Defects in the first step of hemostasis are best detected with: A platelet quantitation Platelet closure tests Factor assays 1 and 2
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A revealing assay. Suppose that you have just examined a young boy with a bleeding disorder highly suggestive of classic hemophilia (factor VIII deficiency). Because of the late hour, the laboratory that carries out specialized coagulation assays is closed. However, you happen to have a sample of blood from a classic hemophiliac whom you admitted to the hospital an hour earlier. What is the simplest and most rapid test that you can perform to determine whether your present patient also is deficient in factor VIII activity?
Cassandra M.
A 25-year-old woman experienced abnormal bleeding after a tooth extraction. She remembers bleeding after a tonsillectomy when she was a child and reports a history of easy bruising, frequent nosebleeds, and heavy menstrual bleeding. Examine her test results below. PT: normal APTT: prolonged Platelet count: normal Platelet function studies: abnormal What disease/condition do the results suggest she has? Why is the APTT prolonged? Other Questions: 1. Define primary and secondary hemostasis. 2. Describe fibrinolysis. 3. VWF: - Where is it made and stored? - How is it processed once released from storage? - What are its two main functions? 4. What is the minimum level of most coagulation factors needed to prevent bleeding? 5. How would the PT and APTT be affected if the blood collection tube was not mixed immediately after collection? 6. Why should hemolyzed samples be rejected? 7. Why should samples for PT and APTT not be stored above 24°C? 8. How does inadequate centrifugation affect coagulation tests? 9. At what temperature are PTs, TT, and APTTs performed? 10. Describe how to perform an APTT and PT test, including the constituents in the reagents. 11. How are FVIII inhibitors detected? 12. What would happen if an incorrect ISI for the lot number of PT reagent was programmed into the coagulation instrument? What type of error is this? 13. What are the characteristic lab findings in DIC? 14. Which coagulation factor deficiency cannot be detected by performing a PT, TT, or APTT? 15. What does the TT and reptilase time detect, and what are the differences between the tests (why are both tests used?)
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