Prothrombin and Partial Thromboplastin Time
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The document discusses prothrombin time (PT) and partial thromboplastin time (PTT) tests used to assess the coagulation cascade. PT measures the extrinsic pathway and is used to monitor warfarin therapy, while PTT measures the intrinsic pathway and monitors heparin therapy. The document also presents a multiple choice question regarding expected lab results for a sepsis patient with signs of disseminated intravascular coagulation, with the correct answer being low platelets, high bleeding time, high PT, high PTT.
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Laboratory investigations in coagulation disorders
This document provides an overview of laboratory investigations for coagulation disorders. It discusses specimen collection and processing, as well as various screening and confirmatory tests used to evaluate the coagulation system. Screening tests include prothrombin time, activated partial thromboplastin time, and thrombin time. Confirmatory tests include reptilase time and mixing tests. The document also covers tests to evaluate circulating inhibitors and the fibrinolytic system.
Prothrombin time and aptt
The document discusses PT and APTT blood tests. PT measures how long it takes blood to clot and is used to check for bleeding disorders and monitor anticoagulant medication. It may also be called an INR test. APTT measures the intrinsic clotting pathway and is used to screen for deficiencies in certain clotting factors. Both tests involve adding reagents to plasma and timing clot formation. Elevated PT or APTT times can indicate conditions such as DIC, liver disease, or clotting factor deficiencies.
Tests of bleeding disorders
The document discusses tests used to evaluate bleeding disorders. It begins by describing normal hemostasis and the role of platelets and coagulation factors. It then discusses specific bleeding disorders that can result from platelet defects, coagulation factor deficiencies, or fragile blood vessels. The document outlines several laboratory tests used to evaluate hemostasis, including bleeding time, clotting time, platelet count, prothrombin time, activated partial thromboplastin time, thrombin time, and capillary fragility test. Each test is described in terms of its methodology, what coagulation or platelet pathways it evaluates, and how results are interpreted to identify potential causes of bleeding disorders.
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The document discusses coagulation testing, including bleeding time, clotting time, prothrombin time (PT), and partial thromboplastin time (PTT). It provides details on each test, including what they measure, normal ranges, and implications of abnormal results. Prolonged PT can indicate deficiencies in factors of the extrinsic pathway, while prolonged PTT suggests deficiencies in the intrinsic pathway or use of anticoagulants like heparin. Inherited bleeding disorders like hemophilia A and B and von Willebrand disease can also prolong test times.
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The document provides information on laboratory diagnosis of bleeding disorders. It discusses various screening tests used to diagnose platelet disorders and coagulation factor deficiencies, including platelet count, bleeding time, prothrombin time, activated partial thromboplastin time, fibrin split products/dimer tests, factor assays. The tests are used in a stepwise manner to differentiate between platelet and coagulation bleeds and identify specific factor deficiencies. Proper sample collection and test interpretation requires relevant clinical history.
Coagulation profile
This document summarizes various tests used to assess the coagulation profile and integrity of the haemostatic mechanism. It describes tests such as bleeding time, clotting time, prothrombin time, partial thromboplastin time, activated partial thromboplastin time, thrombin time, and plasma recalcification time. These tests measure different aspects of the coagulation cascade and help identify bleeding disorders or conditions where coagulation may be prolonged, such as liver disease, vitamin K deficiency, and anticoagulant overdose. Determining the coagulation profile is important before procedures like surgery to assess a patient's bleeding risk.
Anticoagulants and blood preservatives
The document discusses the history and development of anticoagulants and blood preservatives used for collecting, storing, and transfusing blood and blood components. It describes the early methods used and key discoveries that expanded the shelf life of red blood cells and platelets. The document also outlines the various anticoagulant solutions, additive solutions, and storage conditions used to maintain viability and prevent clotting during the collection, storage, and transportation of whole blood and its components prior to transfusion.
Prothrombin time
The prothrombin time (PT) test measures the time it takes for plasma to clot after the addition of tissue factor and calcium chloride. This indicates the efficiency of the extrinsic pathway of coagulation. The test involves warming citrated plasma to 37°C, mixing it with tissue thromboplastin and calcium chloride, then timing clot formation. An abnormally prolonged PT suggests deficiencies in factors II, V, VII, or X, vitamin K deficiency, liver disease, or anticoagulant therapy. Sources of error include improper blood collection, reagents, tubes, or water bath temperature.
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Prothrombin time and aptt
The document discusses PT and APTT blood tests. PT measures how long it takes blood to clot and is used to check for bleeding disorders and monitor anticoagulant medication. It may also be called an INR test. APTT measures the intrinsic clotting pathway and is used to screen for deficiencies in certain clotting factors. Both tests involve adding reagents to plasma and timing clot formation. Elevated PT or APTT times can indicate conditions such as DIC, liver disease, or clotting factor deficiencies.
