Investigations

Question 1

What does a Bethesda assay investigate?

Answer 1

Measures inhibitors in hemophilia

Question 2

What does PFA-100 measure?

Answer 2

Measures platelet function

Question 3

What will a reptilase time correct for?

Answer 3

Heparin

Question 4

Osmotic fragility test will measure what?

Answer 4

Resistance to hemolysis by osmotic stress

Question 5

What is the difference between PT and INR?

Answer 5

PT varies between reagents used

INR is standardised for comparison between laboratories

Question 6

What does a prolonged APTT indicate? (3 things)

Answer 6

Specific factor deficiencies (12, 11, 9, 8)
Monitor patients on heparin
Diagnose lupus anticoagulant

Question 7

If a patient has a prolonged APTT which corrects with mixing tests what do they have?

Answer 7

Factor deficiency

Question 8

Prolonged APTT which doesn’t correct with mixing indicates?

Answer 8

Inhibitor present: heparin or lupus anticoagulant

Question 9

INR prolongation is caused by what?

Answer 9

Vitamin K deficiency (warfarin or deficiency)

Factor 7 deficiency

Question 10

If both INR and APTT are prolonged what are the causative possibilities?

Answer 10

Specific factor deficiency: F5, F10, F2

Multiple factor deficiency (Vit K, liver disease, dilutional coagulopathy, DIC)

Question 11

What investigation do you need to interpret INR & APTT?

Answer 11

fibrinogen

Question 12

What do you need to make fibrin?

Answer 12

fibrinogen

Question 13

What must you ALWAYS check when investigating coagulopathy?

Answer 13

fibrinogen

Question 14

Which coagulopathies can you have with a normal INR, normal APTT and normal fibrinogen and normal platelet count?

Answer 14

F13 deficiency
von Willebrand’s disease
Platelet function defects

Question 15

How do you diagnose F13 deficiency?

Answer 15

Specific F13 assay

Question 16

What does factor 13 do?

Answer 16

cross-links fibrin

Question 17

What will a D-dimer show?

Answer 17

That the patient has formed cross-linked fibrin & broken in down again
(Tell you if a patient has DIC)

Question 18

What is hematocrit?

Answer 18

Percentage of blood that is cells (normal 40-50%)

Question 19

What is bleeding time used to assess?

Answer 19

Platelet function

Question 20

Name 5 conditions associated with an elevated alpha-fetoprotein.

Answer 20

Ataxia telangiectasia
Hepatitis
Hepatocellular carcinoma/hepatoblastoma
Germ cell tumours
Beckwith-Weidemann syndrome