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A 62 year old man is initially seen in the Emergency Room complaining of difficu

ID: 242117 • Letter: A

Question

A 62 year old man is initially seen in the Emergency Room complaining of difficulty with speech and swallowing due to and enlarged tongue. Physical examination also reveals a large, sublingual hematoma. In addition, multiple ecchymoses of his skin are noted. He has no history of trauma nor has there been any pervious episodes of bleeding. Coagulation studies show:

Platelet Count:                       180,000/cumm

PT:                                          12 sec

APPT:                                      72 sec

TCT or thrombin time:          10 sec

Fibrinogen:                225%

Additional laboratory studies reveal:

Normal plasma:                     20%                50%                80%

Patient plasma                       80%                50%                20%

Repeat APPT:                         72 sec             70 sec             68 sec

1. What do the results of the mixing study indicate?

2. What is the most probable cause of this result?

Explanation / Answer

1.mixing study indicates the prolonged APTT Level.normal is 30 to 50 seconds.it is mainly due to heparin therapy or oral anticoagulant use.

2.it is due to factor VIII deficiency