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Medicine (MD/DO)
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First Aid
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First Aid for the USMLE Step 1 (2023)
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First Aid for the USMLE Step 1 (2023) | Medicine (MD/DO) School Study Aid

Page 433 -
7 Picmonics to Learn | 16 mins
Von Willebrand Disease
Mixed platelet and coagulation disorder
Mechanism
Autosomal Dominant Condition Leading to Reduced vWF
Defect in platelet plug formation
Labs
Increased Bleeding Time
PTT increased
Factor VIII decreased
Normal platelet count
Treatment
DDAVP (synthetic vasopressin)
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1 min
Disseminated Intravascular Coagulation (DIC)
Pathophysiology
Bleeding State
Activation of Clotting Factors
Deficiency of Clotting Factors
Causes
Sepsis
Trauma
Obstetric Complications
Acute Pancreatitis
Malignancy
Nephrotic Syndrome
Transfusion
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2 mins
Snake Bite Injury
Local Findings
Edema
Erythema
Tissue Necrosis
Systemic Findings
Neurotoxicity
Distributive Shock
Disseminated Intravascular Coagulation (DIC)
Diagnosis
Diagnosis by Clinical Impression
Management
Antivenom
Closely Monitor Patient
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2 mins
Antithrombin Deficiency
Characteristics
Autosomal Dominant
Increased Thrombin and Factor X
Heparin Resistance
Hypercoagulability
Diagnosis
Family History
Normal PT, PTT, and Bleeding Time
Antithrombin-Heparin Cofactor Assay
Management
Factor Xa Inhibitors
Direct Thrombin Inhibitors
Low Molecular Weight Heparin
Antithrombin Replacement
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3 mins
Factor V Leiden Thrombophilia
Pathophysiology
Most Common Genetic Clotting Disorder in Caucasians
Genetic Point Mutation
Glutamine Replaces Arginine
Mutant Factor V
Resistant to Degradation by Activated Protein C
Symptoms
Hypercoagulability
Recurrent DVT (Increased Risk of Thromboembolism)
Considerations
Avoid Oral Contraceptives
Caution During Pregnancy
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2 mins
Protein C or S Deficiency
Pathophysiology
Autosomal Dominant
Inability to Inactivate Factor Va and VIIIa
Symptoms
Hypercoagulable State
Recurrent DVTs or DVTs at Young Age
Treatment
Begin Heparin
Slowly Bridge to Warfarin
Hemorrhagic Skin Necrosis
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2 mins
Prothrombin G20210A Mutation
Pathophysiology
Second Most Common Genetic Clotting Disorder in Caucasians
Autosomal Dominant
Genetic Point Mutation
3' Untranslated Region
Increased PT
Clinical Features
Hypercoagulability
Increased Risk of Thromboembolism
Considerations
Avoid Oral Contraceptives
Caution During Pregnancy
Caution After Surgery
Caution During Long Flights
Treatment
Anticoagulation
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3 mins

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