Bleeding and bruising: a diagnostic work-up

Bleeding and bruising: a diagnostic work-up

Primary care physicians are often asked about easy bruising, excessive bleeding, or risk of bleeding before surgery. A thorough history, including a family history, will guide the appropriate work-up, and a physical examination may provide clues to diagnosis. A standardized bleeding score system can...

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Bibliographic Details
Published in:American family physician Vol. 77; no. 8; pp. 1117 - 1124
Main Authors: Ballas, Michael, Kraut, Erich H
Format: Journal Article
Language:English
Published: United States American Academy of Family Physicians 15-04-2008
Subjects:
Adult
Blood Cell Count
Blood transfusions
Contusions - diagnosis
Contusions - etiology
Disease
Female
Hemophilia
Hemophilia A - diagnosis
Hemorrhage - diagnosis
Hemorrhage - etiology
Humans
Lupus
Male
Medical diagnosis
Medical History Taking
Middle Aged
Partial Thromboplastin Time
Patients
Physical Examination
Platelet Function Tests
Primary care
Prothrombin Time
Purpura - diagnosis
Referral and Consultation
von Willebrand Diseases - diagnosis
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Summary:Primary care physicians are often asked about easy bruising, excessive bleeding, or risk of bleeding before surgery. A thorough history, including a family history, will guide the appropriate work-up, and a physical examination may provide clues to diagnosis. A standardized bleeding score system can help physicians to organize the patient's bleeding history and to avoid overlooking the most common inherited bleeding disorder, von Willebrand's disease. In cases of suspected bleeding disorders, initial laboratory evaluations should include a complete blood count with platelet count, peripheral blood smear, prothrombin time, and partial thromboplastin time. More specialized yet relatively simple tests, such as the Platelet Function Analyzer-100, mixing studies, and inhibitor assays, may also be helpful. These tests can help diagnose platelet function disorders, quantitative platelet disorders, factor deficiencies, and factor inhibitors.
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ISSN:0002-838X