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The document discusses coagulation testing, including bleeding time, clotting time, prothrombin time (PT), and partial thromboplastin time (PTT). It provides details on each test, including what they measure, normal ranges, and implications of abnormal results. Prolonged PT can indicate deficiencies in factors of the extrinsic pathway, while prolonged PTT suggests deficiencies in the intrinsic pathway or use of anticoagulants like heparin. Inherited bleeding disorders like hemophilia A and B and von Willebrand disease can also prolong test times.
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This document summarizes various tests used to assess the coagulation profile and integrity of the haemostatic mechanism. It describes tests such as bleeding time, clotting time, prothrombin time, partial thromboplastin time, activated partial thromboplastin time, thrombin time, and plasma recalcification time. These tests measure different aspects of the coagulation cascade and help identify bleeding disorders or conditions where coagulation may be prolonged, such as liver disease, vitamin K deficiency, and anticoagulant overdose. Determining the coagulation profile is important before procedures like surgery to assess a patient's bleeding risk.
Anticoagulants and blood preservatives
The document discusses the history and development of anticoagulants and blood preservatives used for collecting, storing, and transfusing blood and blood components. It describes the early methods used and key discoveries that expanded the shelf life of red blood cells and platelets. The document also outlines the various anticoagulant solutions, additive solutions, and storage conditions used to maintain viability and prevent clotting during the collection, storage, and transportation of whole blood and its components prior to transfusion.
Prothrombin time
The prothrombin time (PT) test measures the time it takes for plasma to clot after the addition of tissue factor and calcium chloride. This indicates the efficiency of the extrinsic pathway of coagulation. The test involves warming citrated plasma to 37°C, mixing it with tissue thromboplastin and calcium chloride, then timing clot formation. An abnormally prolonged PT suggests deficiencies in factors II, V, VII, or X, vitamin K deficiency, liver disease, or anticoagulant therapy. Sources of error include improper blood collection, reagents, tubes, or water bath temperature.
prothrombin time
When a blood vessel ruptures, platelets collect at the site of injury to form a temporary plug. A series of coagulation factors then interact to convert fibrinogen into fibrin and form a blood clot. Bleeding disorders occur if coagulation factors are deficient or function improperly. The prothrombin time (PT) and partial thromboplastin time (PTT) tests evaluate the intrinsic and extrinsic clotting pathways. An abnormal PT may indicate a deficiency in certain coagulation factors, while an abnormal PTT suggests a platelet or factor deficiency within the intrinsic pathway. Together these tests help diagnose the cause of bleeding disorders.
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This document discusses the erythrocyte sedimentation rate (ESR) test, including the objectives, principle, mechanism, factors affecting ESR, clinical significance, and methods of estimating ESR. ESR is a non-specific test that measures how far red blood cells fall in one hour, indicating inflammation. The rate depends on factors that promote or resist sedimentation and is affected by physiological conditions and test variables. An increased ESR may indicate infection, inflammation or disease while a decreased ESR can occur in certain blood disorders. Common estimation methods include Wintrobe's, Westergren's and automated techniques.
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This document discusses the history of anticoagulants used for blood transfusion and storage. It describes some of the key developments including:
- Early attempts in the 1800s using defibrinated blood or direct transfusion before anticoagulants were discovered.
- The first chemical anticoagulant experimented with was sodium phosphate by John Braxton Hicks in 1868.
- Important early anticoagulants developed were sodium citrate in 1914 and acid-citrate-dextrose solution in 1943 which allowed blood to be stored for longer periods.
- Common anticoagulants now used include sodium citrate, heparin, EDTA, and oxalates
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Erythrocyte sedimentation rate
1. Erythrocyte sedimentation rate (ESR) measures the rate at which red blood cells settle in a tube of blood over one hour. It is a non-specific test used to detect inflammation.
2. ESR works by fibrinogen proteins adhering to red blood cells, neutralizing their negative charge and allowing them to stick together and fall faster as rouleaux. Conditions with elevated fibrinogen like infection, inflammation, and malignancy increase ESR.
3. ESR is measured using the Westergreen, Wintrobe, or automated methods. The Westergreen method is the reference standard. ESR values are interpreted based on age, sex and clinical context.
Coagulation factors
This document discusses coagulation factors and blood clotting. It defines coagulation as the process where blood loses fluidity and forms a jelly-like clot. Thirteen coagulation factors are involved in a cascade of reactions to form a clot. The cascade involves the formation of prothrombin activator through the intrinsic and extrinsic pathways, followed by the conversion of prothrombin to thrombin and fibrinogen to fibrin. Deficiencies in specific factors can cause bleeding disorders like hemophilia. The clot then undergoes retraction and may be broken down through fibrinolysis.
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This document provides information about the Coombs test, which is used to detect antibody or complement coating of red blood cells. It describes the history and principles of the test, as well as the direct and indirect Coombs test procedures. The direct Coombs test detects in vivo coating of red blood cells and is used to diagnose conditions like hemolytic disease of the newborn. The indirect Coombs test detects in vitro coating of red cells and is used for compatibility testing and antibody screening. Factors affecting the tests and causes of false positive and negative results are also outlined.
