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!

Avsnitt(1145)

Pediatric Palliative Care Expert Panel

Pediatric Palliative Care Expert Panel

Selected audio from our event, Palliative, hosted on June 27, 2022 in conjunction with Children's Hospital Colorado's Department of Palliative Medicine and The Denver Hospice's Footprints Program. Ke...

3 Aug 20221h 6min

Podcast 802: Intranasal Medication Administration for Pediatric Patients

Podcast 802: Intranasal Medication Administration for Pediatric Patients

Contributor: Aaron Lessen, MD Educational Pearls: Intranasal medication administration is a convenient, quick, and relatively painless option for pediatric patients Often used as an initial medicatio...

2 Aug 20223min

Mental Health Monthly #14: Substance-Induced Psychosis (Part II)

Mental Health Monthly #14: Substance-Induced Psychosis (Part II)

In this second episode of a two-part mini-series, we feature Dr. Nadia Haddad, a Colorado psychiatrist, and Dr. Ricky Dhaliwal, an emergency medicine physician, as they discuss the various treatment m...

27 Juli 202224min

Podcast 801: Push Dose Vasopressors

Podcast 801: Push Dose Vasopressors

Contributor: Aaron Lessen, MD Educational Pearls: There are two common options for push-dose vasopressor: phenylephrine and epinephrine. Both have been studied in the setting of the OR, but are lacki...

26 Juli 20223min

Podcast 800: Mortality in Fevers

Podcast 800: Mortality in Fevers

Contributor: Aaron Lessen, MD Educational Pearls: A recent study evaluated the association between the degree of fever and mortality rate in patients presenting to a set of Emergency Departments in I...

25 Juli 20222min

Podcast 799: EKG Abnormalities in Renal Failure

Podcast 799: EKG Abnormalities in Renal Failure

Contributor: Peter Bakes, MD Educational Pearls: Patients in renal failure may have elevated serum potassium levels which can result in EKG changes. EKG changes in the setting of hyperkalemia gener...

19 Juli 20224min

Podcast 797: Vitamin C in Sepsis

Podcast 797: Vitamin C in Sepsis

Contributor: Aaron Lessen, MD Educational Pearls: Prior, smaller studies showed intravenous Vitamin C given to patients with sepsis significantly improved patient mortality and additional outcomes. ...

12 Juli 20222min

Podcast 796: Fluid Amounts in Septic Shock

Podcast 796: Fluid Amounts in Septic Shock

Contributor: Aaron Lessen, MD Educational Pearls: Septic shock management has traditionally endorsed rapid fluid resuscitation and the administration of vasopressors Current guidelines are for patien...

11 Juli 20223min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
pojkmottagningen
dumforklarat
rss-vetenskapsradion-2
halsorevolutionen
rss-vetenskapsradion
rss-ufo-bortom-rimligt-tvivel
sexet
rss-spraket
rss-experimentet
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
medicinvetarna
vetenskapsradion
rss-arkeologi-historia-podden-som-graver-i-vart-kulturlandskap
bildningspodden