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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.