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The prothrombin time (PT) test measures the clotting ability of the extrinsic and common coagulation pathways. It evaluates the function of factors II, V, VII, and X, which are vitamin K dependent and produced in the liver. The PT is used to screen for liver disease or vitamin K deficiency, monitor warfarin therapy, and evaluate other coagulation disorders. The results are typically reported as the international normalized ratio (INR), which standardizes the PT test across different laboratories and thromboplastin preparations. An INR between 2.0-3.0 is generally therapeutic for patients on warfarin therapy.
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prothrombin time
When a blood vessel ruptures, platelets collect at the site of injury to form a temporary plug. A series of coagulation factors then interact to convert fibrinogen into fibrin and form a blood clot. Bleeding disorders occur if coagulation factors are deficient or function improperly. The prothrombin time (PT) and partial thromboplastin time (PTT) tests evaluate the intrinsic and extrinsic clotting pathways. An abnormal PT may indicate a deficiency in certain coagulation factors, while an abnormal PTT suggests a platelet or factor deficiency within the intrinsic pathway. Together these tests help diagnose the cause of bleeding disorders.
Erythrocyte Sedimentation Rate
This document discusses the erythrocyte sedimentation rate (ESR) test, including the objectives, principle, mechanism, factors affecting ESR, clinical significance, and methods of estimating ESR. ESR is a non-specific test that measures how far red blood cells fall in one hour, indicating inflammation. The rate depends on factors that promote or resist sedimentation and is affected by physiological conditions and test variables. An increased ESR may indicate infection, inflammation or disease while a decreased ESR can occur in certain blood disorders. Common estimation methods include Wintrobe's, Westergren's and automated techniques.
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This document discusses various methods for measuring bleeding time and clotting time, which evaluate platelet function and coagulation, respectively. It describes Ivy's method for measuring bleeding time, which involves making three punctures on the forearm and timing how long it takes for bleeding to stop. The standard template method is also discussed. For clotting time, it covers the venepuncture method using two syringes and timing clot formation in a test tube, as well as the capillary method involving puncturing the skin and timing fibrin formation in a capillary tube. Normal ranges and clinical significance of prolonged or shortened times are provided.
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Dr. Pandian M describes the procedure for performing a platelet count. Platelets serve important hemostatic functions and their normal range is 1.5-4 lakhs/cumm. The procedure involves mixing blood with a diluting fluid in a Neubauer chamber, then counting platelets in grid squares under a microscope. For the sample, 40 platelets were counted in 1/50 mm3, indicating a platelet count of 2 lakhs/mm3 of blood, within the normal range. Abnormally high or low platelet counts can occur due to various bone marrow and other disorders.
Fibrinolytic system
The fibrinolytic system prevents excessive fibrin deposition and regulates clot dissolution to maintain a balance between coagulation and fibrinolysis. Key components include plasminogen and its activators, such as tissue plasminogen activator and urokinase, as well as inhibitors that regulate the system. Fibrinolysis is initiated when fibrin is formed and binds plasminogen and activators, localizing plasmin generation. Plasmin then degrades fibrin into degradation products, preventing inappropriate clotting. tight regulation by activator inhibitors and antiplasmins ensures fibrin deposition is removed in a controlled manner without causing bleeding.
Anticoagulants
This document discusses the history of anticoagulants used for blood transfusion and storage. It describes some of the key developments including:
- Early attempts in the 1800s using defibrinated blood or direct transfusion before anticoagulants were discovered.
- The first chemical anticoagulant experimented with was sodium phosphate by John Braxton Hicks in 1868.
- Important early anticoagulants developed were sodium citrate in 1914 and acid-citrate-dextrose solution in 1943 which allowed blood to be stored for longer periods.
- Common anticoagulants now used include sodium citrate, heparin, EDTA, and oxalates
Rbc count
Red blood cells contain hemoglobin and carry oxygen throughout the body. Disruptions to red blood cells can affect oxygen-carrying capacity. Red blood cells are biconcave discs that are flexible and can squeeze through narrow vessels. There are manual and automated methods for counting red blood cells. The manual method uses a hemocytometer, diluting fluid, and involves counting red blood cells in a gridded chamber under a microscope. The automated method uses electronic detection and dilution to count thousands of cells rapidly. Normal red blood cell count ranges are provided for adults and newborns. Conditions that decrease or increase red blood cell counts are also outlined.
Anticoagulants
This document discusses anticoagulants used in hematology and blood banking. It begins by describing the coagulation pathway and defining anticoagulants. It then discusses various anticoagulants used in hematology like EDTA, heparin, sodium citrate, sodium fluoride, and double oxalate. It notes their ideal characteristics, modes of action, concentrations used, advantages, and disadvantages. The document concludes by outlining anticoagulant solutions used in blood banking like ACD, CPD, CPDA-1, and CPDA-2. It provides the constituents of each solution and how they improve storage of red blood cells and post-transfusion viability.
Platelet Function Tests
Platelet function testing assesses platelet adhesion, activation, granule release and aggregation in response to agonists using light transmission platelet aggregometry (LTA) as the gold standard test. Abnormal LTA results can indicate defects in platelet adhesion receptors, activation and secretion, aggregation receptors, or the thromboxane pathway. The pattern of abnormal aggregation in response to different agonists helps localize the platelet function defect.
