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Blood & Clots Series: How do you stop warfarin for surgery?

In Blood & Clots, Medical Concepts by Kerstin de WitLeave a Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical Expert, Scholar Case Description You are assessing a 76 year old lady who takes warfarin for stroke prevention because she had a mechanical aortic valve replacement 4 years ago. She was at the preoperative clinic this morning because she will have a knee replacement surgery in a weeks time. The anesthesiologist said they would  like to …

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Sirens to Scrubs: Subarachnoid Hemorrhage

In Sirens to Scrubs, Working in EM by Michael KruseLeave a Comment

You are dispatched lights and sirens for Jennifer, a 52-year-old female complaining of “the worst headache of my life”. She recalls running on a treadmill then feeling like she had been struck in the back of the head by a clap of thunder. She then proceeded to have a witnessed two-minute episode of syncope. On arrival you find Jennifer coming out of the bathroom where she was just vomiting. As you are getting …

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Blood & Clots Series: What is the optimal antithrombotic strategy for atrial fibrillation post-PCI?

In Blood & Clots, Medical Concepts by Vinai BhagirathLeave a Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical Expert Main Messages  P2Y12 inhibition is important for the first 1-6 months after PCI insertion, and may have ongoing benefits up to 12 months or longer.  Addition of anticoagulant to antiplatelet therapy increases the risk of bleeding, but reduces the risk of stroke.  Use of an anticoagulant plus P2Y12 inhibitor is preferable to anticoagulant plus dual …