Coagulation

COAGULATION

GOAL: 

  • Describe coagulation pathways, testing and appropriate transfusion requirements and be able to apply this knowledge to clinical cases.

DIRECTOR:

Scott C. Kogan, MD
Professor
Department of Laboratory Medicine
Phone: (415) 514-1590
Email: [email protected]

Office address:
Medical Sciences Building, S-561
505 Parnassus 
San Francisco, CA 94143
Mailing address:
Box 0100, UCSF
San Francisco, CA 94143

Structure:

This training is integrated within the six-month Transfusion Service rotation. The fellow will attend weekly Coagulation didactics (Wednesdays from 9 to 9:30 am in L551) and participate in the coagulation service under Dr. Kogan’s supervision for at least two hour per month for six months. Rotation site is at UCSF Medical Center, Moffitt-Long Hospital M-569.

Duration: 6 months (integrated with the TS rotation)

PARTICIPATING FACULTY:

Parul Bhargava MD
Scott C. Kogan MD

SPECIFIC OBJECTIVES:

  1. Make recommendations for diagnosis and treatment of bleeding disorders.
  • Know key questions to assess bleeding history and bleeding risk.
  • Know how to use history to distinguish hereditary and acquired bleeding disorders.
  • Generate a differential diagnosis for bleeding diathesis.
  • Describe what testing is available for evaluation of bleeding diatheses, and how such testing is interpreted.
    • Describe proper sample collection.
    • Discuss the PT and aPTT assays and what clinical conditions lead to long clotting times.
    • Explain how factor activity assays are performed.
    • Explain how factor specific inhibitors are detected and quantitated.
    • Evaluate a patient for von Willebrand disease.
    • Evaluate a patient for qualitative platelet function defects.
  • Discuss treatments are available for characterized bleeding disorders, including both blood products and products available from the hospital pharmacy.  
  • Describe what treatments are becoming available as a result of cellular and/or genetic therapies.
  1. Make recommendations for use and reversal of anticoagulants and antiplatelet agents.
  • List the anticoagulants currently available, how they are used, how they are monitored (or how they are detected for agents that are not routinely monitored), and how they are reversed when needed.
  • List the antiplatelet agents that are currently available, how they are used, how the presence of these agents may be detected, and how bleeding in the presence of these agents might be reversed.
  1. Describe risk factors for venous and arterial thrombosis.
  2. Explain the pathogenesis, diagnosis, and treatment of heparin induced thrombocytopenia.
  3. Discuss the diagnosis and treatment of antiphospholipid syndrome.
  4. Explain how samples are submitted, run, reviewed, and reported in the coagulation laboratory of an academic medical center.
  5. Demonstrate teaching competence by leading one or more Wednesday morning case conference discussions.