Osmotic fragility test
The osmotic fragility test is used to diagnose different types of anemia by examining how red blood cells react in solutions of different tonicity. Red blood cells will swell and rupture in hypotonic solutions like distilled water due to excess water entering the cell. They will shrink and rupture in hypertonic solutions with high salt content due to water leaving the cell. In a normal saline solution that is isotonic, the red blood cells will remain intact. The test involves adding blood to solutions of varying tonicity, then centrifuging and observing if the fluid portion becomes colored, indicating red blood cell rupture.
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Sickle cell anemia is a hereditary blood disorder caused by a genetic mutation that results in abnormal hemoglobin and sickle-shaped red blood cells. It affects approximately 90,000-100,000 people in the United States, primarily those of African descent. Symptoms include episodes of severe pain, organ damage, infections, and stroke due to sickled cells blocking blood flow. While there is no cure, treatment focuses on pain management, blood transfusions, medications, and in some cases stem cell transplants or gene therapy.
Erythrocyte sedimentation rate
1. Erythrocyte sedimentation rate (ESR) measures the rate at which red blood cells settle in a tube of blood over one hour. It is a non-specific test used to detect inflammation.
2. ESR works by fibrinogen proteins adhering to red blood cells, neutralizing their negative charge and allowing them to stick together and fall faster as rouleaux. Conditions with elevated fibrinogen like infection, inflammation, and malignancy increase ESR.
3. ESR is measured using the Westergreen, Wintrobe, or automated methods. The Westergreen method is the reference standard. ESR values are interpreted based on age, sex and clinical context.
Coagulation factors
This document discusses coagulation factors and blood clotting. It defines coagulation as the process where blood loses fluidity and forms a jelly-like clot. Thirteen coagulation factors are involved in a cascade of reactions to form a clot. The cascade involves the formation of prothrombin activator through the intrinsic and extrinsic pathways, followed by the conversion of prothrombin to thrombin and fibrinogen to fibrin. Deficiencies in specific factors can cause bleeding disorders like hemophilia. The clot then undergoes retraction and may be broken down through fibrinolysis.
Coagulation tests
The bleeding time test measures the time it takes for a small puncture wound to stop bleeding. It evaluates platelet function and vascular integrity. The preferred method is the Surgicutt/Simplate method, which uses a spring-loaded device to make a standardized 1mm deep incision. The procedure involves inflating a blood pressure cuff to 40mmHg, making the incision, and blotting the wound every 30 seconds with filter paper to see when bleeding stops. The normal bleeding time range is 1-9 minutes. Sources of error include aspirin use, improper puncture technique, not timing correctly, or allowing the filter paper to touch the wound.
Fibrinolysis
This document discusses the processes of hemostasis, thrombosis, and fibrinolysis. It defines key terms like blood clot, platelet, fibrin, coagulation cascade, and anticoagulants. The document describes the steps of primary hemostasis which involves platelet adhesion and activation at the site of injury. It also outlines the secondary hemostasis process known as the coagulation cascade that generates thrombin and ultimately forms a fibrin clot to stop bleeding. The roles of fibrinolysis and anticoagulant pathways in regulating clot formation are also summarized.
coombs test
The Coombs test, also known as the antiglobulin test, detects antibodies or complement proteins attached to red blood cells. There are two types of Coombs tests - the direct Coombs test detects antibodies bound to red blood cells in vivo, while the indirect Coombs test detects antibodies in a patient's serum that can bind to red blood cells in vitro. The Coombs test is used to diagnose conditions like hemolytic disease of the newborn, autoimmune hemolytic anemia, and hemolytic transfusion reactions. A positive Coombs test indicates red blood cell sensitization, while a negative test suggests the absence of sensitization.
Coombs test
This document provides information about the Coombs test, which is used to detect antibody or complement coating of red blood cells. It describes the history and principles of the test, as well as the direct and indirect Coombs test procedures. The direct Coombs test detects in vivo coating of red blood cells and is used to diagnose conditions like hemolytic disease of the newborn. The indirect Coombs test detects in vitro coating of red cells and is used for compatibility testing and antibody screening. Factors affecting the tests and causes of false positive and negative results are also outlined.
Estimation of iron profile
This document discusses laboratory tests for serum iron, total iron binding capacity (TIBC), transferrin, ferritin, vitamin B12 and serum folate. It provides objectives, principles, methodologies, normal ranges and limitations for each test. The tests are useful in diagnosing iron deficiency anemia and vitamin deficiencies. Sample collection and handling factors that could impact results are also outlined.
Laboratory tests of hemostasis and coagulation system (dr ellinor peerschke ...
