Chapter 14 Answers to case study questions

14.1 Screening tests in a patient with a factor deficiency

The isolated elevated APTT that corrects on mixing indicates an intrinsic pathway defect. The lack of bleeding from minor trauma with a normal platelet count makes a primary haemostatic disorder unlikely. The severity of the bleed together with the results above and the patient’s gender suggest a haemophilia and further investigation would begin with assays for FVIII and FIX.

14.2 Grossly abnormal screening tests

The first set of follow-up results suggest heparin contamination. The second set indicate severe DIC and would be accompanied by elevated levels of fibrin degradation products.

Back to top