The patient presentation may be in the form of an abnormal lab value or abnormal bleeding or clotting. Clotting factor abnormalities in this clinical mind map are pertinent to only disorders which lead to abnormal bleeding and do not include disorders which can cause excessive clotting, such as protein C, S, and antithrombin 3 deficiency. Clotting factor abnormalities are often diagnosed based upon abnormal labs or severe bleeding during a procedure or trauma. Some of these abnormalities are diagnosed during early life (hemophilia) and a clinician can order a standard set of labs to arrive at the diagnosis. Others of these abnormalities are diagnosed in adult life with or without symptoms, such as ITP, vWF def. Platelet deficiencies/disorders present as symptoms and signs such as petechiae and purpura, such that lab work up helps a clinician arrive at the diagnoses. Several scenarios which result in platelet destruction/excessive consumption (such as DIC, hypersplenism, liver disease) present with a constellation of clinical features which help provide clues, and additional lab testing can help establish final diagnoses. Vascular defects are often benign (HSP is an exception), and a careful and thorough history can help a clinician arrive at the diagnosis.
Urgent and emergent situations include sever bleeding, which can result from several disorders. Excessive bleeding can be obvious, which should prompt stabilization and further work up, and in some situations severe bleeding can be occult, which may result in symptoms of severe anemia and shock, and such situations are reflected in abnormal vital signs and a patient’s appearance of distress.
A few mnemonics to memorize differentials are
1) ABCD-KV (for hemophilias A, B, chronic liver disease, Vit K, & drugs)
2) HIT the GAMe with BMW