This document provides an introduction to coagulation testing, including preanalytical and analytical variables. It discusses specimen collection and processing, common coagulation assays, and how to interpret their results. Prolonged screening tests can indicate factor deficiencies or circulating anticoagulants like lupus anticoagulant, requiring additional studies. New direct oral anticoagulants affect clot-based assays in a concentration-dependent manner. D-dimer assays are used to evaluate for fibrinolysis or thrombosis. HIT testing involves screening ELISA to detect heparin-PF4 antibodies followed by confirmatory assays if needed.
Normal hemostasis and coagulation
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Laboratory tests of hemostasis and coagulation system (dr ellinor peerschke ...
Laboratory tests of hemostasis and coagulation system (dr ellinor peerschke ...
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The document discusses hemostasis, which involves a balance between clot formation and clot dissolution. It describes the intrinsic and extrinsic coagulation pathways, factors involved, and PT and aPTT tests used to evaluate these pathways. Fibrinolysis and markers like D-dimer are also summarized. Clinical conditions related to deficiencies in the coagulation or fibrinolytic systems are briefly mentioned.
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The prothrombin time (PT) test measures the clotting ability of the extrinsic and common coagulation pathways. It evaluates the function of factors II, V, VII, and X, which are vitamin K dependent and produced in the liver. The PT is used to screen for liver disease or vitamin K deficiency, monitor warfarin therapy, and evaluate other coagulation disorders. The results are typically reported as the international normalized ratio (INR), which standardizes the PT test across different laboratories and thromboplastin preparations. An INR between 2.0-3.0 is generally therapeutic for patients on warfarin therapy.
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Laboratory tests play an important role in diagnosing, monitoring, and treating coagulation disorders. Common tests include activated prothrombin time (aPT), activated partial thromboplastin time (aPTT), thrombin time, and bleeding time. These tests help identify factor deficiencies, monitor anticoagulation therapy, and provide sensitivity when the clinical picture is known. Proper interpretation requires understanding how the tests are performed and their limitations.
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The document summarizes the blood clotting (coagulation) mechanism. It occurs when blood is shed from damaged blood vessels or tissues. There are two pathways - the extrinsic pathway which is initiated by tissue factor, and the intrinsic pathway initiated by platelets. Both pathways involve a cascade of coagulation factors and ultimately lead to the formation of a prothrombinase complex. This converts prothrombin to thrombin via the common pathway. Thrombin then converts fibrinogen to fibrin to form a mesh and stabilize the platelet plug, sealing the break in the blood vessel.
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The document provides an overview and learning module on coagulation and hemostasis created by a medical student at the University of Vermont College of Medicine. It begins with definitions of key terms and an overview of primary and secondary hemostasis. It then reviews the components of the coagulation cascade including the extrinsic, intrinsic, and common pathways. It discusses pharmacologic considerations and the roles of the endothelium and subendothelium. Finally, it provides a detailed review of coagulation and hemostasis in a series of slides for students to test their knowledge.
Lesson 3 5 Laboratory Aptt
The APTT test screens for deficiencies in the intrinsic coagulation system and the common coagulation pathway. It is more sensitive than PTT and is used to monitor heparin therapy. Prolonged APTT can indicate deficiencies in coagulation factors of the intrinsic system, liver disease, heparin therapy, or DIC. When used together with PT testing, APTT and PT can detect 95% of coagulation defects.
Coagulation profile mak
This document summarizes coagulation profile testing. It discusses the primary and secondary phases of hemostasis and provides an overview of approaches to evaluating coagulation disorders. Specific coagulation tests are described, including aPTT, PT, thrombin time, and fibrinogen assays. The principles, methodologies, normal values, and clinical significance of these screening and diagnostic coagulation tests are outlined.
New Oral Anticoagulants
This document discusses NOACs (new oral anticoagulants) and provides information on their expected coagulation parameters and treatment of bleeding. It presents three clinical cases involving patients on different NOACs (rivaroxaban, apixaban, dabigatran) who presented with bleeding and discusses the coagulation test results and management in each case. Key points discussed include typical drug levels, effects on coagulation assays, limited evidence for pro-haemostatic treatments, and issues surrounding drug monitoring and identification of treatment failure.
Coagulation assays
This document discusses various coagulation assays that can be used in a laboratory setting. It describes functional clot-based assays and chromogenic assays for measuring specific enzymes. It provides examples of assays used to monitor low molecular weight heparin, detect lupus anticoagulant, and evaluate thrombophilia workups. The document emphasizes that chromogenic assays are less affected by preanalytical variables and are preferable to clot-based assays for screening protein C and free protein S deficiencies.
Blood clotting
The document discusses blood clotting and the factors involved. Platelets and clotting factors work together to form blood clots which act as a mesh to stop bleeding from injuries. When a blood vessel is damaged, platelets stick to the injury site and clump together to form a platelet plug. Platelets and damaged tissue then release clotting factors which activate the blood clotting mechanism and produce fibrin to seal the wound. Impaired clotting can lead to excessive bleeding or blockages in arteries from blood clots.
Haemostasis
This document provides an overview of haemostasis (hemostasis). It consists of five main sections:
1. Components of haemostasis - the vascular system, platelets, coagulation, fibrinolysis, and coagulation inhibition systems.
