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Basic Coagulation Testing and Interpretation

The document discusses basic coagulation testing and interpretation. It outlines common coagulation tests including PTT, PT, fibrinogen, thrombin time and platelet count. It describes how to interpret abnormal results and provides guidance on follow up tests such as inhibitor screens and tests for conditions like von Willebrand disease and lupus anticoagulant.

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UWIMANA Jean Claude
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© © All Rights Reserved
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Download as PDF, TXT or read online on Scribd
6 views

Basic Coagulation Testing and Interpretation

The document discusses basic coagulation testing and interpretation. It outlines common coagulation tests including PTT, PT, fibrinogen, thrombin time and platelet count. It describes how to interpret abnormal results and provides guidance on follow up tests such as inhibitor screens and tests for conditions like von Willebrand disease and lupus anticoagulant.

Uploaded by

UWIMANA Jean Claude
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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6/17/2013

Basic coagulation testing and


interpretation
By Dr. Gwen Clarke

…the way coagulation works

http://www.revespcardiol.org/en/the-new-coagulation-cascade-and/articulo/13114167/

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6/17/2013

…the way we test

http://www.recothrom.com/about-recothrom.html

What can we test (easily)


• PTT

• PT (INR)

• Fibrinogen

• Thrombin Time

• Platelet count (and morphology)

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6/17/2013

…the way we test

http://www.recothrom.com/about-recothrom.html

What do abnormal results mean?


That depends…
Clinical History
Medications
Which tests are abnormal
How abnormal are they
Is this finding long standing or new

Factor deficiency, or coagulation inhibitor

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6/17/2013

How can you follow up?


• Repeat if unexpected
• Determine if prolonged due to deficiency or inhibitor… order an
inhibitor screen
• Don’t treat a lab abnormality (in the absence of clinical abnormality)
at least until you figure out the cause…

PT/PTT inhibitor screen


• Mix patient plasma with a normal pool of plasma.
• Incubate.
• Repeat PT or PTT

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6/17/2013

http://www.usmle3.com/

Peripheral blood film


• Review platelet morphology and look at additional findings that might
impact on clotting or bleeding

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6/17/2013

Tests for VWD


• Common bleeding disorder
• May contribute to prolonged PTT (or may not)
• If clinical history is suspicious:
• VWF, Ristocetin Cofactor and Factor VIII are diagnostic tests
• Bleeding Times are not orderable, and not necessary to make this (or
any other) diagnosis

Tests for Lupus anticoagulant


• Prolonged PTT
• Inhibitor screen does NOT correct
• Order
• Lupus anticoagulant
• Antiphospholipid antibodies
• Assess patient for clinical features of antiphospholipid syndrome and
consider hematology consultation

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