Approach to bleeding disorders (thrombocytopenia) Quiz: Ace Your Exams
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A 56-year-old man presents to the emergency department for evaluation of black, tarry stools and lightheadedness for two days. He has a history of cirrhosis due to chronic alcohol use. Temperature is 37ºC (98.6°F), heart rate is 116/min, blood pressure is 96/42 mmHg, respiratory rate is 20/min, and oxygen saturation is 99% on room air. The patient appears pale and fatigued but is oriented to person, place, and time. Physical examination reveals a distended abdomen with a positive fluid wave. Rectal examination reveals guaiac positive dark, tarry stool. Laboratory results are shown below. Intravenous access is established via two peripheral 18-gauge catheters. Which of the following is the best next step in management?
| Laboratory value | Result |
| Hemoglobin | 9.4 g/dL |
| Hematocrit | 28 % |
| Leukocyte count | 12,100 /mm3 |
| Platelet count | 88,000/mm3 |
| PT/INR | 25 seconds |
| PTT | 28 seconds |
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