2. The haemostatic process - consisting of vasoconstriction, platelet plug formation, coagulation cascade, and fibrin clot formation and dissolution.
3. Haemostatic disorders - bleeding disorders due to problems with vessels, platelets, or coagulation factors, and thrombotic disorders.
4. Specific coagulation factor deficiencies - von Willebrand disease, hemophilia A/B, liver disease, vitamin K deficiency.
5
Coagulation assays part 1
This document provides an overview of routine coagulation assays including PT, aPTT, fibrinogen, D-dimer, and mixing studies. It discusses the clinical utility and interpretation of these assays for monitoring coagulation and detecting coagulation disorders or abnormalities. Key points include that PT measures the extrinsic pathway and factors VII, X, and prothrombin, while aPTT is more sensitive to deficiencies in the intrinsic pathway and contact factors. D-dimer has high negative predictive value for ruling out VTE but low positive predictive value due to non-specific elevations. Mixing studies can help distinguish between factor deficiencies and inhibitors like lupus anticoagulant.
Coagulation Disorders
1. Coagulation disorders are caused by deficiencies in clotting factors that lead to defects in normal clot formation. They can be hereditary or acquired.
2. Hereditary disorders include hemophilia A and B which are sex-linked deficiencies in factors VIII and IX respectively, and von Willebrand disease which is an autosomal disorder involving a defect in von Willebrand factor.
3. Acquired disorders involve deficiencies in multiple clotting factors and can result from vitamin K deficiency, liver disease, fibrinolytic defects, or disseminated intravascular coagulation (DIC). DIC occurs as a complication of other systemic illnesses.
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This document discusses thrombotic thrombocytopenic purpura (TTP). It begins by presenting a case of a 32-year-old woman presenting with headaches, difficulty speaking and moving her tongue, and numbness. Her exam and labs show thrombocytopenia and schistocytes. The document then discusses the differential diagnosis, epidemiology, terminology, definitions, types, presentations, investigations, and treatment of TTP, with a focus on plasma exchange therapy to remove antibodies and replace deficient ADAMTS13 protease.
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Laboratory tests of hemostasis and coagulation system
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PROTHROMBIN TIME.pptx
The PT and PTT tests evaluate the coagulation pathway by measuring how long it takes blood to clot. The PT test examines the extrinsic pathway, while the PTT test examines the intrinsic pathway. An increased or prolonged PT can indicate liver disease, vitamin K deficiency, a coagulation factor deficiency, disseminated intravascular coagulation, or anticoagulant therapy.
Interpretation of clinical laboratory test full.pptx
This document discusses several common clinical laboratory tests, including:
1. Hemoglobin, hematocrit, and red blood cell counts which are used to detect anemia or polycythemia. Abnormal levels can indicate conditions like blood loss, bone marrow failure, or cancer.
2. White blood cell counts which are checked for infections, inflammation, or blood cancers. Differential leukocyte counts examine specific white blood cell types.
3. Platelet counts which are used to detect thrombocytopenia or excess bleeding.
4. Coagulation tests like prothrombin time, fibrinogen, and Factor V which evaluate bleeding disorders and liver function.
Preanesthetic evaluation
The document discusses the importance of preoperative evaluation and optimization of patient health before surgery. The key purposes are to document medical conditions requiring surgery, assess overall health status, uncover hidden conditions that could cause problems during or after surgery, determine perioperative risk, and develop an appropriate perioperative care plan. This involves a thorough medical history, physical exam, and laboratory tests to evaluate organ function and minimize surgical risks. The goal is to reduce postoperative complications and facilitate a quick recovery.
investigations of bleeding disorder (1).pptx
The document discusses investigations for bleeding disorders. It describes tests for platelet function like bleeding time and platelet aggregation assays. Tests for coagulation factors include activated partial thromboplastin time, prothrombin time, INR, fibrinogen levels, and specific factor assays. Mixing studies can identify inhibitors. The fibrinolytic system can be assessed through fibrin degradation products and D-dimer levels.
Bleeding tests
This document provides information on tests used to evaluate bleeding disorders. It describes screening tests like bleeding time, platelet count, prothrombin time, activated partial thromboplastin time and thrombin time that can identify platelet, coagulation factor and fibrinolytic abnormalities. Specialized tests like platelet aggregation, coagulation factor assays and D-dimer are used when screening tests suggest a bleeding disorder. Clinical signs of bleeding disorders in the oral cavity and considerations for dental treatment are also outlined.
Investigation of haemostasis.ppt kgiguffug
This document discusses investigation of haemostasis through various coagulation screening tests and follow up tests. The first section outlines common first-line screening tests including prothrombin time, activated partial thromboplastin time, thrombin time, and platelet count. The second section discusses interpretation of first-line tests and indications for second-line tests. Various patterns in screening test results are presented with their potential underlying causes.
