: Singed nasal hairs, soot around mouth, hoarse voice, drooling, and burns to head/face are signs suggestive of inhalation injury. Early intubation is cri...

4 Jun 20186min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
jss
rss-rekommandert
liberal-halvtime
rss-paradigmepodden
sinnsyn
forskningno
villmarksliv
pod-britannia
fjellsportpodden
dekodet-2
rss-lundqvist-podden
rss-nysgjerrige-norge
hva-er-greia-med
tidlose-historier
rss-overskuddsliv
diagnose
tomprat-med-gunnar-tjomlid