A 66-year-old male patient with amyloidosis was admitted to the hospital with severe gastrointestinal bleeding. Admission laboratory data includes: Hgb 10 g/dL Hct 0.32 Platelet count: Adequate PT 45 sec APTT 95 sec Fibrinogen 400mg/dL Thrombin Time 5 sec PT 1:1 mix 13 sec APTT 1:1 mix 30 sec(4-12 sec) Rusell’s Viper venom time55 sec (14-20 sec) What test result indicates factor deficiency and not the presence of circulating anticoagulant?If adsorbed plasma were used in the mixing studies what would be the expected result?Why both PT and APTT test are prolonged?What additional test should be done that would help in the diagnosis?

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Answered: A 66-year-old male patient with…

4th Edition

ISBN:9781305465763

Author:ROMICH

Publisher:ROMICH

Chapter8: Have A Heart

Section: Chapter Questions

Problem 1M

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Question

A 66-year-old male patient with amyloidosis was admitted to the hospital with severe gastrointestinal bleeding. Admission laboratory data includes:

Hgb 10 g/dL

Hct 0.32

Platelet count: Adequate

PT 45 sec APTT 95 sec

Fibrinogen 400mg/dL

Thrombin Time 5 sec

PT 1:1 mix 13 sec

APTT 1:1 mix 30 sec

(4-12 sec)

Rusell’s Viper venom time

55 sec (14-20 sec)

What test result indicates factor deficiency and not the presence of circulating anticoagulant?
If adsorbed plasma were used in the mixing studies what would be the expected result?
Why both PT and APTT test are prolonged?
What additional test should be done that would help in the diagnosis?

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