Portal hypertension
Portal hypertension is defined as elevated portal pressure above 10-12 mm Hg. It is classified as pre-hepatic, intra-hepatic, or post-hepatic based on the location of blockage. Common causes include liver cirrhosis and blockages in the portal vein. Clinical features include upper GI bleeding, splenomegaly, ascites, and hepatic encephalopathy. Management involves treating acute bleeding episodes endoscopically and use of beta-blockers for prevention, along with diuretics and paracentesis for ascites. More advanced treatments include TIPSS, surgical shunting, and liver transplantation.
Renal disorders quesions and answers with rationals
This document contains 13 multiple choice questions about renal disorders and care of clients with renal issues. It provides the questions, possible answer choices, and a rationale for the correct answer. The questions cover topics like interpreting lab values related to renal function, dietary management for clients on hemodialysis, emergency interventions for potential complications of hemodialysis like air embolism, and assessing clients for possible bladder trauma. The rationales provided explain why each correct answer choice is most appropriate based on considerations like normal lab value ranges and priority nursing actions.
Surgical closure Neonatal PDA
This document discusses surgical closure of patent ductus arteriosus (PDA) in premature infants. It provides guidelines for when surgical referral is appropriate, such as when two courses of medication have failed to close a large PDA. The success rate of medication closure is 79% for infants over 1750g and lower for infants under 800g. The document outlines pre-operative testing and guidelines for the surgery including echocardiogram, bloodwork and discussions between medical teams. Potential complications are discussed such as hemorrhage, recurrent ductal patency and respiratory problems. Post-ligation cardiac syndrome is also summarized, which can involve low blood pressure, increased ventilation needs, and interventions like inotropic support.
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1. The document provides instructions for a patient with peripheral artery disease (PAD) and endocarditis, including wound care, antibiotic use, and signs of complications to watch for.
2. It also outlines teaching for a patient receiving a pacemaker, including limitations on physical activity, wound care, and when to raise the arm.
3. The document discusses monitoring laboratory values for patients receiving heparin or warfarin therapy.
Pre analytical errors.
The document discusses pre-analytical errors that can occur during the specimen collection and processing phases of laboratory testing. It identifies several factors that can lead to errors, such as improper patient identification, non-fasting blood draws, issues with venipuncture technique and site selection, incorrect tube filling or mixing, and improper sample handling and processing. Failure to follow standards for these pre-analytical variables can compromise test results and patient care. The document provides extensive details on proper procedures to minimize pre-analytical errors.
Surgery in Bleeding disorders- A challenging problem to all surgeons
Surgery in patients with bleeding disorders requires careful evaluation and management to minimize bleeding risks. The document discusses:
1) The physiology of hemostasis including the vessel wall, platelet, and coagulation responses.
2) Evaluation of patients including history, exam, and screening tests to identify bleeding disorders.
3) Four case examples of patients who bled excessively during or after surgery, who were found to have thrombocytopathy, hemophilia, or other disorders.
4) Common bleeding disorders surgeons may encounter including thrombocytopenia, thrombocytopathy, hemophilia A/B, von Willebrand disease, DIC, and liver disease.
5) Guidelines
Coagulation profile final by Pandian M
DEFINITION
FACTORS INVOLVED IN BLOOD CLOTTING
SEQUENCE OF CLOTTING MECHANISM
BLOOD CLOT
ANTICLOTTING MECHANISM IN THE BODY
ANTICOAGULANTS
PHYSICAL METHODS TO PREVENT BLOOD CLOTTING
PROCOAGULANTS
TESTS FOR BLOOD CLOTTING
APPLIED PHYSIOLOGY
03 laboratory tests part 1
Lab Tests are tools that provide information about the client.
Tests may be used for basic screening as part of a wellness check.
Frequently tests are used to help confirm a diagnosis, monitor an illness, and provide valuable information about the client’s response to treatment.
coagulation_disorders.ppt
This document provides an overview of the clinical and laboratory approaches to evaluating and diagnosing coagulation disorders. The clinical approach involves determining the severity and type of bleeding, whether it is localized or systemic, and if it is due to a platelet or coagulation factor disorder. The laboratory approach includes basic coagulation screening tests like the platelet count, bleeding time, clotting time, prothrombin time, activated partial thromboplastin time, and thrombin time. Further specific tests are used to identify the underlying coagulation factor deficiency, inhibitor, or other cause based on the screening test results.
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The document discusses various techniques for monitoring critical and emergency patients, including monitoring vital signs, blood pressure, cardiac function, respiration, oxygenation, and organ functions. Effective monitoring is important for detecting clinical changes, guiding treatment, and optimizing tissue oxygen delivery for critically ill patients. The document provides guidelines for standard monitoring, classification of monitoring techniques, and interpreting data from monitoring equipment.
New Microsoft Office PowerPoint Presentation.pptx
This document discusses laboratory investigations used to supplement clinical findings. It defines haematological, immunological, histopathological and cytopathological tests and provides details on specific tests including complete blood count, bleeding time, prothrombin time and differential leukocyte count. Proper sample collection and test methodologies are outlined. The tests provide quantitative and qualitative information to identify diseases, establish baselines, monitor therapy and confirm clinical impressions.
