A 62-year-old man is initially seen in the Emergency Room complaining of difficulty with speech and swallowing due to an enlarged tongue. Physical examination also reveals a large, sublingual hematoma. In addition, multiple ecchymoses of his skin are noted. He has no history of trauma nor has there been any pervious episodes of bleeding. Coagulation studies show: Platelet Count: 180,000/cumm PT: 12 sec APPT: 72 sec TCT or thrombin time: 10 sec Fibrinogen: 225% Additional laboratory studies reveal: (Mixing Studies) Normal plasma:  20%       50%         80% Patient plasma   80%       50%         20% Repeat APPT:     72 sec   70 sec      68 sec   Questions: What additional Laboratory test to confirm the diagnosis? Give the relevance of the laboratory tests ordered to the case. Why it is necessary?

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
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A 62-year-old man is initially seen in the Emergency Room complaining of difficulty with speech and swallowing due to an enlarged tongue. Physical examination also reveals a large, sublingual hematoma. In addition, multiple ecchymoses of his skin are noted. He has no history of trauma nor has there been any pervious episodes of bleeding. Coagulation studies show:

Platelet Count: 180,000/cumm

PT: 12 sec

APPT: 72 sec

TCT or thrombin time: 10 sec

Fibrinogen: 225%

Additional laboratory studies reveal: (Mixing Studies)

Normal plasma:  20%       50%         80%

Patient plasma   80%       50%         20%

Repeat APPT:     72 sec   70 sec      68 sec

 

Questions:

  1. What additional Laboratory test to confirm the diagnosis?
  2. Give the relevance of the laboratory tests ordered to the case. Why it is necessary?
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