American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the typical fibrinogen level threshold for using cryoprecipitate in bleeds?

1. 50 mg/dL

2. 100 mg/dL

3. 150 mg/dL

4. 200 mg/dL

The correct answer is: 100 mg/dL

The typical threshold for using cryoprecipitate in patients experiencing bleeding is primarily based on fibrinogen levels. When fibrinogen levels fall below 100 mg/dL, there is an increased risk of bleeding, and cryoprecipitate is often indicated to help improve coagulation. Cryoprecipitate is a blood product rich in fibrinogen, factor VIII, and von Willebrand factor, making it particularly useful in situations where significant bleeding occurs due to low fibrinogen levels. Utilizing cryoprecipitate at this threshold helps to restore adequate fibrinogen concentrations, which are crucial for effective coagulation and hemostasis. In clinical practice, prompt administration of cryoprecipitate can enhance the patient's ability to form clots, thereby managing bleeding effectively. This understanding reinforces the importance of monitoring fibrinogen levels, especially in cases of trauma, surgery, or conditions like disseminated intravascular coagulation (DIC) where fibrinogen may be depleted. Management protocols commonly recommend targeting fibrinogen levels of 100 mg/dL when administering cryoprecipitate, ensuring that when hemorrhage occurs, the patient's coagulation status is optimized.