Physiologic Monitoring
The document discusses various parameters that are monitored during physiologic monitoring, including hemodynamic monitoring (arterial and central venous catheterization), respiratory monitoring (ventilation and gas exchange), renal monitoring (urine output and glomerular function tests), and neurologic and metabolic monitoring. Key details provided include normal values, indications for monitoring, techniques, and potential complications.
Physiologic Monitoring
The document discusses various parameters that are monitored during physiologic monitoring, including hemodynamic monitoring (arterial and central venous catheterization), respiratory monitoring (ventilation and gas exchange), renal monitoring (urine output and glomerular function tests), and neurologic and metabolic monitoring. Key details provided include normal values, indications for monitoring, techniques, and potential complications.
Physiologic Monitoring
The document discusses various parameters that are monitored during physiologic monitoring, including hemodynamic monitoring (arterial and central venous catheterization), respiratory monitoring (ventilation and gas exchange), renal monitoring (urine output and glomerular function tests), neurologic monitoring (intracranial pressure, electrophysiology, ultrasound, venous oximetry), metabolic monitoring (caloric demands, respiratory quotient), and temperature monitoring (rectal, middle ear, esophageal). Precise monitoring of these parameters provides important clinical information to guide treatment decisions and optimize patient care and outcomes.
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Prothrombin and Partial Thromboplastin Time
- 1. Camille Renee Dr. M.C. PHSL1 2122 STV
- 2. Used to measure the function of the extrinsic pathway of the coagulation cascade Assesses vitamin K status, liver damage, and monitors warfarin therapy Method: blood plasma is centrifuged and tissue factor III is added
- 4. Used to measure the function of the intrinsic pathway of the coagulation cascade Also used to assess heparin therapy Method: blood sample is collected and phospholipids, calcium, and an activator are added Termed ‘partial’ because tissue factor III is not added to the mixture
- 5. Prothrombin Time (PT) Partial Thromboplastin Time (PTT) Measures extrinsic pathway Normal: 10-15 seconds Used to assist with diagnosing clotting disorders Monitors warfarin therapy Measures intrinsic pathway Normal: 25-40 seconds Used to assist with diagnosing bleeding disorders Monitors heparin therapy
- 6. Question On your rotation in the intensive care unit, you follow a patient with advanced sepsis from a central line infection. On exam you notice marked petechiae on his extremities as well as some large clots around his mouth. Concerned about disseminated intravascular coagulation, you check his labs. What would you expect? a) High platelets, low bleeding time, high PT, high PTT b) Low platelets, high bleeding time, high PT, high PTT c) Low platelets, high bleeding time, low PT, high PTT d) Low platelets, low bleeding time, high PT, high PTT e) Low platelets, low bleeding time, low PT, low PTT
- 7. Platelets. C. M. (2014). PHSL1 2122 STV. Saint James School of Medicine. Prothrombin time. Wikipedia. (2014). Retrieved from http://en.wikipedia.org/wiki/Prothrombin_time Partial thromboplastin time. Wikipedia. (2014). Retrieved from http://en.wikipedia.org/wiki/Partial_thromboplastin_time Wikipedia. (2014). Prothrombin time. [Web Image]. Retrieved from http://upload.wikimedia.org/wikipedia/commons/thumb/2/25/Fibrin- nach-Thromboplastin.jpg/230px-Fibrin-nach-Thromboplastin.jpg Cleveland Clinic. (2009). Pulmonary embolism. [Web Image]. Retrieved from http://my.clevelandclinic.org/ccf/media/Images/heart/ptinr_test.jpg Dentalcare.com. (2014). Dental management of patients with bleeding disorders. [Web Image]. Retrieved from http://media.dentalcare.com/images/en-US/education/ce319/diag02- coagulation.gif
Editor's Notes
- Used to monitor oral anticoagulant therapy (Warfarin / Coumadin). When a patient who is not taking anti-coagulant drugs has signs or symptoms of a bleeding disorder. When a patient is to undergo an invasive medical procedure, such as surgery, to ensure normal clotting ability.
- The prothrombin time is most commonly measured using blood plasma. Blood is drawn into a test tube containing liquid sodium citrate, which acts as an anticoagulant by binding the calcium in a sample. The blood is mixed, then centrifuged to separate blood cells from plasma. Tissue factor (also known as factor III) is added, and the time the sample takes to clot is measured optically
- DIC = increased consumption of factor 7! Disseminated intravascular coagulation (DIC), also known as disseminated intravascular coagulopathy or less commonly as consumptive coagulopathy, is a pathological process characterized by the widespread activation of the clotting cascade that results in the formation of blood clots in the small blood vessels throughout the body. The basis of disseminated intravascular coagulation is excessive consumption of clotting factors and platelets to the point where bleeding can no longer be stopped. Thus you see a paradox of clotting and bleeding in the same clinical picture. The consumption of coagulation factors and platelets leads to prolonged PT and PTT as well as a low platelet count. Bleeding time is determined mainly by platelet count--the fewer platelets, the longer it takes for the platelet plug to be formed, the longer the bleeding time