Medical history (history of illness) represents an important component in the diagnosis of increased bleeding tendency.
Family history
- What is the general health of your family members?
- Are there any diseases in your family that are common?
- Are there any hereditary diseases in your family?
Social history
- What is your profession?
Current medical history/systemic history (somatic and psychological complaints).
- What symptoms have you noticed?
- How long have the symptoms been present?
- If you have skin and mucous membrane changes.
- Did the skin or mucosal changes occur acutely? Or have they developed over a long period of time?
- Where are the skin or mucosal changes located? Are they localized or do they occur all over the body?
- Are the skin or mucosal changes painful?
- Are there any other symptoms? Acute onset fever, general feeling of illness?* .
- Was there a trigger for the symptomatology?
- Do you bruise easily? Even without having bumped hard?
- Do you suffer from frequent nosebleeds? Increased and prolonged menstruation?
- Have you noticed joint or muscle swelling?
- Have you noticed that you have bled for a long time after injury or surgery (for example, after tooth removal)?
Vegetative anamnesis incl. nutritional anamnesis.
Self anamnesis incl. medication anamnesis
- Previous diseases (blood diseases, immunological diseases, liver diseases, kidney diseases (renal failure, uremia), tumor diseases trauma / injuries).
- Operations
- Radiotherapy
- Vaccination status
- Allergies
- Environmental history
Medication history (A claim to completeness does not exist!)
- Antibiotics – cephalosporins (cefriaxone, ceftazidine, cefuroxime) + oral cephaosporins.
- Anticoagulants* (heparin, tinzaparin, enoxaparin, fondaparinux, rt-PA).
- Omega-3 fatty acids (> 3 g per day).
Platelet dysfunction (A claim to completeness does not exist!):
- Antibiotics*
- Acylaminopenicillin + ß-lactamase inhibitor (piperacillin + tazobactam, amoxicillin + clavulanic acid, ampicillin + sulbactam).
- Aminopenicillin (amoxicillin, ampicillin).
- Benzylpenicillin (penicillin G)
- Cephalosporins (cefalexin, cefazolin, cefepime, ceftazidime, ceftriaxone, ceftriazone, cefuroxime axetil, loracarbef).
- Penicillin (piperacillin + tazobactam, penicillin G, penicillin V).
- Staphylococcal penicillins (flucloxacillin).
* The simultaneous use of anticoagulants and antibiotics leads to an increased risk of bleeding!
Thrombocytopenia (A claim to completeness does not exist!):
- Antiepileptic drugs (valproic acid/valproate).
- Antiprotozoal agents (pentamidine).
- Heparin + HIT II (heparin-induced thrombocytopenia) – argatroban, danaparoid, lepirudin.
- Unfractionated heparin (UFH): occurrence of HIT II in approximately 3% of cases.
- Fractionated heparin (NMH): occurrence of HIT II in approximately 0.2% of cases.
- Phosphodiesterase III inhibitors (enoximone, milrinone).
- Antiplatelet agents (TAH): clopidogrel, prasugrel, ticlopidine.
- Antivirals
- Antisense oligonucleotide (fomivirsen).
- Nucleoside analogues (cidofovir, ganciclovir, valganciclovir).
- Other (foscarnet)
