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?

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
Section: Chapter Questions
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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)

 

  1. What test result indicates factor deficiency and not the presence of circulating anticoagulant?
  2. If adsorbed plasma were used in the mixing studies what would be the expected result?
  3. Why both PT and APTT test are prolonged?
  4. What additional test should be done that would help in the diagnosis?
  5.  
  6.  
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