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Cases

Bruises she cannot explain

A 38-year-old with new bruising and a fierce headache keeps losing her thread mid-sentence.

38-year-old womanED, bay 3Fictitious educational patient
Previously wellTwo days of dark urine per triage note

Day 0 · 17:05

Arrival

Three days of fatigue, spreading bruises she cannot account for, a severe headache, and moments where her words 'go sideways' for a minute at a time, witnessed once by the triage nurse. The first counts return as you examine her.

Vitals

HR102BP138/84RR18SpO298%T37.8

Results

TestDay 0 · 17:30Reference
Hb84L120160 g/L
Plt12LL150400 ×10⁹/L
WBC9.8411 ×10⁹/L
Cr132H60110 µmol/L
Bili46H321 µmol/L
INR10.91.1
aPTT292535 s
Fib3.61.54 g/L

Anemia plus platelets of 12 with NORMAL clotting times. Which single test do you need within the hour?

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