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10/28/2021
PROTHROMBIN
TIME
G.KALAIVANI
1
PROTHROMBIN TIME
• THIS TEST IS OFTEN KNOWN AS THE “QUICK”
TIME AFTER Dr. A. QUICK ,WHO DESCRIBED IT
10/28/2021
PROTHROMBIN
TIME
G.KALAIVANI
2
DEFINITION
TIME REQUIRED FOR CLOTTING OF CITRATE OR OXALATE
PLASMA IN A GLASS TUBE AFTER THE ADDITION OF CALCIUM
AND TISSUE THROMBOPLASTIN
10/28/2021
PROTHROMBIN
TIME
G.KALAIVANI
3
MATERIALS REQUIREDD
• WATER BATH
• STOP WATCH
• TEST TUBES
• BRAIN THROMBOPLASTIN (COMMERCIAL NAME
THROMBOKINASES TABLETS )
• 0.156g/dl CALCIUM CHLORIDE
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TIME
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PRINCIPLE
• THROMBIN KINASE (THROMBOPLASTIN PREPARATION OF
HUMAN /RABBIT BRAIN )CONTAINING CALCIUM IONS IS
ADDED TO CITRATED PLASMA
• COAGULATION MECHANISM IS TRIGGERED AND THE
CLOTTING TIME IS RECORDED AFTER THE ADDITION OF
THROMBOKINASE IN ADDITION TO CALCIUM IONS
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TIME
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5
PROCEDURE
• KEEP 2ml OF CALCIUM CHLORIDE AT 37 c IN A TEST TUBE
• PIPETTE 0.1 ml OF PLASMA IN A SMALL TEST TUBE
• ADD 0.1ml OF BRAIN THROMBOPLASTIN AND MIX
• WAIT FOR 2 MINUTES
• ADD 0.1ml OF PRE-WARMED CALCIUM CHLORIDE,MIX AND
START THE STOP WATCH
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TIME
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6
PROCEDURE
• HOLD THE TUBE IN FRONT OF SOURCE OF LIGHT
• KEEP TITLING THE TUBE GENTLY
• AT THE APPEARANCE OF FIBRIN CLOT,STOP THE WATCH
IMMEDIATELY
• RECORD THE TIME
• THE TEST MUST BE PERFORMED IN DUPLICATE S WITH THE TEST
AND CONTROL PLASMA AND AVERAGE VALUES OBTAINED
• REPEAT PROTHROMBIN TIME IN SECONDS
10/28/2021
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TIME
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CLINICAL CONDITIONS &
NORMAL VALUE
• PT IS DONE IN HAEMORRHAGIC CONDITIONS
• NORMAL VALUE – 14 +/- 2 seconds
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TIME
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PROLONGED PT
• LIVER DISEASE,DUE TO DIMINISHED SYNTHESIS OF CLOTTING
FACTORS
• MASSIVE BLOOD TRANSFUSION DUE TO DILUTION OF PLASMA
CLOTTING FACTORS
FIBRINOGEN ABNORMALITY (Eg. HYPOFIBRINOGENEMIA)
10/28/2021
PROTHROMBIN
TIME
G.KALAIVANI
9
CAUSES OF DECREASED PT
• VITAMIN K SUPPLEMENTATION
• FRESH FROZEN PLASMA TRANSFUSION
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PROTHROMBIN
TIME
G.KALAIVANI
10
10/28/2021
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TIME
G.KALAIVANI
11
activated PARTIAL
THROMBOPLATIN TIME
THE TIME REQUIRED FOR CLOTTING OF CITRATE PLASMA IN A
GLASS TUBE AFTER THE ADDITION OF CEPHALIN ,PLASMA AND
CALCIUM
10/28/2021
PROTHROMBIN
TIME
G.KALAIVANI
12
MATERIALS REQUIREMENTS
• WATERBATH
• STOPWATCH
• CHLOROFORM EXTRACT OF BRAIN (PHOSPHOLIPIDS)
• CALCIUM CHLORIDE - 0.025M
• TEST TUBE
• CONTROL PLASMA
10/28/2021
PROTHROMBIN
TIME
G.KALAIVANI
13
PRINCIPLE
• THE PLATELET SUBSTITUTE (CEPHALIN) IN THE FORM OF
PARTIAL THROMBOPLASTIN (PREPARED FROM RABBIT BRAIN
AS CHLOROFORM EXTRACT)
• WHEN MIXED WITH TEST PLASMA AND CALCIUM IONS,CLOT
FORMATION TAKE PLACE
10/28/2021
PROTHROMBIN
TIME
G.KALAIVANI
14
PROCEDURE
PIPETTE 0.2ml OF BRAIN EXTRACT IN A SMALL TEST TUBE
ADD 0.2ml OF PLASMA
ADD 0.2 ml OF PRE- WARMED (AT 37 c) CALCIUM CHLORIDE START
STOP WATCH
IN THE TUBE TILL THE FIBRIN CLOT APPEARS
NOTE THE TIME
REPORT THE TIME
REPORT THE PROCEDURE FOR CONTROL SERUM
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TIME
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• THE VOLUME OF THE CONTROL SHOULD BE WITHIN THE
NORMAL RANGE,OTHERWISE CHECK THE REAGENTS
• THIS TEST SHOULD BE PERFORMED IMMEDIATELY AFTER THE
BLOOD COLLECTION BY A DISPOSABLE PLASTIC SYRINGE
PREFERABLY IN PLASTIC TUBE
• NORMAL RANGE: 60 TO 80 SECONDS
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TIME
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ABNORMAL PTT
• INDICATES STAGE 1,COAGULATION DEFECTS THAT IS
DEFICIENCY OF ONE OR MORE FACTORS –XI,XII,IX,V,II
• 1.PRESENCE OF INHIBITORS OF COAGULATION SUCH AS
FACTOR INHIBITORS FOUND IN SLE – SYSTEMIC LUPUS
ERYTHEMA (AN INFLAMMATORY DISEASE CAUSED WHEN THE
IMMUNE SYSTEM ATTACKS ITS OWN TISSUES)
• DIC - DISEMMINATED INTRAVASCULAR COAGULATION(BLOOD
CLOTS AND BLEEDING,POSSIBLY FROM MANY SITES IN THE
BODY)
10/28/2021
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TIME
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17
PREVIOUS YEAR QUESTIONS
• APTT (3MARKS) SEPTEMBER 2014
• NAME VARIOUS ANTICOAGULANTS USED IN BLOOD BANK
AND DISCUSS VARIOUS ROUTINE HEMATOLOGICAL
INVESTIGATIONS DONE IN BLEEDING DISORDERS AUG/SEP
2009
• PT (5 MARKS) QUESTION BANK /MARCH 2013
10/28/2021
PROTHROMBIN
TIME
G.KALAIVANI
18
10/28/2021
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TIME
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