Warfarin skin necrosis occurs within the first 2 to 3 days after ...

[krzymel]

Warfarin skin necrosis occurs within the first 2 to 3 days after starting warfarin therapy because:
 
  a. The platelet count decreases to fewer than 100  109/L, and significant bleeding occurs.
  b. Protein C decreases significantly before full anticoagulation, and skin thrombosis results.
  c. Prothrombin decreases rapidly generating less thrombin, and significant bleeding occurs.
  d. Plasminogen increases, and rapid clot lysis occurs.

Question 2

An INR of 6.5 is obtained on a patient taking warfarin. All quality control is acceptable. What should be done?
 
  a. Report the result.
  b. Report only the PT in seconds and ignore the INR.
  c. Send an e-mail to the healthcare provider.
  d. Call the healthcare provider immediately.

[blakeserpa]

Answer to Question 1

ANS: B
Protein C has a 6-hour half-life, and so it rapidly decreases when warfarin therapy is begun, along with factor VII (both are vitamin Kdependent proteins). Full anticoagulation with warfarin is not obtained until factors X and prothrombin are decreased to less than 50, requANS: B
Protein C has a 6-hour half-life, and so it rapidly decreases when warfarin therapy is begun, along with factor VII (both are vitamin Kdependent proteins). Full anticoagulation with warfarin is not obtained until factors X and prothrombin are decreased to less than 50, requiring 4 to 7 days based on their half-lives. Because protein C is important in controlling clot formation, its decrease actually puts the patient in a prethrombotic state until full anticoagulation is obtained.
iring 4 to 7 days based on their half-lives. Because protein C is important in controlling clot formation, its decrease actually puts the patient in a prethrombotic state until full anticoagulation is obtained.

Answer to Question 2

ANS: D
The clinical laboratory scientist must immediately call the healthcare provider because this is a critical INR result and he or she must be able to intervene with appropriate patient care. The call must be documented according to the protocol established by clinical scientists in the laboratory. This is essential to prevent a bad outcome for the patient.

[krzymel]

Thank you

[blakeserpa]

No problemo