Factor disorder

Question 1

Fibrinogen level normal in dysfibrinogenemia, why is that possible?(1)

Answer 1

It can be the case of Fibrinogen being determined using IMA, as dysfibrinogenemia is a quality rather than quantity problem.

Question 2

Name a condition that causes vitamin K deficiency (1)

Answer 2

Cholestasis, bile salt is required for absorption of fat-soluble vitamin (like vitamin K)

Question 3

Give 4 common conditions that causes prolonged PT & APTT (4)

Answer 3

DIC, Liver disease, vitamin K deficiency, LA, Factor deficiency, Factor inhibitor, heparin, warfarin

Question 4

Antibody against heparin-PF4, what can you think of? (1)

Answer 4

HIT

Question 5

What are the reference ranges of PT, APTT, TT? (2)

Answer 5

PT: 10~15 (INR 2~3/3.5)
TT: 15~20
APTT: 20~30 (APTT 2.5X/3X UL)

Question 6

How to do factor activity assay for a specific factor? (4)

Answer 6

8 cal point by reference plasma (99~100%) dilutions mix with factor -deficient plasma.
3 sample point by patient plasma (?%) dilutions mix with factor-deficient plasma.
Check for Non-parallelism caused by LA, anticoagulants & severe deficiency
RI: 50~200% (for result >150%, dilute using factor diluent)

Question 7

What factors exist in Prothrombin complex concentrate? (4) When would you prescribe this instead of plasma? (1)

Answer 7

PCC contains factor 2,7,9,10.
It is better than FFP for warfarin reversal, with no grouping concern.

Question 8

Name 2 conditions in which Warfarin will be prescribed (2)

Answer 8

atrial fibrillation & DVT

Question 9

When you see red joint fluid, what coagulation disorder would you consider? (1)

Answer 9

hemophilia A

Question 10

Which type of vWD is most common? (1)

Answer 10

type 1