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Coagulation Case Studies
Exam 6 Lecture 40/41
18
Biology
Undergraduate 3
11/19/2014

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Term
What is the diagnosis: 10 year old male is admitted to ER with a badly swollen knee and hematuria. He has had frequent severe bleeding episodes since birth. His coagulation results were as follows:
PLT count: 280,000
BT: 4 minutes
PT: 11 seconds
APTT: 88 seconds
Definition
Factor VIII Deficiency
Term
What type of disorder:
10 year old male is admitted to ER with a badly swollen knee and hematuria. He has had frequent severe bleeding episodes since birth. His coagulation results were as follows:
PLT count: 280,000
BT: 4 minutes
PT: 11 seconds
APTT: 88 seconds
Definition
Hemophilia A
Term
32 year old female was taken to the ER as a result of bleeding after a dental extraction. There were no additional findings except for a previously diagnosed and treated severe RA. She has no family history of bleeding. Coagulation results:
APTT: 29 second
PT: 12
Fibrinogen: 200 mg/dLl
BT: 15 minutes
Tournique test: +
PLT aggreg: No aggreg with ADP
Factor VIII: 90% activity
Definition
Plt inactivation due to aspirin or aspirin-containing drugs for the RA
Term
After an appendectomy, a 10 year old started oozing at the incision. He had a history of a mild bleeding tendency. Coagulation results were as follows:
PT 25 sec
APTT 31 sec
BT: 5 minutes
If PT corrects with aged serum what is the diagnosis
Definition
Factor VII Deficiency
Term
A 4 year old boy was admitted with headache, fever, disorientation and petichiae over the lower trunk and extremities. Some of the lab results were as follows:

Bacteria Meningitis Antigens: spinal fluid positive for Streptococcus pneumoniae
Platelet count: 15,000/µL
PT: 28 seconds
APTT: 73 seconds
Fibrinogen: 80 mg/dL
Definition
DIC
Term
25 year old newly married female was admitted to the hospital with a PE. Therapy was initiated immediately
24 hours later:
PT 12
APTT 39
Fibrinogen Normal
Definition
AT-III Deficient
Term
10 year old male is admitted to ER with a badly swollen knee and hematuria. He has had frequent severe bleeding episodes since birth. His coagulation results were as follows:
PLT count: 280,000
BT: 4 minutes
PT: 11 seconds
APTT: 88 seconds

Which factor deficiencies would you consider?
Definition
VIII, IX, XI, XII
Term
10 year old male is admitted to ER with a badly swollen knee and hematuria. He has had frequent severe bleeding episodes since birth. His coagulation results were as follows:
PLT count: 280,000
BT: 4 minutes
PT: 11 seconds
APTT: 88 seconds

What is the etiology of this disease?
Definition
Sex-linked defect
Term
10 year old male is admitted to ER with a badly swollen knee and hematuria. He has had frequent severe bleeding episodes since birth. His coagulation results were as follows:
PLT count: 280,000
BT: 4 minutes
PT: 11 seconds
APTT: 88 seconds

Are the Plt count and BT important?
Definition
Yes, they rule out vWF
Term
32 year old female was taken to the ER as a result of bleeding after a dental extraction. There were no additional findings except for a previously diagnosed and treated severe RA. She has no family history of bleeding. Coagulation results:
APTT: 29 second
PT: 12
Fibrinogen: 200 mg/dLl
BT: 15 minutes
Tournique test: +
PLT aggreg: No aggreg with ADP
Factor VIII: 90% activity

Which system of coag appears most likely affected
Definition
Platelets
Term
32 year old female was taken to the ER as a result of bleeding after a dental extraction. There were no additional findings except for a previously diagnosed and treated severe RA. She has no family history of bleeding. Coagulation results:
APTT: 29 second
PT: 12
Fibrinogen: 200 mg/dLl
BT: 15 minutes
Tournique test: +
PLT aggreg: No aggreg with ADP
Factor VIII: 90% activity

What is the significance of the factor VIII assay?
Definition
Abnormal in vWF, Normal in Lupus
Term
After an appendectomy, a 10 year old started oozing at the incision. He had a history of a mild bleeding tendency. Coagulation results were as follows:
PT 25 sec
APTT 31 sec
BT: 5 minutes
If PT corrects with aged serum what is the diagnosis

What treatment would probably be given?
Definition
FFP
Term
PT is NOT used to
Definition
Monitor Low molecular weight heparin
Term
A 4 year old boy was admitted with headache, fever, disorientation and petichiae over the lower trunk and extremities. Some of the lab results were as follows:

Bacteria Meningitis Antigens: spinal fluid positive for Streptococcus pneumoniae
Platelet count: 15,000/µL
PT: 28 seconds
APTT: 73 seconds
Fibrinogen: 80 mg/dL

What is the diagnosis for this patient?
Definition
Bacterial meningitis
Term
Which coagulation test is the most helpful when diagnosing DIC?
Definition
D-Dimer
Term
25 year old newly married female was admitted to the hospital with a PE. Therapy was initiated immediately
24 hours later:
PT 12
APTT 39
Fibrinogen Normal

What is the most common treatment for this condition?
Definition
Heparin and coumadin thearpy
Term
How will a low AT-III affect heparin?
Definition
Low AT-III levels decreases the response to heparin therapy
Term
What therapy is usually initiated when AT-III is low?
Definition
AT-III replacement therapy
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