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)

Podcast 633: Pathologic Femur Fractures

Podcast 633: Pathologic Femur Fractures

Contributor: Jared Scott, MD Educational Pearls: Pathologic bone fractures occur due to weakened bones from chronic disease and with less force when compared to non-pathologic fractures Can be due to...

19 Jan 20215min

Podcast 632: Neonatal Jaundice

Podcast 632: Neonatal Jaundice

Contributor: Jared Scott, MD Educational Pearls: Bilirubin is natural breakdown product of red blood cells but can be neurotoxic if levels become too high Fetal red blood cells are fragile and break ...

18 Jan 20216min

Pharmacy Phriday #7: Bactrim Adverse Events

Pharmacy Phriday #7: Bactrim Adverse Events

Contributor: Cheyenne Bean, PharmD Educational Pearls: Bactrim (TMP-SMX) is a sulfa antibiotic used for a number of infections but can have untoward effects. Hypoglycemia can be induced by the sulfa ...

15 Jan 20214min

Podcast 631: UK COVID-19 Mutation

Podcast 631: UK COVID-19 Mutation

Contributor: Gretchen Hinson, MD Educational Pearls: Viruses mutate frequently and a new variant of COVID has been found in the United Kingdom. Mutations typically occur due to transcription errors d...

13 Jan 20215min

Podcast 630: Evolution of an STEMI

Podcast 630: Evolution of an STEMI

Contributor: Peter Bakes, MD Educational Pearls: Hyperacute T waves can occur immediately and typical last less than an hour Hyperacute T waves are typically broader than peaked T-waves, which are ...

12 Jan 20215min

Podcast 629: Inferior STEMI

Podcast 629: Inferior STEMI

Contributor: Jared Scott, MD Educational Pearls: EKGs look at different angles, or vectors, of the heart's electrical conduction as it travels through the heart. Knowing how to read these vectors is ...

11 Jan 20214min

Podcast 628: ST Elevation

Podcast 628: ST Elevation

Contributor: Peter Bakes, MD Educational Pearls: STEMI criteria is not just 1mm elevation in contiguous leads 1.5 mm in V2-V3 for women 2.0 mm in V2-V3 for men 2.5 mm in V2-V3 for men under 40 In...

5 Jan 20215min

Podcast 627: Oxygen Like It's Hot

Podcast 627: Oxygen Like It's Hot

Contributor: Aaron Lessen, MD Educational Pearls: High flow nasal cannula (HFNC) has become more utilized with COVID pandemic Multiple studies have shown this method improves both oxygenation and ven...

4 Jan 20213min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
det-morka-psyket
kapitalet-en-podd-om-ekonomi
pojkmottagningen
sexet
rss-ufo-bortom-rimligt-tvivel
rss-vetenskapsradion-2
rss-vetenskapsradion
dumforklarat
halsorevolutionen
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
medicinvetarna
rss-experimentet
bildningspodden
vetenskapsradion
hacka-livet
intergalaktiskt