| | UpToDate Approach to the patient with a bleeding diathesis |
 | | Bleeding that is spontaneous, excessive, or delayed in onset following tissue injury results from a localized pathologic process or a disorder of the hemostatic process, involving a complex interplay among vascular integrity, platelet number and function, coagulation factors, and fibrinolysis. |
 | | Given the variability in patients' perceptions of bleeding, as well as the lack of a uniform clinical measure of bleeding severity [3], a dialogue between the patient and physician is essential for the consideration of a bleeding diathesis. |
 | | A careful assessment of the presenting complaint can provide important clues as to where a defect might reside in the hemostatic process and whether the defect is inherited or acquired, providing a rational approach to laboratory investigation (show table 1). |
| patients.uptodate.com /topic.asp?file=coagulat/8369 (559 words) |